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NCCN breast cancer clinical practice guidelines in oncology: an update.

The 2002 NCCN Breast Cancer Clinical Practice Guidelines in Oncology represent the 7th annual update produced by a multidisciplinary panel of breast cancer experts from the NCCN member institutions. The Breast Cancer Panel uses an objective, evidence-based method when high-level evidence from clinical trials exists. In clinical situations in which high-level evidence is lacking, recommendations are generated through a multidisciplinary consensus development process. The NCCN institutions also review the complete guideline on an annual basis. In this update, several of the modifications in the 2002 Breast Cancer Guidelines are highlighted, including the use of aromatase inhibitors and leuteinizing hormone-releasing hormone agonists plus tamoxifen in the first-line therapy of metastatic breast cancer and the use of anastrozole in the adjuvant setting. The new guidelines for axillary lymph node staging are reported on in a companion article in this issue.