The European quality assurance (QA) scheme for breast cancer services focuses on improving the outcomes of care while taking into account patient experience and satisfaction.

The scheme is available to all interested services (hospitals, clinics, diagnostic centres, etc.) worldwide.


The QA scheme is a collection of requirements to support breast cancer services in improving the quality of care offered. Compliance with these requirements will be evaluated, whenever appropriate using several tools, including quantitative indicators.

The multidisciplinary panel Quality Assurance Scheme Development Group (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 QA scheme can be implemented at European level.



The requirements are defined and selected in a structured way by all QASDG members.

The procedure consists of 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 existing literature, guidelines, indicator databases and quality assurance schemes, and are presented with reference to their evidence. In cases where the requirements retrieved do not address all the relevant quality potentials in the breast cancer care pathway, the QASDG develops new ones. Requirements that do not meet predefined inclusion criteria are excluded.

2. Panel process

In Delphi-style rounds, requirements are first rated for their understandability and relevance and then for their feasibility. Relevance relates to the significance of the requirements for a patient-centred care outcome. Feasibility relates to the ability of the requirements to actually be implemented and provide meaningful data at service-provider level.

Only requirements that are rated high for understandability, relevance and feasibility by the majority of the QASDG members are included in the European QA scheme.

3. Feasibility and pilot run

The requirements are tested in the feasibility checks in real settings exercise and the pilot run. They are amended according to the feedback gathered and then implemented within the scheme.

Next steps

The feasibility checks took place between September 2021 and March 2022.

The pilot run has now started and will be finalised by February 2023.

The update of the requirements is planned for the first half of 2023.