A SHARED EFFORT TOWARD BETTER QUALITY OF CARE - THE CONSENSUS CONFERENCE ON BREAST-CANCER FOLLOW-UP

Background: Even though several radiological and laboratory tests are currently used in clinical practice for breast cancer surveillance, th e benefits of early detection of distant metastases have never been es tablished. Two recently published randomized clinical trials assessing the effectiveness of an intensive follow-up strategy (with periodic c linical examination, mammography, bone scan, liver echography, chest-X -ray and laboratory tests) over a minimalist one (including only perio dic clinical examination and mammography) failed to show a significant advantage for the more intensive policy. Intensive follow-up, however , is quite common in clinical practice. Aim of the Consensus Conferenc e: To contribute to the definition of the state of the art in this fie ld and develop recommendations for follow-up in clinical practice. Con duct of the Consensus Conference: A Jury, including representatives fr om all the relevant stakeholders, (professional societies, patients an d consumer associations, epidemiologists, health economists and admini strators) was convened to critically appraise and interpret available scientific evidence and the information provided by three specific wor king groups which had the task of examining the clinical, economic and psyco-social aspects of breast cancer follow-up, respectively. Conclu sions: This conference was planned to make explicit and properly repre sent the viewpoints of all the stakeholders. Furthermore, special effo rts were devoted to the development of final recommendations in suffic ient detail so as to provide a significant aid for decision-making in clinical practice. It is argued that the Consensus Conference model, d esigned to elicit and represent the interpretation of scientific evide nce by all the stakeholders, would be useful for the development of cl inical policies more in line with societal values.