Latest European Commission Initiative on Breast Cancer Recommendations

Newly published European Breast Guidelines, evidence-based recommendations

The European Commission, Directorate General Joint Research Centre announced on 9 November 2018 availability of the latest European Commission Initiative on Breast Cancer (ECIBC) recommendations on breast cancer screening and diagnosis. 

The ECIBC is developing the European Breast Guidelines,evidence-based recommendations. The European Breast Guidelines provide women and healthcare providers with clear, objective and independent guidance on breast cancer screening and diagnosis. They guide healthcare managers and policy-makers in planning, organising and monitoring the effectiveness of services for breast cancer screening and diagnosis. The recommendations already available can be found online, and more will be released in the coming months, as soon as they are finalised.

In terms of screening, new recommendations tackle next areas:

What is the optimal strategy to invite women to organised breast cancer screening programmes?

This set of recommendations aims to determine the best way to invite women to attend their periodic screening.

How should mammography screening be implemented?

This recommendation clarifies that organised screening programmes have greater ability to cover the target population, greater effectiveness as well as providing a more equitable access to these services.

How should screening mammographies be read?

Practice varies with respect to image reading and diagnostic protocols. One of the methods that can be adopted to improve sensitivity of mammography screening is double reading, whereby the mammograms are read, generally independently, by two trained readers.

In terms of diagnosis, new recommendations tackle next areas: 

Which method should be used to obtain a sample of suspicious breast lesion?

Currently, there are two non-operative methods to obtain samples of a breast lesion: fine needle aspiration cytology and needle core biopsy. This recommendation evaluates these two different methods.

What threshold of oestrogen and/or progesterone should be used to provide endocrine therapy in women with invasive cancer? 

The hormone receptor status of an invasive breast carcinoma is a strong predictive marker of tumour response to endocrine therapy. Different thresholds are currently used. The aim of these questions was to determine the most appropriate threshold to use.

Should Ki-67 testing (in addition to clinico-pathological indices and breast biomarkers) be used to guide the administration of adjuvant chemotherapy in patients with hormone receptor positive, HER2-negative, lymph node negative invasive breast cancer?

The measurement of tumour cell proliferation using the Ki67 index may provide additional prognostic and predictive information and assist decision making regarding administration of adjuvant chemotherapy to patients with invasive breast cancer. The aim of this recommendation was to answer this question.