Elsevier

European Journal of Cancer

Volume 49, Issue 17, November 2013, Pages 3579-3587
European Journal of Cancer

The requirements of a specialist Breast Centre

https://doi.org/10.1016/j.ejca.2013.07.017Get rights and content

Abstract

Introduction

In recognition of the advances and evidence based changes in clinical practice that have occurred in recent years and taking into account the knowledge and experience accumulated through the voluntary breast unit certification programme, Eusoma has produced this up-dated and revised guidelines on the requirements of a Specialist Breast Centre (BC).

Methods

The content of these guidelines is based on evidence from the recent relevant peer reviewed literature and the consensus of a multidisciplinary team of European experts. The guidelines define the requirements for each breast service and for the specialists who work in specialist Breast Centres.

Results

The guidelines identify the minimum requirements needed to set up a BC, these being an integrated Breast Centre, dealing with a sufficient number of cases to allow effective working and continuing expertise, dedicated specialists working with a multidisciplinary approach, providing all services throughout the patients pathway and data collection and audit. It is essential that the BC also guarantees the continuity of care for patients with advanced (metastatic) disease offering treatments according to multidisciplinary competencies and a high quality palliative care service. The BC must ensure that comprehensive support and expertise may be needed, not only through the core BC team, but also ensure that all other medical and paramedical expertise that may be necessary depending on the individual case are freely available, referring the patient to the specific care provider depending on the problem.

Conclusions

Applying minimum requirements and quality indicators is essential to improve organisation, performance and outcome in breast care. Efficacy and compliance have to be constantly monitored to evaluate the quality of patient care and to allow appropriate corrective actions leading to improvements in patient care.

Introduction

In 2000 Eusoma, the European Society of Breast Cancer Specialists, published a position paper ‘The Requirements of a Specialist Breast Unit’ [1]. This document represented the starting point towards accomplishing of what was demanded by the consensus statement [2] of the first European Breast Cancer Conference (EBCC1) that all women have access to fully equipped multidisciplinary and multiprofessional breast clinics based on populations of around 250,000 and that quality assurance programmes for breast services should become mandatory.

This paper has now been widely accepted and recognised as a benchmark for the set-up of a Breast Centre.

The European Parliament in its 2003 and 2006 Resolutions on Breast Cancer refer to this Eusoma paper in its recommendations that breast disease is diagnosed and treated in dedicated Breast Centres [3], [4].

Eusoma has decided to up-date and revise its paper, taking into account advances in diagnosis and treatment and evidence based changes in practice that have occurred in recent years with respect to the organisation of a Breast Centre and the experience collected through the voluntary certification process.

The objectives of this paper is to define the organisational model for a Breast Centre, the minimum standards for the resources, expertise and data audit required of specialist Breast Centres to ensure that they provide high quality care to all women with breast cancer.

The main concept continues to be the multidisciplinary approach [5] to breast cancer care provided by health care professionals that are specialists in and dedicated to breast diagnosis, treatment and long-term care.

Section snippets

Definitions

Breast Centre: Is the place where breast cancer is diagnosed and treated. It has to provide all the services necessary, from genetics and prevention, through the treatment of the primary tumour, to care of advanced disease, palliation and survivorship.

The Breast Centre is made up by a cohesive group of dedicated breast cancer specialists working together as a multidisciplinary team with access to all the facilities required to deliver high quality care throughout the breast cancer pathway. This

Breast Centre

There must be an official formal document (that complies with any national regulations) that demonstrates the set-up of the Breast Centre.

The Breast Centre is encouraged to make a cost evaluation of its activity on a yearly basis.

Critical mass

A Breast Centre must be of sufficient size to have at least 150 [6], [7], [8] newly diagnosed cases of primary breast cancer (at all ages and stages together) coming under its care each year, on a population base of about 250.000 [2], [9].

The reason for recommending a

Core team

All core team members should comply with the recommendations and standards defined in the Eusoma guidelines for specialised Health Professionals [15].

Clinics

Dedicated clinics run by Breast Centre core team members guarantee patients continuity of care. All consultations for breast disease must be done in dedicated clinics, i.e. new patient clinics, advanced patient clinics and follow up clinics must be separate, i.e. to each of them a specific slot of time and location must be assigned.

It is desirable that the Breast Centre is able to offer advice with regard to dietary, nutrition and complementary medicine.

Clinical genetics clinic

The Breast Centre must have a dedicated

Conflict of interest statement

None declared.

References (18)

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