Dealing with breast cancer is not a walk in the park: it is tiring and uncertain, but there are places that can make the journey less difficult. We are talking about the Breast Units, the multidisciplinary breast care centers, within which – studies in hand – the treatment of breast cancers is more likely to be successful: mortality 5 years after diagnosis is reduced by 18% compared to that of centers that they treat less than 150 cases a year, not to mention the psychological benefits for patients and a more rational and effective use of resources. They are also well aware of this in the Marche Region, which today sees the birth of a new consensus document to improve the level of assistance for women affected by breast cancer, presented today during the seventh edition of the “Female Tumors” Conference which was held in Ancona (here the link to review the live broadcast on the Facebook channel of Oncologia Marche).
Measure the quality
The model of the Breast Unit, in fact, cannot ignore the creation of a monitoring system and verification of the quality of the activity. Precisely for this reason, objective parameters have been defined, to be used as indicators of treatment efficacy and quality of performance. To draw up the consensus document, a committee of experts from the Marche Breast Units was set up. “The research – explains Rossana Berardi, Professor of Oncology at the Polytechnic University of Marche, Director of the Oncology Clinic, AOU Ospedali Riuniti of Ancona and member of the National Board of AIOM (Italian Association of Medical Oncology) – has produced the collection of 59 indicators, then grouped into sub-categories: diagnosis, waiting times, surgical therapy, radiotherapy, medical therapy, staging, counseling, follow-up, Breast Unit “.
The 10 key indicators
Regional experts have identified a group of 10 key indicators, while the other 49 can be optionally adopted by individual regional Breast Units. “Among the important parameters – continues Berardi – we remember the volume of interventions per structure and year (which must be greater than 150, ed), the proportion of reconstruction or insertion of expander in the same session of the demolition surgery (equal to or higher than 70%, ed.) and the surgical intervention to remove malignant neoplasm within 30 days from the moment in which the intervention was indicated by the specialist (more than 90%, ed.) “. This document is the result of a shared work between professionals from the Marche who, with different multidisciplinary skills in the context of the Region’s Breast Units, have assessed the indicators relating to the Diagnostic Therapeutic and Care Pathway (PDTA) for this pathology. For parameters in which the breast center does not reach the expected standard, the multidisciplinary team will have to agree on corrective actions.
The value of Breast Units
The Breast Unit is a model of assistance specialized in the diagnosis, treatment and psychophysical rehabilitation of women affected by breast cancer, entrusted to a multidisciplinary group of dedicated professionals with specific experience in the breast sector. “Surgery, in fact, represents only a part, albeit an essential one, of the therapeutic process that must be integrated with other professionals in the context of a team formed and dedicated specifically to the pathology”, explains Luigi Cataliotti, President of Senonetwork Italia, an association that brings together breast care centers and which promotes treatment in dedicated centers that comply with European requirements to offer all women equal opportunities for treatment: “The good results obtained with an organization of this kind are to be attributed to the correct integration of the various disciplines each of which brings its contribution of knowledge “.
Path
The main professional figures involved in the work group are the breast surgeon, the plastic surgeon, the anatomopathologist, the radiologist, the nuclear doctor, the radiotherapist, the oncologist, the nurse with case management functions and with speci? C training in communication, the data manager, that is the clinical research coordinator, the clinical psychologist, the? siatra and the geneticist. The role of each practitioner varies according to the stage of disease management. “The taking in charge takes place through a Diagnostic Therapeutic and Assistance Path”, explains Filippo Saltamartini, Councilor for Health of the Marche Region: “The patient no longer has to go personally and separately from the various professional figures, but is treated by highly specialized and operating according to high international standards. In addition, you have the opportunity to participate in multicentre, national and international clinical trials ”.
“The verification of the quality of care is guaranteed regardless of the different organizational choices at the local level, through the creation of a system of common indicators and standards, capable of allowing a comparison between professionals and optimizing the outcomes of the care provided”, reiterates Roberto Papa, Head of Quality, Clinical Risk, Management and Technological Innovation of the University Hospital of Ospedali Riuniti of Ancona: “This virtuous path produces an increase in professional and organizational quality, which translates into an improvement in the quality perceived by patients”. “The effort to organize these quality scientific comparisons is well compensated by the ultimate goal of the ever-increasing benefits for those who have to face these challenging diagnostic-therapeutic paths”, adds and concludes Michele Caporossi, General Manager of the University Hospital of Ospedali Riuniti of Ancona. . “The work of sq The team of professionals behind this project is an added value “.