Guideline statement	LoE/GoR	Consensus
Alternative therapies (i.e. therapies used instead of scientifically based medicines) are not recommended in any phase or stage of cancer treatment.	N/A/E	100 %
Breast cancer centers/units/departments should be aware that the majority of their patients would like to be informed about CIM and that many of them are using it. Physicians should actively ask for information about its use in view of the potential deleterious interactions with specific anticancer therapies. If complementary therapies are not available at the center, certified contacts should be available to promote referral to practitioners qualified in the therapies people are interested in receiving.	Expert opinion/C	100 %
Some complementary therapies have the potential to reduce disease symptom burden and/or side effects of anticancer therapies, and therefore improve the QoL of patients with ABC.	Expert opinion/C	100 %
Evidence suggests beneficial effects of the following methods, which can therefore be used: •Physical exercise/sport (equivalent to 3–5 h of moderate walking per week) improves QoL, cardiorespiratory fitness, physical performance and fatigue, and it may also improve PFS and OS. •MBSR programs, hypnosis and yoga may improve QoL and fatigue, and help reduce anxiety, distress and some side effects of anticancer therapies. •Acupuncture may help against ChT-induced nausea and vomiting, fatigue and hot flushes.	I/B	100 %
Methods with no or unfavorable effects The following methods of alternative medicine are not recommended in ABC since available evidence shows no effect at best, or even association with worse outcome: o Antioxidant supplements; o Drugs outside the approved indication (e.g. methadone); o Herbs including Chinese herbal medicine; o Orthomolecular substances (selenium, zinc …); o Oxygen and ozone therapy; o Proteolytic enzymes, thymic peptides; o Phytoestrogens (soy food, isoflavones); o High-dose vitamins (vitamin C, D, E, carotenoids, etc.); o L-carnitine, laetrile.	II/E	100 %