Breast Centers in Austria

Breast centers (BRCs) in Austria are currently managed and will be managed in the future as interdisciplinary and largely virtual, well-structured entities. The goals of the initiative to set up these centers are convergence of care, enhancement of the quality of care delivered to women diagnosed with breast cancer, and a significant actual benefit for the affected women. Given the geographical and infrastructural circumstances and partly already existing diagnostic and therapeutic facilities, a collaborating center model seems to be the target-oriented solution to employ the already existing resources. Evaluation and optimization of outcome quality (i.e. overall survival rate, disease-free survival, breast conservation rate, etc.) necessitate the implementation of treatment pathways with data collection and recording in a central registry. The aim should be to create an independent 'neutral' certification commission (a standard setter) in order to adapt the requirements of BRCs to Austrian circumstances. An appointed certification agency reviews compliance with the specifications of the certification commission. The European Society of Mastology (EUSOMA) specifications, as laid down in the European Parliament, serve as guidelines. These specifications were compiled by the brain trust of the Austrian Federal Institute of Health (ÖBIG) in Chapter 3.6.11 'Breast Health Centers' for implementation in the Austrian Health Care Structure Plan (ÖSG). BRCs in Austria should demonstrate a minimum caseload of 100 primary diagnoses per year. The collaborating partners - the affiliated centers - may, however, join a BRC with a demonstrated minimum caseload of 30 per year. In this model, the outcome quality should be achieved even with a smaller caseload with structure quality assurance. It is planned that, by the end of 2016, breast health centers will take over the comprehensive care of breast cancer patients nationwide. Center certification is viewed as quality enhancement since care is provided to all patients on a verifiable high quality level, subject to constant improvements.