Review

360 Health Analysis (H360) – A Proposal for an Integrated Vision of Breast Cancer in Portugal

10.5152/ejbh.2020.5144

  • Sara Coelho
  • Inês Brandão Rego
  • Maria Rita Dionísio
  • Joana Cavaco-Silva
  • Patrícia Miguel Semedo
  • Francisco Pavão
  • Ricardo Baptista Leite
  • Luís Costa

Received Date: 13.08.2019 Accepted Date: 22.12.2019 Eur J Breast Health 2020;16(2):91-98

H360 aims to provide a comprehensive picture of breast cancer management in Portugal by retrieving real-world data from 10 Portuguese hospitals and deriving a snapshot from the medical interpretation of evidence-based data to patient perspective on the quality and effectiveness of medical care provided. This article reviews evidence on breast cancer clinical practice and quality of care and disease management in Portugal. A review of evidence on breast cancer clinical practice and quality of care over the last 10 years was performed in PubMed using the query “Organization and Administration"[Mesh] AND "breast cancer"[All Fields] NOT “Review” [ptyp]. National cancer initiatives relevant for quality of care and national and international guidelines and consensus were analyzed. Retrieved results showed that breast cancer incidence is still increasing, including in Portugal. Studies investigating disease outcomes seek to derive improvements to clinical practice and better financial resource allocation. Setting performance measures (KPIs) in institutions treating cancer is not a reality in Portugal yet, but has potential to leverage the quality of clinical performance. A multidisciplinary approach within one health structure is also desirable. More investment in clinical (including academic) research is key to optimize the quality of care. Implementation of clinical practice guidelines (largely based on ESMO guidelines in Portugal) is crucial to improve patient outcomes. Not less importantly, quality of life is a treatment goal on its own in breast cancer care. Breast cancer remains a health challenge and a multidimensional, 360-degree appraisal, beyond the exclusively clinical perspective, may provide new insights towards an optimal patient-centered approach.

Keywords: Breast cancer, Portugal, multidimensional, real-world, review