The treatment of breast cancer is constantly evolving, making it hard for oncologists to be up-to-date with all aspects of the disease. Guidelines summarizing the current treatment standard for different clinical scenarios may be used to overcome these challenges. There are several guidelines that can be used in clinical practice: The NCCN guidelines, most widely known around the world, are very up-to-date and cover all treatment options for a wide range of scenarios using decision trees. The German S3-guidelines are text-based and include levels of evidence and grades of recommendation. Those of the German ‘Arbeitsgemeinschaft für Gynäkologische Onkologie‘ (AGO) in addition provide short summaries of recent publications to support the recommendations. The St. Gallen recommendations for early breast cancer are consensus-based and very interdisciplinary. And finally, the ESMO guidelines for advanced breast cancer most recently include the ESMO Scale for a Actionability of Molecular Targets (ESMO-ESCAT), which helps in deciding which molecular test to use with respect to treatment decisions.
Most guidelines are very up-to-date and may be a helpful in clinical decision-making. However, one should never forget that the complexity of clinical scenarios goes beyond the factors that can be mapped in guidelines. This also includes, for example, age, comorbidities and, last but not least, our patients’ preferences.