A shared effort toward better quality of care. The Consensus Conference on Breast Cancer Follow-up

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Abstract
Background : Even though several radiological and laboratory tests are currently used in clinical practice for breast cancer surveillance, the benefits of early detection of distant metastases have never been established. Two recently published randomized clinical trials assessing the effectiveness of an intensive follow-up strategy (with periodic clinical examination, mammography, bone scan, liver echography, chest-X-ray and laboratory tests) over a minimalist one (including only periodic 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 Conference : To contribute to the definition of the state of the art in this field and develop recommendations for follow-up in clinical practice. Conduct of the Consensus Conference : A Jury, including representatives from all the relevant stakeholders, (professional societies, patients and consumer associations, epidemiologists, health econ-omists and administrators) was convened to critically appraise and interpret available scientific evidence and the information provided by three specific working groups which had the task of examining the clinical, economic and psyco-social aspects of breast cancer follow-up, respectively. Conclusions : This conference was planned to make explicit and properly represent the viewpoints of all the stakeholders. Furthermore, special efforts were devoted to the development of final recommendations in sufficient detail so as to provide a significant aid for decision-making in clinical practice. It is argued that the Consensus Conference model, designed to elicit and represent the interpretation of scientific evidence by all the stakeholders, would be useful for the development of clinical policies more in line with societal values.