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At its seventh annual meeting, the National Comprehensive Cancer Network (NCCN) announced that it has updated its Breast Cancer Treatment Practice Guidelines for physicians, nurses, and other healthcare professionals. The guidelines are created and updated by experts and the field and serve as "the most authoritative and up-to-date information in cancer care." Changes to the guidelines included new recommendations about the drug Arimidex (generic name, anastrozole) for post-menopausal breast cancer patients and the use of sentinel lymph node biopsy for removing lymph nodes to determine whether breast cancer has spread. The NCCN is a prestigious non-profit organization of 19 top cancer institutions; the NCCN’s breast cancer treatment guidelines are updated each year and have become the treatment standard for oncology professionals across the United States. According to the NCCN, the guidelines are the recognized standard reference for appropriate practice in the field of oncology. Experts decided to revise the Breast Cancer Treatment Guidelines after reviewing newly published studies on emerging therapies and techniques to treat the disease. In particular, the guidelines contain more information on sentinel lymph node biopsy, a procedure that is gaining acceptance in the medical community as an alternative to axillary node dissection. Sentinel lymph node biopsy involves removing only one to three lymph nodes (the first nodes in the lymphatic chain) to check them for cancer. Axillary node dissection, the standard method of removing lymph nodes, requires the removal of approximately 10 to 20 lymph nodes. If sentinel lymph node biopsy finds that the lymph nodes are cancer-free, women may be spared additional surgery to remove the remaining nodes. There is also emerging data that show that sentinel lymph node biopsy may reduce lymphedema (chronic arm swelling), which occurs in 15% to 20% of breast cancer patients who undergo axillary node dissection. The NCCN guidelines also include updated information on the drug Arimidex, based on the ATAC study (Arimidex and Tamoxifen Alone or in Combination). Specifically, the guidelines advise that Arimidex provides a longer disease-free survival time for patients and less toxic side effects than the standard drug treatment, tamoxifen (brand name, Nolvadex), for post-menopausal women with breast cancer. The results are based on treating breast cancer patients for an average of 30.7 months with a follow-up time of 33.3 months. Thus, the guidelines say that Arimidex may be a viable option over tamoxifen and should be discussed with the patient. The NCCN guidelines have been revised twice since the last annual meeting of the NCCN in March 2001. "Since new developments in cancer research are truly happening all the time, we revise our Practice Guidelines continuously," said Rodger Winn, MD, Chairman of the NCCN Guidelines Steering Committee, in an NCCN news release. The NCCN also publishes Breast Cancer Treatment Guidelines for Patients, in collaboration with the American Cancer Society. The patient guidelines provide breast cancer patients and their families with access to reliable, specific, and easy-to-understand about breast cancer treatment options. Patient guidelines are also available (in English and Spanish) for colon and rectal cancer, prostate cancer, cancer pain, nausea and vomiting, and fatigue. The new Breast Cancer Treatment Guidelines for physicians are available online at http://www.nccn.org/ or a CD-ROM may be requested by writing to NCCN, 50 Huntington Pike, Ste 200, Rockledge, PA 10946. Fax requests may be made in the U.S. to 1.215.728.3877. Patient guidelines are available free of charge on the NCCN website at http://www.nccn.org/ Members of the National Comprehensive Cancer Network (NCCN), 2002:
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