The Japanese Breast Cancer Society clinical practice guidelines for surgical treatment of breast cancer, 2018 edition
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We have prepared the Japanese Breast Cancer Society clinical practice guidelines (CPGs) for surgical treatment of breast cancer, 2018 update after a systematic review (SR) of the literature based upon the Medical Information Network Distribution Service (Minds) procedure. The CPG committee for surgical treatment of breast cancer, composed of breast surgeons and plastic surgeons treating breast cancer, has developed the CPGs. Eight clinical questions (CQs) were selected and divided roughly into the following five categories: (1) breast surgery in initial therapy (CQs 1–3); (2) axillary surgery in initial therapy (CQs 4–5); (3) breast reconstruction in initial therapy (CQ 6); (4) surgical treatment for recurrent and metastatic breast cancer (CQs 7–8); and (5) others. Recommendations for these CQs were decided by the GRADE grid method. In addition, 4 outlines, 14 background questions (BQs), and 12 future research questions (FQs) were also selected. Statements for these BQs and FQs are provided. We developed the updated CPGs for surgical treatment of breast cancer, 2018, which include 8 CQs and recommendations. As a decision-making tool for the understanding and treatment of breast cancer, these guidelines will help surgical oncologists dealing with breast cancer, medical staff, and patients, along with their family members.
KeywordsClinical practice guideline Clinical question Surgical treatment of breast cancer
The authors are grateful to Ms. Yayoi Adachi, Ms. Yumi Kashikura, Mr. Hiroaki Shima, Mr. Takahiro Tsukioki, and Ms. Kazuyo Yoshida for their essential help with the systematic review. The authors would also like to thank Fujimi Kawai of the Japanese Medical Library Society and Prof. Masahiro Yoshida of International University of Health and Welfare for their generous advice. They also thanks Kanehara Publishing Co., Ltd. Hitomi Sasaki and Kazuyo Uno.
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Conflict of interest
M Inokuchi, G. Kutomi, Y. Kijima, T. Sakai, M. Sawaki, T. Shien, N. Hanamura, K. Yano, and N. Wada have no conflicts of interest. S. Saji reports grants and personal fees (honoraria for lectures) from Eisai, grants and personal fees from Chugai, grants and personal fees from Astra Zeneca, grants and personal fees from Takeda, grants and personal fees from Novartis, grants and personal fees from Taiho, personal fees from Kyowahakko Kirin, personal fees from Pfizer, personal fees from Daiichi Sankyo, grants and personal fees from Nihon Kayaku, grants from Ono, outside the submitted work;. S. Saji is executive board member of Japan Breast cancer Research Group (JBCRG) and Japanese Breast Cancer Society (JBCS). H. Iwata reports grants and personal fees from Chugai, personal fees from AstraZeneca, personal fees from Daiichi Sankyo, grants and personal fees from Novartis, grants from MSD, grants and personal fees from Lilly, personal fees from Kyowa Hakko Kirin, personal fees from Pfizer, during the conduct of the study; However, H. Iwata confirm total fee from each company is not over the limited fee determined by JBCS. H. Iwata is executive board member of JBCS.
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