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Breast Cancer - Further information
What is a breast center?
A breast centre is a clinical department consisting of cooperating interdisciplinary clinics and, if necessary, general practitioners that specialises in the diagnosis, treatment, prevention and research of all diseases of the female - and in rare cases also the male - breast.
The main purpose of a breast center is to diagnose, prevent and treat breast cancer, the most common type of cancer in women. In a breast centre, a wide range of medical disciplines - including gynecology, oncology, hematology, oncology, radiology, pathology and psycho-oncology - work together to identify and treat breast cancer.
Unfortunately, the term "breast center" is not protected, so any clinic can wrongly use this term whithout providing any information about the quality of the breast cancer diagnosis and treatment offered at a clinic. For this reason, the German Cancer Society (DGS), in cooperation with the German Society for Senology (DGS), has established a catalogue of criteria for breast cancer centers.
What is a certified breast cancer center?
A certified breast cancer center is a medical facility that - in contrast to a non-certified breast center - has been awarded the quality seal "Certified Breast Cancer Center" by the German Cancer Society (DGK) and the German Society for Senology (DGS). This seal is only awarded to hospital departments or networks of departments from different hospitals that have successfully completed the certification procedure for breast cancer centers offered jointly by the DKG and the DGS since the summer of 2003 and meet the specified certification criteria of the catalogue of requirements for certified breast cancer centers. The first certified breast center was in Tübingen.
The catalogue of requirements not only includes professional prerequisites such as minimum quantities of diagnosed and treated breast cancer cases per specialist, but also requires documentation of the treatment results and the introduction of an officially recognised quality management system at the clinic, which would like to obtain certification as a breast cancer center. The so-called "Professional requirements for Breast Cancer Centers ", which form the basis for the certification of breast cancer centers, have been defined in a survey form which must be completed by a breast cancer center prior to the certification procedure. Here, the clinics or hospital departments must explain how and to what extent they meet the requirements placed on a certified breast cancer center.
How many certified breast cancer centers are there in Germany?
In Germany, around 255 clinics and hospital departments currently have the "Certified Breast Cancer Center" quality seal awarded by the DKG and DKS (as of 2011). This ensures that breast cancer patients are cared for almost everywhere in Germany. However, the certified breast cancer centers are distributed very differently in the German federal states. While Baden-Wuerttemberg has 54 certified breast cancer centers, only 4 clinics in Mecklenburg-Vorpommern are certified as breast cancer centers. The number of women with breast cancer who have to be treated per breast cancer centre therefore varies greatly in the German federal states.
Background information on breast cancer
Breast cancer is a malignant tumor of the mammary gland and by far the most common cancer in women. One in nine women in Germany will develop breast cancer in the course of her life. In total, there are more than 70,000 new cases of breast cancer in Germany every year (i.e. about one in ten women in Germany develops cancer in the course of her life). The most important risk factors include a higher age as well as breast cancer cases in close relatives, such as the mother or the sister.
Most women suffering from breast cancer can be cured today thanks to developments in medicine. Breast cancer can be treated by various methods, including surgery, chemotherapy and radiotherapy. As breast cancer manifests itself in many different forms, the optimal treatment may look different for each patient. For this reason, it makes sense for the treatment to be carried out in a certified breast cancer center by an experienced team of doctors from the various medical disciplines involved.
Objective of certified breast cancer centers
Since the term "breast center" unfortunately is not legally protected, any clinic may use it. An evaluation of the quality of the diagnostic and therapeutic services offered by a self-proclaimed breast center, however, is not associated with the term. It is difficult for the affected breast cancer patients to judge whether a clinic, which calls itself a breast center, actually has the necessary experience and quality in the diagnosis and treatment of malignant breast diseases.
The certificate as a breast cancer center awarded by the DKG and DGS therefore aims to give the patients affected the assurance that they are in good hands. Patients can tell from the seal and the certification as a breast cancer center that a clinic fulfils the quality requirements defined by a neutral and respected specialist society and that its medical team is thus among the specialists in the field of diagnosis and therapy of breast cancer.
Another aim of the certification of breast cancer centers is to improve the care of breast cancer patients and to provide them with a treatment that at each stage is based on high quality standards and the current state of science.
Certification criteria for a breast cancer center according tot he DKG and DGS
The German Cancer Society (DKG) and the German Society of Senology (DGS) have established a comprehensive catalogue of criteria for Certified Breast Cancer Centers - the so-called "Professional Requirements for Breast Cancer Centers" - in a long development and evaluation process, and have coordinated it with all specialist societies involved in the treatment of breast cancer. Since the summer of 2003, only those clinics that fulfill these requirements have been able to receive the quality seal "Certified Breast Cancer Center" according to an objective certification procedure carried out by the independent certification institute OnkoZert.
In order to be awarded the quality seal "Certified Breast Cancer Center" of the DGK and DGS and to be allowed to own it permanently, clinics and specialist departments specializing in the treatment of breast cancer must meet the following requirements, among others:
- Treatment of approximately 100 primary cases of breast cancer per year at initial certification as a breast cancer center (after 3 years treatment of approximately 150 breast cancer cases at the main site)
- Each site must have at least 1 breast surgeon with specialist status who performs at least 50 breast surgeries per year.
- close, contractually fixed cooperation with experts from the fields of radiodiagnostics (at least 2), pathology, radiotherapy, etc.
- Implementation and continuous further development of the S3 guidelines of the professional associations DKG and DGS
- Proof that the Breast Cancer Center has implemented a generally accepted quality management system (DIN ISO 9001 or KTQ).
In preparation for the certification audit, a breast cancer center that is to be certified must present a survey form showing how and to what extent it fulfills the certification criteria. After certification, the "Certified Breast Cancer Center" quality seals issued by the DKG and DGS are generally valid for three years. The examination, whether the professionla requirements are still fulfilled, takes place annually in so-called surveillance audits. At the end of the three years, the certificate is recertified and, if successful, extended for a further three years.
Throughout Germany, qualified breast centres have been certified by the German Cancer Societies and the German Society for Senology.
The first certified breast center in Germany is that of the University Women's Hospital in Tübingen under the direction of Prof. Dr. Diethelm Wallwiener. All therapy decisions are made jointly at the regular tumor conferences. These "breast centers" must undergo certification by specialist committees in order to make the quality they offer transparent and verifiable.