Important advances in breast cancer screening and treatment and changes in the way guidelines are developed, from expert consensus-based to evidence-based, led to the need for new European Guidelines.


The objective of the European Guidelines is to improve the prevention and diagnosis of breast cancer.


  1. The European Commission selected, via an open call, a multidisciplinary panel of experts including patient advocates, the Guidelines Development Group (GDG), who voluntarily participate in this initiative.
  2. The European Commission applied conflict of interest rules compliant with international provisions. The GDG members declare interests annually and for each specific healthcare question that leads to a recommendation.
  3. The GDG prioritised a set of healthcare questions from a broader list that included questions coming from a public consultation carried out among different stakeholders.
  4. GDG framed each question using the PICO format - Population under study (for example women of certain age); Intervention (for example a medical examination); Comparator (other main options such as an alternative medical examination); and Outcomes (results).
  5. An external and independent team, with specific expertise in the field, carried out systematic reviews for each question.
  6. The GDG assesses the quality of the evidence retrieved and use GRADE Evidence to Decision (EtD) frameworks to decide on the recommendation and its strength by applying a series of pre-determined criteria, such as: anticipated harms and benefits of the options considered, the certainty of the evidence for those effects, the costs and feasibility of the options, etc.
  7. Recommendations are updated when new evidence becomes available.


The Guidelines are being developed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and in particular using GRADEpro Guideline Development Tool (GRADEpro GDT).

Next steps

All recommendations will be published by the end of 2019.
Recommendations will be updated as new evidence arises.


  • EtD: Evidence to Decision
  • GDG: Guidelines Development Group
  • GRADE: Grading of Recommendations Assessment, Development and Evaluation
  • PICO: Population, Intervention, Comparator, Outcome


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