Brussels Statement
3rd European Breast Cancer
Conference - Barcelona Oct00
It is important to note while
reading that there is absolutely no mention of prevention!
At the 1st European Breast Cancer Conference, Florence, 29 Septembee-3 October 1998 delegates voted for the 'Florence Statement', setting out their vision for the future in research, treatment and care of breast cancer.
At the 2nd European Breast Cancer Conference, Brussels, 26-30 September 2000 delegates voted for the 'Brussels statement', the contents of which are represented below.
Brussels statement
Introduction
The second European Breast cancer conference reached a consensus on several key issues during the closing plenary session on the 30th September 2000 in Brussels. Several hundreds of clinicians, scientists, health care consumers representing 3150 participants used a computerised voting system in plenary session to formulate the Brussels Statement. This document sets the agenda for the future activities of the three major groups involved in breast cancer research, treatment, prevention and advocacy :
- The Breast Cancer Group of the European Organization for Research and Treatment in Cancer (EORTC-BCG)
- The European Society of Mastology (EUSOMA)
- Europa Donna, the European Breast Cancer Coalition
It is hoped that the objectives outlined in this document will stimulate much-needed change in the field of breast cancer. EORTC-BCG, EUSOMA together with the breast cancer advocacy activities of EUROPA DONNA, will work towards these goals by lobbying European Governments and the European Commission and by mobilising health-service providers, the scientific community and the health - care industry. These measures called for by EBCC-2 delegates will be assessed and reviewed at EBCC-3 to be held in Barcelona in March 2002.
Breast cancer is the commonest cancer and the most frequent cause of cancer death in women throughout Europe. Because of its importance and its potential for successful treatment, breast cancer deserves special attention and effort.
The Brussels conference makes the following statements:
Breast cancer should be managed in multidisciplinary clinics
Following the Florence Statement, which established that all women should have access to fully equipped, dedicated breast units, the three Societies have produced European Guidelines defining the requirements for such units. These European guidelines stress the importance of multidisciplinarity (ie the collaboration between surgeons, radiologists, clinicians, pathologists, etc...) and multiprofessionality (ie the collaboration between doctors, nurses, psychologists, social workers, etc..).
The Conference demands that national governments establish and accredit breast units in their countries in accordance with the Guidelines and ensure that breast cancer diagnosis and care are carried out in those units.
All breast units should develop quality assurance programmes entering their data onto a common European database.The Conference pledges for all the breast units to collect data on incidence and mortality and to pool them in a common European database.
Breast cancer screening
All women should be offered full information about the benefits and the risks of mammographic screening programmes. However, the conference acknowledges the important contribution made by mammographic screening to decreasing mortality and improving breast cancer care.
All European women between the age of 50 and 75 should be offered quality-assured mammographic breast screening free at the point of delivery. Programmes should not be provided without adequate provision for assessment and treatment of screen-detected abnormalities.
Quality assurance in breast cancer research
The Conference wishes to stress the importance of quality assurance procedures as an integral part of the conduct of studies for all involved disciplines. It invites health service providers and research funding agencies to consider the additional cost for quality assurance procedures as an investment to obtain better outcomes and results.
Researchers and clinical investigators should recognise the ethical and scientific necessity of always including quality assurance procedures in their study protocols.
Risk assessment
The Conference wishes to bring to everyone's attention the increasing potentials offered by new methods to assess breast cancer risk for an individual woman and encourages researchers to identify a standardised risk-assessment methodology suitable for European women.
In addressing the issue of genetic testing the Conference agrees that not all women with a family history are at high risk and necessarily need a genetic test.
Genetic testing should be provided only after receiving appropriate specialist counselling.
The Conference expresses the opinion that genetic testing and counselling should not be encouraged in the absence of protective legislation against socio-economic discrimination and of scientifically proven preventive measures, such as lifestyle modifications, prophylactic surgery, mammographic screening and/or chemoprevention.
Treatment tailoring
The Conference welcomes the progress made in tailoring treatment programmes to individual patients and acknowledges the fact that a great contribution to this progress comes from translational research (ie those studies which result from the interaction between laboratory and clinical research).
The Conference wishes to assist in the coming years to a great development of translational research in breast cancer by means of well-funded research projects on frozen tumour specimens for which free circulation among different countries should also be ensured. Legislators on data protection are asked to facilitate this scientific evolution by recognising the importance of these studies.
Informed consented collection of frozen tumour specimens should be obtained from all breast cancer patients as a routine procedure.
Participation in clinical trials
Randomized clinical trials represent the most effective way of evaluating new therapies but also offer optimal treatment opportunities. Obstacles to the participation both for patients and clinicians should be as low as possible.
Press, broadcasting media and internet providers are invited to increase awareness of the importance of participation in clinical trials as the best contribution to the progress of medicine and the best option for maximum quality care. Health authorities and research agencies should give adequate support to national and international data centres conducting clinical trials in breast cancer.
Brussels, 30 September 2000
http://www.fecs.be/ebcc3statement.html
