Breast Cancer Society Clinical Practice Research Articles

The Japanese Breast Cancer Society clinical practice guidelines for pathological diagnosis of breast cancer, 2015 edition.

The Japanese Breast Cancer Society clinical practice guidelines for pathological diagnosis of breast cancer, 2015 edition.

The Japanese Breast Cancer Society Clinical Practice Guideline for systemic treatment of breast cancer, 2015 edition.

The Japanese Breast Cancer Society Clinical Practice Guideline for systemic treatment of breast cancer, 2015 edition.

The Japanese Breast Cancer Society Clinical Practice Guideline for radiation treatment of breast cancer, 2015 edition.

The Japanese Breast Cancer Society Clinical Practice Guideline for radiation treatment of breast cancer, 2015 edition.

The Japanese Breast Cancer Society clinical practice guidelines for epidemiology and prevention of breast cancer, 2015 edition.

The Japanese Breast Cancer Society clinical practice guidelines for epidemiology and prevention of breast cancer, 2015 edition.

The Japanese Breast Cancer Society Clinical Practice Guideline for systemic treatment of breast cancer

1. For operable, postmenopausal, hormone receptorpositive, HER2-negative breast cancer, preoperative endocrine therapy may be considered for the purpose of breast conservation (Grade C1). 2. Preoperative endocrine therapy improves the breast conservation rate in premenopausal breast cancer as well as postmenopausal breast cancer. However, it is not generally recommended since evidence is scarce (Grade C2).

Japan Breast Cancer Society clinical practice guideline for surgical treatment of breast cancer.

From 1972 to 1989, 6 randomized controlled trials (RCT) of breast-conserving surgery followed by radiotherapy and radical mastectomy were performed. The two groups did not significantly differ in long-term survival rate after 20 years [1, 2]. Breast-conserving therapy is now a standard of care for Stage I and II breast cancer. As for ductal carcinoma in situ (DCIS), no RCTs compared breast-conserving therapy with mastectomy, but many published case series, reviews and meta-analyses showed good local control rates and high overall survival (OS) results [3]. Most Stage 0–II breast cancers are candidates for breastconserving therapy, but as the EBCTCG’s meta-analysis showed that local recurrence adversely affected survival rates [4], caution is warranted regarding indication or contraindication for breast-conservation therapy and extent of resection.

The Japanese Breast Cancer Society Clinical Practice Guideline for screening and imaging diagnosis of breast cancer.

The Japanese Breast Cancer Society Clinical Practice Guideline for screening and imaging diagnosis of breast cancer.

The Japanese Breast Cancer Society clinical practice guideline for epidemiology and prevention of breast cancer.

The Japanese Breast Cancer Society clinical practice guideline for epidemiology and prevention of breast cancer.

The Japanese Breast Cancer Society clinical practice guideline for radiotherapy of breast cancer.

Radiotherapy should be recommended (Grade A). Although breast-conserving surgery without radiotherapy is performed for some of patients with early-stage breast cancer in Japan, it was found that the rate of local recurrence in the conserved breast was significantly decreased in seven randomized controlled trials (RCTs) from different parts of the world [1–7], a meta-analysis of these clinical trials analyzed by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) [8] with the conclusion that postoperative radiotherapy is essential. The recent meta-analysis of these RCTs confirmed that postoperative radiotherapy significantly improved patient survival rates [8, 9].

The Japanese Breast Cancer Society Clinical Practice Guideline for pathological diagnosis of breast cancer.

FNAC and CNB are recommended as diagnostic procedures for breast lesions (Grade B). For palpable breast lesions, FNAC has been in use as one of the most reliable diagnostic modalities for many decades. This technique is valuable because of its simplicity, cost-effectiveness, minimal invasiveness and low rate of complications. However, due to limitations of the diagnosis of breast lesions by FNAC, for instance, the difficulty of classifying a breast cancer into noninvasive or invasive carcinoma, its high rates of inadequacy and questionable accuracy, the role of FNAC has been debated recently [1]. In a previous review, the sensitivity of FNAC was reported to range from 65 to 98 % and its specificity from 34 to 100 % [2]. In Japan, a large-scale survey regarding the accuracy of FNAC by the Working Group of the Japanese Society of Clinical Cytology was conducted [3]. The survey showed that the cytological diagnosis had an inadequacy rate of 17.7 %, an indeterminate rate of This article is an English digested edition of the Nyugan Shinryo guideline 2013 nen ban, published by Kanehara & Co., LTD.