Aims
While survival for women with breast cancer in Australia is amongst the highest in the world, there is evidence of unwarranted variations in breast cancer practice that impact on patient experiences and outcomes. Cancer Australia has developed the Cancer Australia Statement – influencing best practice in breast cancer to support effective, patient-centred cancer care and improve cancer outcomes. The Statement aims to encourage health professionals to reflect on their clinical practice to ensure that it is aligned with the evidence.
Methods
An Expert Group was established with representation from relevant clinical colleges and cancer and consumer organisations. Candidate breast cancer practices were identified from relevant national and international clinical guidelines, publications and position statements, with additional practices nominated by the Expert Group. Consensus on a final list of practices was informed by agreed selection criteria, including evidence of benefit or harm, evidence of unwarranted variation in practice in Australia, alignment with patient preferences and personal values, evidence of inconsistent use and high potential to change clinical practice.
Results
The Statement comprises 12 key appropriate and inappropriate breast cancer practices, spanning the cancer care continuum from diagnosis to end-of-life care. Each practice is supported by explanatory text detailing context, supporting evidence and value to patients, together with supporting references. All relevant clinical colleges, cancer and consumer organisations reviewed and had input into the agreed final wording of the Statement.
Conclusions
The Statement represents agreed priorities in breast cancer practice which, if implemented, will reduce unnecessary variations in care and outcomes. It is intended to complement relevant clinical practice guidelines, and highlight what ‘ought to be done’ in breast cancer care to maximise clinical benefit, minimise harm and deliver patient-centred care. The value of the Statement will be realised in informing and influencing wise decision-making between patients and their health care professionals.