Breast Medical Oncology

The department is responsible for the medical treatment of breast carcinoma in the early stages (adjuvant-neo adjuvant), locally advanced, and metastatic phases. It also manages the follow-up of breast cancer patients treated within the unit, in collaboration with colleagues in senology and radiotherapy. 

The medical treatments provided include both “standard of care” approaches in accordance with national and international guidelines, and innovative therapies through profit and non-profit studies. It is a simple structure affiliated with the Medical Oncology Department 1. The unit conducts its activities according to internal quality protocols, which are periodically reviewed and updated. 

CLINICAL ACTIVITIES 

The pathology managed includes carcinoma of the female and male breast. The unit is characterized by adopting a multidisciplinary approach that applies to all disease stages (initial, locally advanced, metastatic, and palliative). This approach is supported by a dedicated Multidisciplinary Clinic within the Breast Unit, involving multiple specialists depending on the disease phase, and multidisciplinary collegial meetings for discussion and therapeutic decision-making regarding operated patients. This activity is supported by the presence of a dedicated “Case Manager.” 

During the first visit in the Multidisciplinary Clinic, after appropriate diagnostic and instrumental examinations, a shared care plan is developed with the patient and the specialists involved in the pathology. At the end of this process, the patient is referred to the appropriate specialist (surgeon, oncologist and radiotherapist). Additionally, multidisciplinary visits are conducted in this clinic for patients already under the care of the Breast Unit who, at specific points in their disease course, require an integrated re-evaluation of emerging critical issues. 

There are also two outpatient clinics for managing patients under the care of the Breast Oncology Service, where the clinical-assistive and therapeutic pathway is carried out for patients referred from the Multidisciplinary Clinics, as well as for patients attending their first oncological consultation. A third outpatient clinic is mainly dedicated to managing patients enrolled in certain research protocols. To ensure the best therapeutic and care pathway, a Breast Unit-specific PDTA (Pathway of Care) has been formalized and is periodically updated for different disease stages. 

The clinical organization includes: 

Initial oncological consultations, dedicated to new patient intake; 

Follow-up oncological visits for treatment and monitoring of patients in active treatment or under care within the unit; follow-up is shared with radiotherapy and senology colleagues; 

Oncological visits for managing patients enrolled in profit and non-profit clinical trials (phases 1-3) for breast carcinoma. 

RESEARCH ACTIVITIES 

Currently, the department allows the enrollment of breast cancer patients in various profit and non-profit clinical trials involving drugs; observational studies without drugs are also conducted. As of now, approximately 20 clinical studies are active within the Breast Oncology Department. The aim of the research activities is to provide innovative treatments in the neo-adjuvant, adjuvant, and metastatic phases of the disease, in accordance with current literature and national and international guidelines. Sometimes, Expanded Access Programs (EAP) are available to allow early access to innovative treatments immediately before or after regulatory approval. 

The observational studies promoted by the department itself or resulting from collaborations with Italian and international centers aim to collect biological material, information on various treatments in “real-world” populations, and foster collaboration with different preclinical and translational research groups.