15 April 2008


EBCC6 take home messages

EUROPA DONNA- The European Breast Cancer Coalition’s Final Statement and Take Home messages from EBCC 6, Berlin 15-19 April 2008
Advocates must take care and beware in order to ensure that best practice will be available to the women of Europe.
Women and patients today are faced with difficult decisions concerning all aspects of breast cancer from screening, diagnosis through many complex targeted treatment options. As advocates however, we must be careful that all information and treatment possibilities have been presented and are available to women diagnosed with this disease. To do this we must be aware of the decisions and activities already accepted in a wide range of fields: research, medicine, surgery, oncology, and health economics. Collaboration and teamwork involving all stakeholders is essential in this process as has been shown in the past in the development of EU guidelines for quality assurance in breast cancer screening and diagnosis and specialist breast units. These guidelines involving many stakeholders can serve as a model for the type of collaboration we need to continue in order to make the best decisions on behalf of future patients especially in areas such as drug pricing and health care budgeting. The on-going partnership in EBCC has resulted in improvements and innovations at each conference such as the Wrap up session, etc.
Some Key Points and take home messages are:

  • Patients must have access to all medicines proven effective in treating breast cancer. We must ensure transparency in pricing decisions, and the involvement of advocates in the decision making process concerning health economic decisions regarding access to new medicines. Guidelines to this should be developed and included in the guidelines for specialist breast units.
  • Survivorship issues will become more and more important in the future as the number of women living with breast cancer increases.
  • We must give more consideration to certain segments of breast cancer patients whose needs require special attention: younger women, older women and those with metastatic breast cancer.
  • Education concerning screening programs and lifestyle factors influencing incidence and survival may improve cancer statistics in the future.
  • Early detection – more widespread screening will mean extending meaningful life span: more programmes are being implemented across Europe and some are now moving to digitization.
  • Breast cancer patients should have a right to be treated by a multidisciplinary team in a certified specialist unit. Several initiatives are designed to encourage this such as Senonetwork and the EUSOMA accreditation programme.
  • Rehabilitation programmes- with many more long term survivors this will be increasingly important to ensure return to the workforce and overcoming discrimination.
  • New trials such as Transbig’s MINDACT that is now recruiting, are attempting to identify patients who do not need chemotherapy- this is better for patients and will also result in cost savings for health systems.
  • Independent research is needed to ensure that trials are carried out without bias and address areas that might not interest industry.

From the film shown the first day to the last presentations on MINDACT and clinical trials what has emerged is the need and importance of communication in improving outcomes for this disease – communication between patients and doctors, among all the members of the multi-disciplinary team in a breast unit, and with friends, family and the public.
We have come a long way in breast cancer early detection, screening and treatment and have arrived at a point that presents us with complicated challenges. Many of the presentations emphasized the inequalities that exist between countries and in regions of countries with regard to access to best practice in breast cancer services. By forging new partnerships, by insisting on transparency and clarity, and ensuring that advocates are educated, involved and are part of the decision making process that needs to take place, we will be on the correct path to finding solutions acceptable to society, patients, and citizens. There may be difficulties and obstacles, but only through this open honest dialogue and involvement that we have here at EBCC, will we have the best chance of providing the best care that is possible to all patients in the future.