Journal Article
. 2016 Mar;14(3).
doi: 10.6004/jnccn.2016.0037.

Invasive Breast Cancer Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

William J Gradishar  Benjamin O Anderson  Ron Balassanian  Sarah L Blair  Harold J Burstein  Amy Cyr  Anthony D Elias  William B Farrar  Andres Forero  Sharon Hermes Giordano  Matthew Goetz  Lori J Goldstein  Clifford A Hudis  Steven J Isakoff  P Kelly Marcom  Ingrid A Mayer  Beryl McCormick  Meena Moran  Sameer A Patel  Lori J Pierce  Elizabeth C Reed  Kilian E Salerno  Lee S Schwartzberg  Karen Lisa Smith  Mary Lou Smith  Hatem Soliman  George Somlo  Melinda Telli  John H Ward  Dorothy A Shead  Rashmi Kumar  
  • PMID: 26957618
  •     124 citations


Breast cancer is the most common malignancy in women in the United States and is second only to lung cancer as a cause of cancer death. The overall management of breast cancer includes the treatment of local disease with surgery, radiation therapy, or both, and the treatment of systemic disease with cytotoxic chemotherapy, endocrine therapy, biologic therapy, or combinations of these. This article outlines the NCCN Guidelines specific to breast cancer that is locoregional (restricted to one region of the body), and discusses the management of clinical stage I, II, and IIIA (T3N1M0) tumors. For NCCN Guidelines on systemic adjuvant therapy after locoregional management of clinical stage I, II and IIIA (T3N1M0) and for management for other clinical stages of breast cancer, see the complete version of these guidelines at

