The availability of new therapeutic options is exciting for patients and providers but introduces new challenges, including determining optimal agent, optimal sequence on disease progression, and combinations that minimize toxicity and maximize patient benefit.

As a result of the therapeutic advances and clinical research affecting the management of patients with cancer, clinicians can benefit by comparing their individual skills of diagnosis, treatment, and management of patients with their peers. This peer interaction is an integral part in enhancing clinical decision-making skills that can improve patient care.

These NCCN Guidelines Insights focus on the most recent updates to recommendations for adjuvant systemic therapy in patients with nonmetastatic, early-stage, hormone receptor–positive, HER2-negative breast cancer.

With the large number of breast cancer survivors in the United States, it is critical for clinicians providing survivorship care to be informed about the possible late and long-term effects they may experience. In addition, clinicians need information about healthy lifestyle changes that can decrease the risks of these effects and appropriate screening and management strategies for them. With this information, clinicians can help breast cancer survivors live long and healthy lives after treatment ends.

Diagnosis of central nervous system (CNS) involvement is now more common in patients with breast cancer as therapy for metastatic disease is improving. Because brain metastases are often managed by physicians from multiple disciplines, multidisciplinary consultation prior to treatment is encouraged for optimal planning.

Staying up-to-date with the available treatment options is important to integrate new evidence-based data into their clinical practice and being familiar with their toxicity profile is important to optimize patient outcomes.

Education regarding treatment and supportive care issues is required to bridge the gap in AYA cancer care and improve outcomes in this population.

By staying up-to-date on new approaches and options for neoadjuvant/adjuvant systemic therapy, clinicians should be able to provide appropriate care using a shared decision-making process with the patient, taking into account patient and disease characteristics, including risk of recurrence, and weighing the potential benefits and risks of each option. In addition, it is important for clinicians to be aware of new supportive care interventions available to improve the quality of life of patients.

Considerable progress has been made in understanding which patients will benefit from radiation therapy and ways to administer treatment that maximize clinical benefit while minimizing toxicity. However, many controversies exist as well.  In order to define clinical situations that require appropriate locoregional therapies and use the right approach, clinicians need to stay current on the updates and controversies.

Genetic testing should be considered in individuals for whom there is a personal or family history suggesting susceptibility to hereditary cancer and for whom results can potentially impact risk management and treatment.