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Guidelines for breast cancer have been developed in many countries to assist
clinicians and patients to make decisions about treatment and thus improve health
outcomes. Observed differences in treatment outcome between populations suggest
opportunities for improvement. Moreover, potentially important variations in clinical
practice are well documented in many countries. Treatment practice that is informed
by evidence, such as greater use of breast conserving surgery, has been observed more
frequently among clinicians who regularly treat patients with breast cancer. Furthermore,
congruence of treatment practice with published guidelines has been directly associated
with improved patient survival. Improved treatment practice has the potential to improve
survival by up to 15%. Therefore, enhanced implementation of soundly developed,
evidence-based treatment guidelines is an important goal for health services and
individual clinicians.
In many countries clinicians, scientists and patients involved in breast cancer
diagnosis and treatment have formed cooperative groups to improve breast cancer
treatment guidelines. These guidelines were prepared by the World Health Organization
(WHO) Regional Office for the Eastern Mediterranean and the King Faisal Specialist
Hospital and Research Centre, a WHO collaborating centre for cancer prevention and
care. The guidelines are aimed at oncologists, internists, secondary and tertiary hospitals,
ministries of health and other health decision-makers. The purpose is to provide answers
to the practical questions involved in decision-making about day-to-day management of
breast cancer. The paradigms that underpin them are also outlined, promoting evidencebased
and cost-effective interventions. It is hoped that these guidelines will support the
choices made by both health care providers and patients.
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