Issues relating to the inclusion of high-dose chemotherapy in breast cancer treatment guidelines

The development of guidelines for the use of high-dose chemotherapy in the treatment of breast cancer is a challenging task. The absence of large amounts of data from prospective, randomized, phase III clinical trials, and the variability of patient populations and treatment strategies in phase II studies mean that these guidelines have to be developed in the absence of conclusive clinical data. Nonetheless, the available information suggests strategies for incorporating this therapy into the care of certain patients with breast cancer.