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Breast Care (Basel), 2020 Sep 29; 15(4). PMID: 32982643    Free PMC article.
Biomarker heterogeneity between primary breast cancer and synchronous axillary lymph node metastases.
Xun Xi, Xing-Wei Huang, +3 authors, Fu-Lan Yang.
Oncol Lett, 2020 Oct 06; 20(5). PMID: 33014152    Free PMC article.
Prospective evaluation of whole-body MRI and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients.
Nils Martin Bruckmann, Lino M Sawicki, +15 authors, Christian Buchbender.
Eur J Nucl Med Mol Imaging, 2020 Apr 26; 47(12). PMID: 32333068    Free PMC article.
Ultrasonographic evaluation of chronic shoulder pain after breast cancer surgery: single center, cross-sectional study.
Jung Hun Kim, Se Hee Kim, +8 authors, Hong Ki Min.
Sci Rep, 2020 Oct 10; 10(1). PMID: 33033299    Free PMC article.
The prognostic value of Ki67 in ovarian high-grade serous carcinoma: an 11-year cohort study of Chinese patients.
Ming Chen, Shuzhong Yao, +3 authors, Mian He.
Oncotarget, 2018 Jan 04; 8(64). PMID: 29296209    Free PMC article.
Role of dynamic contrast-enhanced MRI in evaluating the association between contralateral parenchymal enhancement and survival outcome in ER-positive, HER2-negative, node-negative invasive breast cancer.
Gi Won Shin, Yang Zhang, +5 authors, Vivian Youngjean Park.
J Magn Reson Imaging, 2018 May 08; 48(6). PMID: 29734483    Free PMC article.
Expression of survivin does not appear to influence breast cancer recurrence risk.
Lindsay J Collin, Deirdre P Cronin-Fenton, +9 authors, Timothy L Lash.
Acta Oncol, 2018 Oct 24; 58(2). PMID: 30351173    Free PMC article.
Advances in Breast MRI in the Setting of Ductal Carcinoma In Situ.
Nita Amornsiripanitch, Diana L Lam, Habib Rahbar.
Semin Roentgenol, 2018 Nov 20; 53(4). PMID: 30449344    Free PMC article.
Interdisciplinary Screening, Diagnosis, Therapy and Follow-up of Breast Cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) - Part 2 with Recommendations for the Therapy of Primary, Recurrent and Advanced Breast Cancer.
Achim Wöckel, Jasmin Festl, +94 authors, Stephanie Stangl.
Geburtshilfe Frauenheilkd, 2018 Dec 26; 78(11). PMID: 30581198    Free PMC article.
Systemic treatment and radiotherapy, breast cancer subtypes, and survival after long-term clinical follow-up.
Sherry X Yang, Eric C Polley.
Breast Cancer Res Treat, 2019 Feb 13; 175(2). PMID: 30746635    Free PMC article.
A critical review of the chest CT scans performed to detect asymptomatic synchronous metastasis in new and recurrent breast cancers.
Justin James, Melanie Teo, +3 authors, Michael Cheng.
World J Surg Oncol, 2019 Feb 25; 17(1). PMID: 30797241    Free PMC article.
Screening for distant metastases in patients with ipsilateral breast tumor recurrence: the impact of different imaging modalities on distant recurrence-free interval.
Ingrid G M Poodt, Robert-Jan Schipper, +7 authors, Sentinel Node And Recurrent Breast Cancer (SNARB) Research Group.
Breast Cancer Res Treat, 2019 Apr 08; 175(2). PMID: 30955183    Free PMC article.
Incidental dose distribution to locoregional lymph nodes of breast cancer patients undergoing adjuvant radiotherapy with tomotherapy - is it time to adjust current contouring guidelines to the radiation technique?
Michael Mayinger, Kai Joachim Borm, +6 authors, Daniel Habermehl.
Radiat Oncol, 2019 Aug 03; 14(1). PMID: 31370876    Free PMC article.
Genome-wide DNA methylation analysis of breast cancer MCF-7 / Taxol cells with MeDIP-Seq.
Ying Shi, Weihua Gong, +2 authors, Xin Zhao.
PLoS One, 2020 Dec 12; 15(12). PMID: 33306680    Free PMC article.
Gaps in Online Breast Cancer Treatment Information for Older Women.
Alison S Baskin, Ton Wang, +3 authors, Lesly A Dossett.
Ann Surg Oncol, 2020 Aug 01; 28(2). PMID: 32734367    Free PMC article.
Addition of carboplatin-gemcitabine as second-line neoadjuvant chemotherapy in non-responsive locally advanced breast cancer patients to standard neoadjuvant chemotherapy and evaluation of factors affecting response: a randomized controlled trial.
Dena Firouzabadi, Amirreza Dehghanian, +2 authors, Abdolrasoul Talei.
BMC Cancer, 2021 Jan 13; 21(1). PMID: 33430808    Free PMC article.
The expression of programmed death-ligand 1 in patients with invasive breast cancer.
Yi Meng, Hongyan Wu, Yongzhong Yao, Rong Li.
Gland Surg, 2021 Jan 16; 9(6). PMID: 33447561    Free PMC article.
The Effects of Low HER2/neu Expression on the Clinicopathological Characteristics of Triple-Negative Breast Cancer Patients.
Mehdi Dehghani, Pedram Keshavarz, +4 authors, Maryam Ghanbari.
Asian Pac J Cancer Prev, 2020 Oct 29; 21(10). PMID: 33112563    Free PMC article.
Normalization of Elevated Tumor Marker CA27-29 After Bilateral Lung Transplantation in a Patient With Breast Cancer and Idiopathic Pulmonary Fibrosis.
Mehmet Sitki Copur, Julie Marie Wurdeman, +3 authors, David Crockett.
Oncol Res, 2017 Dec 13; 26(3). PMID: 29229020    Free PMC article.
Globally Rare BRCA2 Variants With Founder Haplotypes in the South African Population: Implications for Point-of-Care Testing Based on a Single-Institution BRCA1/2 Next-Generation Sequencing Study.
Jaco Oosthuizen, Maritha J Kotze, +3 authors, Nerina C van der Merwe.
Front Oncol, 2021 Mar 02; 10. PMID: 33643918    Free PMC article.
Early Discontinuation of Endocrine Therapy and Recurrence of Breast Cancer among Premenopausal Women.
Lindsay J Collin, Deirdre P Cronin-Fenton, +10 authors, Timothy L Lash.
Clin Cancer Res, 2020 Dec 19; 27(5). PMID: 33334905    Free PMC article.
Contralateral prophylactic mastectomy: A narrative review of the evidence and acceptability.
Josien C C Scheepens, Laura van 't Veer, +2 authors, Rita A Mukhtar.
Breast, 2021 Feb 24; 56. PMID: 33621798    Free PMC article.
The role of gonadotropin-releasing hormone agonists in female fertility preservation.
Jae Hoon Lee, Young Sik Choi.
Clin Exp Reprod Med, 2021 Mar 02; 48(1). PMID: 33648041    Free PMC article.
Inhibition of NUPR1-Karyopherin β1 Binding Increases Anticancer Drug Sensitivity.
Chanhee Park, Jiwon Oh, +4 authors, Kyungsoo Oh.
Int J Mol Sci, 2021 Apr 04; 22(6). PMID: 33801927    Free PMC article.
Trends in Contralateral Prophylactic Mastectomy Utilization for Small Unilateral Breast Cancer.
Alison S Baskin, Ton Wang, +3 authors, Lesly A Dossett.
J Surg Res, 2021 Feb 07; 262. PMID: 33548676    Free PMC article.