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Breast cancer screening best practices: a Canadian multidisciplinary consensus-based approach for primary care
Neha Pathak1,2, Ann Marie Corrado2, Jean M Seely3,4
1Division of Medical Oncology and Hematology, University of Toronto, Toronto, Ontario, Canada.
Objectives:
International guidelines on breast cancer (BC) screening have differing recommendations leading to uncertainty on best practices for primary care providers. The purpose of this study was to create a Canadian best practices document on BC health and screening for primary healthcare providers through multidisciplinary consensus using Nominal Group Technique and Delphi method.
Participants:
A 9-member multidisciplinary expert group and a patient advocate participated in the consensus methods and voting. Experts included those involved in BC management and two primary care physicians. Twenty-nine experts across BC disciplines participated in external review.
Primary And Secondary Outcomes:
Two study objectives included (1) building consensus on key 'best practice' behaviours related to BC-related health and screening and (2) building consensus on specific definitions related to BC screening.
Results:
The final consensus document consists of 65 statements grouped in five categories with companion resources to support uptake of all best practices. Categories include identification and work-up for diagnostic imaging, risk factors and identifying individuals eligible for high-risk screening, shared decision-making, decisions and referrals for BC screening and screening outcomes. Special areas of focus were shared decision-making, age to initiate screening, and BC screening in special populations.
Conclusions:
We created a comprehensive consensus document distilling the latest evidence to provide practical Canadian consensus-based advice on specific 'best practice behaviours' related to BC health and screening to serve as a resource for providers.
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