Guidelines in the management of breast cancer should lead to:
- a uniformly high standard of surgical treatment throughout the country
- reassurance of patients that surgical management is standardised
- standardisation of radiotherapy and chemotherapy
- identification of resources needed to fulfil these guidelines in all hospitals treating breast cancer
In Ireland, most patients with breast cancer present when they are symptomatic. The introduction of screening will increase the number of asymptomatic lesions. The highest quality of care is required to optimise the chances of cure with the least morbidity for all patients. This is best achieved in a multidisciplinary setting with high-quality surgery, medical oncology and radiotherapy together with the support provided by a breast care nursing service.
A team consisting of surgeons, radiologists, pathologists, medical oncologists and nurse specialists, each of whom specialises in breast disease, should manage breast cancer. A Breast Unit should treat a minimum of 100 new primary breast cancer patients annually.
A Breast Unit is defined by the staff, multidisciplinary teams and resources that it applies to the management of breast disease.
Most of the Breast Unit’s work is outpatient-based and involves ‘reassuring the worried well’. A multidisciplinary approach is more effective if all clinicians follow guidelines. Standards of treatment and outcome of breast cancer vary between and within countries. Guidelines can help to reduce these variations and allay public concern.
A breast practice generates a large administrative workload and it is essential that the breast team has adequate clerical support.
Medicine and Health Sciences | Surgery
Walsh TN and O'Higgins N. Breast Cancer Management Clinical Guidelines. Dublin: Royal College of Surgeons in Ireland, 2000.