Ioannis G. Papanikolaou
Professor
Title: Standards for quality of care in breast cancer treatment. European criteria for certification of breast units and breast surgeons.
Biography
Biography: Ioannis G. Papanikolaou
Abstract
As the topic of my Lecture suggests, I will focus on certification criteria of Breast Units and Breast Surgeons across Europe, which are crucial issues for the appropriate therapeutic management of breast cancer. The last GLOBOCAN estimates for breast cancer, classify this carcinoma as the most common in the female. Treatment options have changed and modern breast surgery tends to have a more conservative and cosmesis-preserving face. Breast cancer treatment involves many medical specialties and requires deep knowledge, training, expertise and dedication. The European Board for Surgical Qualification gives guidelines on eligibility criteria for involvement in breast surgery defining metrics for operations that a breast surgeon should have performed and defines with precise metrics the numbers of procedures in which a qualified breast surgeons should be involved. Different international societies are involved in education and certification of competency in breast surgery. Many authors highlight that treatment of breast cancer in high-volume centers is of crucial importance because it improves 5-year survival up to 33%. Furthermore, the number of breast cancer surgeries that a breast surgeon performs per year seems to be an independent prognostic factor for patients’ survival, recurrence and general outcome. For all these reasons, treatment of breast cancer in certified breast units by specialized breast surgeons is mandatory. New techniques of oncoplastic breast-conserving surgery, challenge the current armamentarium of therapeutic options, proving excellent cosmetic results with comparable oncological outcome to the standard breast-conserving surgery. Furthermore, oncoplastic techniques improve patients’ satisfaction and quality of life after breast cancer diagnosis. Genetic counseling, psychological support and multimodal treatment from a breast-dedicated team which involves many specialties are mandatory for qualitative standards of care. There is an urgent need for certified education in breast surgery, not only for breast centers but also for breast surgeons. Dedication is a key principle in breast surgery, because it improves outcomes. Considering high incidence and mortality rates in the global population, current care for breast cancer needs to be based on quality. Breast surgery is a field with which, Obstetricians and Gynecologists should deal with and begin to be involved in Europe, after an accurate and strict training process which provided final certification.