The European breast quality assurance scheme for breast cancer services focuses on improving the outcomes of care taking also into account the patient experience/ satisfaction. The scheme will be available to all interested breast cancer services (hospitals, clinics, diagnostic centres, etc.) worldwide.


The aim of this document is to provide details on how the requirements for breast cancer services (‘service/process requirements’) are defined and selected by the multidisciplinary panel Quality Assurance Scheme Development Group (QASDG).


The European scheme is a collection of requirements. Compliance with these requirements will be evaluated, whenever appropriate, via indicators.

The QASDG has defined the 'care pathway' for breast cancer screening and care, the interventions and services to be considered, the quality domains to be included and how the scheme can be implemented in Europe.


The main steps for the development of the scheme are: definition of the scope of the scheme, selection of the requirements and piloting of the scheme.

The requirements are selected in a structured way by all QASDG members (including breast cancer professionals and patients).

The procedure comprises the following essential steps:

1. Collection of requirements
Requirements for all breast cancer care processes (from screening to follow-up until end-of-life care) are researched in the literature, guidelines, indicator databases and existing quality assurance schemes. They are presented with reference to their evidence. In cases where the requirements retrieved do not address all the relevant quality potentials in the pathway for breast cancer care, new ones are developed by the QASDG. Those requirements not meeting predefined inclusion criteria are excluded.

2. Panel process
Requirements are selected by a multi-disciplinary panel, the Quality Assurance Scheme Development Group (QASDG). In Delphi like rounds, requirements are first rated for understandability and relevance and then rated for feasibility. Relevance relates to the significance of the requirements for a person-oriented outcome of care. Feasibility relates to the ability of the requirements to actually be implemented and to provide meaningful data at the service-provider level.

Only requirements voting high in understandability, relevance and feasibility by the majority of the QASDG will be included in the scheme.

3. Pilot testing
Requirements are tested in a pilot run. They are amended according to the experiences gathered during the pilot run and then implemented within the scheme.


Related links