I and level II evidence in these guidelines. Readers should turn to the appropriate sections to understand the context of this evidence.
Appropriate counselling has the potential to improve quality of life.
The survival of patients with breast and other cancers is better if they are treated by a specialist who also treats a large number of similar patients, and who has access to the full range of treatment options in a multidisciplinary setting. There is no difference in the rate of survival or distant metastasis between women having mastectomy and those having breast conserving surgery where appropriate. Not all women with nodal disease on axillary sampling develop clinical lymph node metastases. II 111 Survival rates are not decreased by delaying radiotherapy to the axilla, although local control is less likely. II 112 Radiotherapy after lumpectomy significantly reduces the risk of local recurrence.