Report in English with a Dutch summary (KCE reports 63A)

KCE reports 63 Breast Cancer 3
Table of contents
Scientific summary
1 INTRODUCTION............................................................................................. 5
2 METHODOLOGY............................................................................................. 6
2.1 GENERAL APPROACH................................................................................................................6
2.2 CLINICAL QUESTIONS ..............................................................................................................6
2.3 SEARCH FOR EVIDENCE ...........................................................................................................7
2.3.1 Clinical practice guidelines................................................................................................7
2.3.2 Additional evidence............................................................................................................9
2.4 QUALITY APPRAISAL..................................................................................................................9
2.4.1 Clinical practice guidelines................................................................................................9
2.4.2 Additional evidence............................................................................................................9
2.5 DATA EXTRACTION AND SUMMARY ................................................................................9
2.6 FORMULATION OF RECOMMENDATIONS.......................................................................9
2.7 EXTERNAL REVIEW.....................................................................................................................9
3 FINAL RECOMMENDATIONS..................................................................... 11
3.1 GENERAL ALGORITHM .......................................................................................................... 11
3.2 POPULATION SCREENING ................................................................................................... 12
3.3 MANAGEMENT OF HIGH-RISK WOMEN......................................................................... 13
3.3.1 Definition of high-risk ..................................................................................................... 13
3.3.2 Breast cancer susceptibility gene testing.................................................................... 13
3.3.3 Surveillance of women with a high risk for developing breast cancer................ 14
3.3.4 Treatment of women with a high risk for developing breast cancer.................. 14
3.4 DIAGNOSIS OF BREAST CANCER ...................................................................................... 17
3.4.1 Triple assessment ............................................................................................................ 17
3.4.2 Magnetic resonance imaging (MRI).............................................................................. 18
3.4.3 99mTc-MIBI scintimammography (SMM)................................................................... 18
3.5 STAGING OF BREAST CANCER .......................................................................................... 19
3.5.1 Routine staging tests ....................................................................................................... 19
3.5.2 Tumour markers.............................................................................................................. 19