New frontiers for fairer breast cancer care in a globalized world.

Today, breast cancer is the most frequently diagnosed cancer in women and the most common cause of cancer death in women. The risk of breast cancer diagnosis varies widely by world region. Breast cancer care in any country is a costly and complex disease, for which effective management depends on the quality of early detection, diagnosis and treatment . Significant variation in treatment modalities and quality management is observed worldwide.
In early 2020, the book and E-book: “Breast cancer: Global Quality Care” was published by the Oxford University Press . It became a worldwide success. In November 2021 it was discussed during IOLC (International Oncology Leadership Conference ) in Rome with the participation of the ESO (European School of Oncology )
The aim of our work is to reflect on the potential to achieve a world-wide improvement in quality care, assessing value for expense. A lot of activities were organised to disseminate further the main message of the project: “A call for fairer breast cancer care for all women in a globalised world”. The project was highly appreciated by a lot of journals and organizations such as ASCO (American Society of Clinical Oncology) , ESO (European School of Oncology) , the Value Based Health Care initiative (Thinkers Magazine) and ESMO (European Society of Medical Oncology). The book was recommended to all readers of the ASCO post.
Because cancer care delivery is becoming unsustainable in many countries assessing healthcare value for the cost is becoming increasingly important. Specific recommendations are made considering the local resource facilities. The multidisciplinary breast conference is discussed as “the jewel in the crown” of the integrated practice unit (IPU), connecting multiple specialisations and functions around the breast cancer patient.
A research project is in progress with EUSOMA studying the evolution of the use of radiation therapy and systemic treatment in certified breast centers in different European countries.
The participation in this project of two world-leading cancer programmes, the CONCORD programme and the Breast Health Global Initiative are particularly important.
Methods to realize the project
1. scientific publications
2. social media
3. E-learnings: virtual meetings, interviews, webinars
4. resource-stratified guidelines
5. national and international congresses
6. participation to KEY international initiatives and studies
1. Publications in ESMO-open (Breast Cancer: global quality care optimizing care delivery with existing financial and personnel resources ,D. Verhoeven et al. 2020;4:e000861, in the European Journal of Breast Health: New Frontiers for Fairer Breast Cancer Care in a Globalized World (2021) and most recently again in ESMO Open: The assessment of Quality indicators of systemic treatment in breast cancer in Belgium 2021; 6(4):1-12. https://doi.org/10.1016/j.esmoop.2021.100207.
We are working on a new publication about: ”High value breast cancer care with limited resources”
2. Social media participation. In the world we live today, social determinants are important to improve health outcome. Social and family engagement is stimulated using the social media to address the project and its opportunities (e.g., Facebook/ LinkedIN/ Twitter/for ex. Freely available audiogram: https://research.one.surgery/new-frontiers-for-fairer-breast-cancer-care-in-a-globalized-world ). Video PITCH will be send separately.
3. E-learnings are organized, with an interview by ecancer in Sept 2020, a webinar around the project organized with the Association of cancer executives in the US and a virtual symposium during the 4th IOLC ( 16/11/2020) .
Organization from 2022 on (4 times a year-1 hour) of an interacting international webinar , freely available, discussing aspects of value based breast cancer and global oncology.
4. High income country (HIC ) guidelines do not provide information about prioritization of resource-acquisition when not all resources are available. Resource-stratified guidelines are discussed with ideas about local quality management. Updating planned in a next open access edition. One of our goals is to encourage the authors of international guidelines to embrace the concept of value-based health care on a global scale.
5. Each year, we organize the IOLC, bringing together experts from Europe, North America and other continents reflecting about management of (breast) cancer care. This year it will be in Barcelona ( 14-16/10 ).
Active participation to the next SIS (Senologic international society) congress in Rodos, September 2022 with a session and round table with focus on outcome and value based breast cancer care.
Lecture during National Consortium of Breast Centers, USA, 3/2022: Tucker FL, “Value-Based Breast Care”.
6.We now actively participate to the Global Breast Cancer Initiative of the World health organization (leaded by B.Anderson), to the Lancet Commission on breast cancer (leaded by C.Coles ), and to a study of the London School of Hygiene and Tropical Medicine about the right to health applied to breast cancer
o Our project is continuously under review with feedback from the faculty. The final plan is to arrive to an open access platform and e-publication by OUP freely available to all interested people. The regular webinars will also help to promote our messages.

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