[Treatment guidelines for systemic adjuvant therapy of breast cancer]

The rapidly growing body of knowledge provided by an efficient clinical trials process requires periodic revisions of clinical practice guidelines. These guidelines are prepared by experts whose delicate task is to digest the evidence provided by the clinical trials which may indicate a weak or a strong average treatment effect for a patient population and to translate this evidence into implications for individual patient care. Guidelines are thought to enhance the quality of care by reducing under-treatment, over-treatment and wrong treatment. At least one study has shown an adverse impact on overall mortality if treatment guidelines are not followed. Guidelines that have authority in the adjuvant treatment of breast cancer are the NIH and NCCN guidelines, those developed in St. Gallen and those by Japan Breast Cancer Society.