Introduction
Table of Contents and associated protocol files (.pdfs)
Protocols - pages 1-34 (.pdf 402 KB)
Development Committee
Acknowledgements
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The first distribution of these protocols
was generously sponsored by Astra Zeneca Oncology
In order to translate the breast cancer treatment guidelines (approved by the National Health and Medical Research Council—NHMRC) into changed practice the Westmead BCI has developed and published agreed Protocols, which will serve as a model for other breast centres being established in major teaching hospitals.
The Protocols are intended for use by specialists and trainees, and will be available on request to general practitioners. The Protocols are designed to provide information to assist decision-making and are based on the best information available at the time of publication.
The first edition of the Westmead Breast Cancer Institute (BCI) Clinical Treatment Protocols was developed as follows:
The protocols will be evaluated and revised as required six months after first publication.
Audience: These protocols are intended for use by specialists and trainees, and will be available on request to general practitioners. The protocols have been informed by breast cancer treatment guidelines approved by the National Health Medical Research Council (NHMRC).
Disclaimer: The Westmead BCI clinical treatment protocols are designed to guide appropriate practice, to be followed only subject to the clinician’s judgement in each individual case.
The protocols are designed to provide information to assist decision-making and are based on the best information available at the time of publication.
It is important to realise that protocols cannot always account for individual variation among patients. They are not intended to supplant physicians’ judgement with respect to particular patients or special clinical situations and cannot be considered inclusive of all proper methods of care or exclusive of other treatments reasonably directed at obtaining the same results.
PDF files are attached the first 34 pages of the protocols listed below. To receive a full set of Breast Cancer Treatment Protocols, see the order form.
| Breaking bad news |
| Communication |
| Provision of information—general |
| Provision of information—specific |
| Familial aspects of breast cancer |
| International Breast Cancer Intervention Study (IBIS) Trial |
| BreastScreen Westmead |
| Criteria for diagnosis of breast cancer |
| Breast imaging reporting |
| Fine needle aspiration—cytology report |
Localisation biopsy
|
| Pre-treatment investigations |
| TNM classification |
Ductal carcinoma in situ
|
| Paget’s disease of the nipple |
| Lobular carcinoma in situ |
Early operable breast cancer
|
Breast conservation—outcomes
|
Total mastectomy
|
| Post-mastectomy radiation therapy—indications |
| Prophylactic mastectomy |
Adjuvant systemic therapy
|
| Adjuvant therapy—surgical oophorectomy |
| Locally advanced breast cancer |
Recurrent/metastatic breast cancer
|
| Male breast cancer |
| Phyllodes tumour |
| Follow-up |
| Appendices |
Appendix 1
|
Appendix 2
|
Appendix 3
|
Appendix 4
|
Appendix 5
|
| Bibliograp |
©2001 Westmead Breast Cancer Institute
These protocols are copyright. Apart from copying permitted under the Copyright Act, neither this document nor any part of it may be reproduced in any form by any means.
Mr Tom Bonar, Surgeon (Chairman)
Dr Geoff Delaney, Radiation Oncologist
Dr Eugene Moylan, Medical Oncologist
Mr Pat Cregan, Surgeon
Dr Verity Ahern, Radiation Oncologist
Dr Nicholas Wilcken, Medical Oncologist
Mr Owen Ung, Surgeon
A/Prof. John Boyages, Radiation Oncologist
A/Prof. Paul Harnett, Medical Oncologist
Dr Stephen Cahill, Radiology
A/Prof. Michael Bilous, Pathology
Dr Judy Kirk, Genetics
A/Prof. John Boyages, Executive Director, Westmead Breast Cancer Institute
Dr Boon Chua, Radiation Oncology Breast Fellow, Westmead Breast Cancer Institute
Ms Eleonore Fuchter, Clinical Program Manager, Westmead Breast Cancer Institute
Dr Greg Heard, Principal Consultant, Nullegai Communications
Cathie Lyons and Niranjala Hillyard provided administrative support for the preparation of this document.
An advanced draft of these protocols was distributed for review to cancer specialists across New South Wales. The following clinicians provided written feedback on a pilot ‘implementation version’ of these protocols: