Early Diagnosis and Treatment
The European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis
The European Commission has published guidelines to establish recommendations for high-quality mammography screening, diagnosis and the setting up of specialist breast units in order to achieve the best medical practice and care possible. The guidelines were created with input from top European cancer organisations. They are EUROPA DONNA’s reference document for benchmarking and best practice and are a fundamental tool for advocates in the Coalition’s member countries, including all EU Member States.
Women, advocates, politicians and policy makers need to know what high-quality mammography screening and breast care services to expect, demand and implement. EUROPA DONNA has created the Short Guide to the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis to assist in the achievement of this standard. It highlights the key points of each chapter in the guidelines following the structure of the guidelines document. Readers are encouraged to refer to the full guidelines for their complete recommendation.
The 2010 Written Declaration on the Fight Against Breast Cancer in the European Union, the 2006 European Parliament Resolution on Breast Cancer in the Enlarged European Union, and the first Resolution of 2003, call for every woman across Europe to have access to equal, high-quality breast cancer care, in compliance with the European guidelines. The aim is to reduce mortality from breast cancer across the EU and to reduce the disparity in survival rates between countries. The European Parliament has judged the most effective means of reducing disparities in care and mortality to be through population-based mammography screening programmes and the setting up of specialist breast units, as well as through training and auditing to assure quality standards.
The European guidelines must be implemented across Europe so that mammography screening programmes, diagnostic procedures, treatment and aftercare for breast cancer are of the highest quality.
Treatment Consensus Recommendations from the Main European Breast Cancer Conferences and Organisations
The St Gallen Oncology Conference is a private charity foundation that has held biennial international conferences on primary therapy of breast cancer since 1978. The conference brings together 40 to 50 international breast cancer experts to produce consensus recommendations on breast cancer treatment. This consensus document tends to have an international impact on the treatment of early breast cancer.
The 2015 meeting held in Vienna welcomed between 3,500 and 4,000 participants from 134 countries. The major theme of the conference was the refinement of the classification, the risk of relapse and the prediction of response to multidisciplinary treatment for early breast cancer. Major issues included: the “semantic” classification of breast cancer subtypes by pathology-based biomarkers (e.g. estrogen receptor, progesterone receptor and HER2) vs. genomic classifiers; the biomarker prognostication dissecting the impact of the various gene signatures and pathologic variables in predicting the outcome of patients with early breast cancer in terms of early and late relapse; the challenges stemming from the intra- and inter-observer variability in the assessment of pathologic variables and the role of gene signatures for the prediction of response to specific therapeutic approach such as endocrine therapy and chemotherapy and for personalizing local treatment of patients with early breast cancer.
For the full consensus document: Tailoring therapies – improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015
For the conference report: Highlights from the 14th St Gallen International Breast Cancer Conference 2015 in Vienna: Dealing with classification, prognostication, and prediction refinement to personalize the treatment of patients with early breast cancer
Major issues that were highlighted in 2013 included: tumour biology to determine responsiveness to various treatments; tumour extent to estimate the level of benefit when justifying treatment for the individual patient; and estimates of the risks of therapy and patient preference to define preferred management. The meeting also discussed a number of controversial areas, including surgery of the primary tumour; surgery of the axilla; radiation (partial breast, post-mastectomy, nodal areas, advanced technologies); pathology; multigene signatures; stroma (extracellular matrix and prognosis); endocrine therapies (ovarian suppression, tamoxifen, aromatase inhibitors); chemotherapies (luminal A, duration, regimen); anti-HER2 therapies (combination, duration; neoadjuvant systemic therapy); bisphosphonates (anti-tumour effects); and follow-up after early breast cancer.
For the full consensus document: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013
For the conference report: Highlights from the 13th St Gallen International Breast Cancer Conference 2013. Access to innovation for patients with breast cancer: how to speed it up?
EUROPA DONNA hosts this biennial conference in partnership with the European Organisation for Research and Treatment of Cancer (EORTC) and the European Society of Breast Cancer Specialists (EUSOMA). EBCC is unique in bringing together patient advocates and major breast cancer institutions in one arena. As the largest breast cancer conference outside the United States, it is also increasingly becoming a venue for the release of new study findings. EBCC-8 provided in-depth coverage and discussion of areas key to treatment such as surgery, radiotherapy and pharmacological treatment. Discussions also sought to improve the understanding of the biology of metastasis, as well as of the management of both younger and older patients. EUROPA DONNA sessions provided the patient’s perspective on many treatment issues.
Webcasts and full materials from past conferences are available online through the European Cancer Organisation. EUROPA DONNA also publishes highlights in its newsletter:
8th European Breast Cancer Conference (EBCC-8), 21-24 March 2012 Vienna, Austria
EUROPA DONNA News Summer/Autumn 2012
Advanced Breast Cancer International Consensus Conference
The biennial Advanced Breast Cancer (ABC) Consensus Conference aims to improve outcomes for women with advanced breast cancer. It develops international consensus guidelines based on results of the conference. EUROPA DONNA is a member of the 40-member consensus panel and the European Society of Oncology Advanced Breast Cancer Task Force, all comprising top-level panellists from the world over. The programme and recommendations cover general guidelines such as multidisciplinary management; assessment guidelines for diagnosis and monitoring; general treatment guidelines depending on breast cancer type; guidelines for bone and brain metastases; supportive and palliative care guidelines; as well as guidelines for metastatic male breast cancer.
Second International Consensus Conference was held 7-9 November 2013 Lisbon, Portugal. Europa Donna served on the Advocacy Committee of this conference organised by ESO. Click here to see the programme.
To access the Second International Consensus Guidelines for Advanced Breast Cancer (ABC2) click here.
Advanced Breast Cancer Third International Consensus Conference (ABC3) will take place in Lisbon, Portugal, on 5-7 November 2015. Europa Donna will serve on the Advocacy Committee of this conference organised by ESO. Click here to see the programme.
European Society of Breast Cancer Specialists (EUSOMA)
EUSOMA is an organisation of breast cancer specialists that holds conferences and workshops and creates guidelines and consensus documents. EUSOMA’s Requirements of a Specialist Breast Unit formed the base of the chapter on specialist breast units published in the 4th edition of the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis. The society has published a number of breast cancer care guidelines, including an update to its Requirements of a Specialist Breast Unit, management of young women with breast cancer, magnetic resonance imaging of the breast, guidelines on endocrine therapy, among others.
The Requirements of a Specialist Breast Unit, 2010 update
The European Society of Breast Cancer Specialists recommendations for the management of young women with breast cancer
Other EUSOMA guidelines