Florence Statement on Breast Cancer, 1998 Forging the Way Ahead for More
Research on and Better Care in Breast Cancer
The first European consensus on key issues in breast cancer was
reached on 3 October 1998 by nearly 1000 clinicians, scientists and healthcare
consumers attending a mass voting session at the 1st European Breast Cancer
Conference (EBCC-1) in Florence, Italy.
The Florence Statement sets the agenda for everyone involved in
these key issues in breast cancer research, treatment, prevention and advocacy
including the three major groups and organisers of EBCC-1:
The Breast Cancer Co-operative Group of the European
Organization for the Research and Treatment of Cancer (EORTC-BCCG).
The European Society of Mastology (EUSOMA).
Europa Donna, the European Breast Cancer Coalition.
This objective-setting document will stimulate much needed change
in the field of breast cancer. EORTC-BCCG, EUSOMA and the patient-advocacy
activities of Europa Donna will work towards these goals by lobbying European
governments and mobilising health-service providers, the scientific community
and the healthcare industry.
These new actions demanded by the EBCC-1 delegates will be
assessed and reviewed in 2 years at EBCC-2, to be held in Brussels from 26-30
Florence Statement on Breast Cancer, 1998
Breast cancer is the commonest cancer and the most frequent cause of cancer
death in women in every European Union country. Because of its importance and
its potentially high curability, breast cancer deserves special attention and
The 1st European Breast Cancer Conference calls on the European Parliament to
devote a plenary session to breast cancer. The Florence conference also makes
the following statements:
Clinical trials are the mainstay for the development of optimal treatment of
breast cancer and this conference is committed to encouraging maximum
participation in clinical trials. Consumers should be fully involved at all
stages in the design and conduct of clinical trials, by clear public
information, discussion with ethics committees and increased accessibility to
This conference is committed to the application of pressure on governments,
medical charities and the healthcare industry to invest more in breast cancer
research, especially into translational studies. In addition, the major
European charities are invited to co-ordinate their efforts to avoid
unnecessary duplication of research programmes in different countries and
thereby release resources to underpin European studies.
On genetic predisposition
Given that knowledge about inherited predisposition to breast cancer is
constantly emerging and that management options for mutation carriers are still
not proven to be of benefit, the conference resolves that genetic testing
should be undertaken in the setting of clinical research only. Such a setting
needs personnel and facilities to study further the psychological effects and
clinical outcomes in those who present for testing.
Genetic testing represents a potential threat to the privacy and security of
women and could lead to commercial exploitation through gene patenting. The
conference, therefore, demands national legislation and a European directive to
protect women from personal, professional, financial or other discrimination.
On psychosocial status
This conference believes that the measurement of psychosocial status should be
mandatory in the assessment and management of women's health and should not
just be part of a clinical trial.
This conference demands that those responsible for organising and funding
breast cancer care ensure that all women have access to fully equipped
multidisciplinary and multiprofessional breast clinics based on populations of
around 250 000.
On quality of care
Given the importance of the quality of surgery, radiotherapy and chemotherapy
in determining outcome, quality assurance programmes should become mandatory
for breast cancer services to qualify for funding from healthcare providers.
Evidence-based multidisciplinary management guidelines defined at
national and European level with the consensus of healthcare professionals,
voluntary organisations, other health-service providers and consumers will
further improve outcome.
"Florence Statement on Breast Cancer, 1998 Forging the Way
Ahead for More Research on and Better Care in Breast Cancer"
L.Cataliotti, A.Costa, P.A.Daly, L.Fallowfield, G.Freilich,
L.Holmberg, M.Piccart, C.J.H.van de Velde and U.Veronesi, European Journal of
Cancer, Vol.35, No. 1 pp. 14-15, 1999, reproduced with permission from Elsevier