[breadcrumbs] best practice

Hi all
what is the current thinking on breadcrumbs.

I have a situation where a client want to display the page name in the
breadcrumb, then repeat the page name immediately afterwards as a heading,
which I know can be a nuisance for text-to-speech users.

Are their any firm rules on breadcrumbs, or strong views for that matter :)

Kindest regards
Harry