The Nice Manifesto

Almost 5,000 delegates at the 5th European Breast Cancer Conference (EBCC-5) today attended the presentation of the Nice Manifesto. The manifesto represents a commitment from doctors, nurses, patients and advocates to support breast cancer research and improve patient care. Breast Cancer is the most common cancer in European women and although survival rates are improving there is still a long way to go.

The manifesto is endorsed by the three organisations – Europa Donna – The European Breast Cancer Coalition, The European Organisation for Research and Treatment of Cancer (EORTC) and the European Society of Mastology (EUSOMA) who hosted the event. This conference is the only one of its kind as it represents the views of all the major breast cancer advocacy groups and institutions in one arena. This manifesto is a unique document that represents the concerns of all those involved in breast cancer treatment, from the patient to the oncologist.

Dr A. Costa, the chair of the European Breast Cancer Conference, and Dr S. Kyriakides, co-chair stated, “Europe is now 500 million strong, more than half of these are women, and at least one in ten will experience breast cancer. This is a major public health priority. The Nice manifesto is a promise to improve breast cancer care for all those patients across Europe. It is a basic right for patients to expect the best care and the conference pledges to meet the challenge.”

The following seven goals form the basis of the manifesto:

1. Improve the number and quality of European screening programmes
Population based screening programmes carried out in accordance with EU guidelines for quality assurance in mammography screening help to detect early breast cancer and save lives. Increasing the number of screening programmes free at the point of access and improving their quality would save the lives of many European women. Women should be encouraged to participate in screening programmes.

2. Support breast cancer research
Independent academic research is under threat due to insufficient funding in many European countries. It is a driving force in improving our knowledge of cancer and developing tailored, potentially cost-saving therapies. Studies which answer important clinical questions and which have the potential to increase our knowledge of the biological and genetic basis of the disease should be given priority.

3. Rethink the breast cancer staging system
Researchers and clinicians should be creative in designing new quality assured diagnostic and staging systems which improve prediction of outcome. The genetic makeup of the tumour, for instance, should be defined in greater detail to identify the natural history of the disease in each individual patient, and the likelihood of response to standard therapies and molecular targeted treatments.

4. Define metastatic breast cancer guidelines
Most women still die from metastatic breast cancer. The general criteria on how to manage metastatic breast cancer need to be defined. Specific guidelines can help the patient and the clinician make the right choice.

5. Increase the number of breast care nurses
In most European countries today there are no breast care nurses. Breast care nurses can improve the treatment and management of breast cancer for patients. Greater involvement will improve patient care and quality of life.

6. Expand the Breast Unit accreditation process
Breast units should be accredited to ensure that they meet guideline requirements for standardisation of best care. Accreditation guidelines for carrying this out should be developed not only by professionals, but also by patient advocacy groups. Women should have equity of access and the choice to select appropriate facilities for diagnosis and treatment and be sure they are getting gold standard.

7. Give recognition to the essential role played by charities in independent breast cancer research
Encourage those charities to realise the potential benefits of their effort for all European patients and to expand their work even further.