The Breast Units, a crucial hub and essential touchpoint, are designed to offer women with breast cancer multidisciplinary, coordinated care aimed at improving quality of life, ensuring access to the most innovative therapies, and guaranteeing greater continuity of care even in advanced or complex stages of the disease, such as metastatic breast cancer. This is the view of 180 Italian oncologists, drawn from a survey conducted between October and November 2024 by IQVIA Italy, a global leader in clinical research services and commercial insights.
A Multisystemic and Multimodal Approach
Beyond surgery and the various potential oncologic therapies—traditional options such as chemotherapy and/or radiotherapy, immunotherapy, and hormonal therapy—the management and treatment of breast cancer require a broader, more holistic approach that also addresses other dimensions and needs of the woman; ongoing, integrated, and person-centered care is needed, including psycho-oncologic support, nutritional guidance, and a physiotherapy/rehabilitation pathway.
These opportunities, introduced in Italy in 2014 in line with European recommendations and present in over 80% of centers, could be accessed by more patients. However, access would only reach about half of patients, one in two, depriving them of a valuable chance.
The Difference in the Care Pathway
Survival chances and quality of life improve: these are two of the key benefits of guiding a woman through the disease process within a Breast Unit, as supported by multiple studies in the literature. For example, benefits of about 10 percentage points in tangible measures of physical, emotional, and social well-being are observed compared with patients treated in general surgery wards.
These results would be ensured by the unit-based approach to patient care—systematic, integrated, and personalized—that follows a woman through the entire disease course, from diagnosis to surgery, from oncologic therapy to rehabilitation. The multidisciplinary and specialized approach impacts several factors: it ensures greater continuity of care, reduces recurrence risk, and thus also improves survival. The evidence suggests survival gains of up to 20% for women treated in Breast Units compared with those treated in non-specialized centers. These opportunities are even more valuable for patients with metastatic cancer, where care by a multidisciplinary team is crucial to promoting the best possible quality of life, treatment adherence, and overall well-being.
An Untapped Opportunity
The support from Breast Units, according to the survey, would be used and utilized by only 50–60% of breast cancer patients, including those with advanced disease. For instance, psychological support, available in 84% of centers (versus 65% in non-specialized centers), would be used by only 50% of patients; nutritional counseling offered by 87% of Breast Units (versus 66%) is used by about 60% of women; post-surgical physiotherapy, available in 75% (versus 53%), is used by just over half of patients. In non-specialized centers, support is often demand-driven and left to the patient’s initiative. There is thus a sizable gap between what centers offer and what patients actually receive or utilize to their full potential.
Advanced Therapies and Beyond
Not only a sophisticated and broad level of support, Breast Units also provide cutting-edge therapeutic programs capable of changing the course of the disease, with opportunities even in the later stages of illness.
Among the newer therapies are cyclin-dependent kinase (CDK) inhibitors, now prescribed in 42% of cases for women with hormone receptor-positive, HER2-negative breast cancer, and targeted therapies, drugs designed to selectively attack cancer cells.
These therapies are effective in treating HER2-positive tumors, used in 38% of cases. The personalized approach, based on the molecular profile of the disease, is becoming the key to extending survival and improving quality of life, even in the presence of metastases.
A Standard-Setting Model for Every Oncology Center
Breast Units should become the national standard to optimize care, ensuring continuity of care and integrated treatment pathways for all patients, regardless of disease stage or place of residence.
It is also essential to monitor not just the availability of services but their actual use by patients, promoting their active involvement in treatment decisions. This must be done within a framework of humanizing care: expanding this approach nationwide is a crucial step to guaranteeing equity and value in breast cancer treatment. Extending the Breast Unit model to include metastatic patients is a priority to ensure therapeutic continuity, psychological support, and quality of life even in advanced disease.
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