Breast cancer screening best practices: a Canadian multidisciplinary consensus-based approach for primary care providers.

OBJECTIVES

International guidelines on breast cancer (BC) screening have differing recommendations leading to uncertainty on best practices for primary care providers. The purpose of this study was to create a Canadian best practices document on BC health and screening for primary healthcare providers through multidisciplinary consensus using Nominal Group Technique and Delphi method.

PARTICIPANTS

A 9-member multidisciplinary expert group and a patient advocate participated in the consensus methods and voting. Experts included those involved in BC management and two primary care physicians. Twenty-nine experts across BC disciplines participated in external review.

PRIMARY AND SECONDARY OUTCOMES: Two study objectives included (1) building consensus on key 'best practice' behaviours related to BC-related health and screening and (2) building consensus on specific definitions related to BC screening.

RESULTS

The final consensus document consists of 65 statements grouped in five categories with companion resources to support uptake of all best practices. Categories include identification and work-up for diagnostic imaging, risk factors and identifying individuals eligible for high-risk screening, shared decision-making, decisions and referrals for BC screening and screening outcomes. Special areas of focus were shared decision-making, age to initiate screening, and BC screening in special populations.

CONCLUSIONS

We created a comprehensive consensus document distilling the latest evidence to provide practical Canadian consensus-based advice on specific 'best practice behaviours' related to BC health and screening to serve as a resource for providers.