From PDTA to PIDTA: a new integrated care pathway to improve survival and quality of life in breast cancer patients.

The Percorso Diagnostico-Terapeutico Assistenziale (Diagnostic, Therapeutic and Care Pathway, PDTA), has long provided a structured framework for cancer care, supporting continuity and adherence to clinical standards. However, as improvements in cancer outcomes are accompanied by increasing complexity in patient needs, particularly in breast cancer, greater attention is being directed towards models of care that extend beyond survival to include quality-of-life outcomes and long-term survivorship needs. Within this context, interest is emerging in the PIDTA (Percorso Integrato Diagnostico-Terapeutico Assistenziale; Integrated Diagnostic, Therapeutic and Care Pathway) as a conceptual extension of the PDTA model. The PIDTA framework proposes the integration of evidence-informed supportive interventions alongside standard oncologic care within a multidisciplinary setting across the cancer continuum. These may include psycho-oncological support, nutritional counselling, structured physical activity programs, and other supportive care interventions embedded within routine clinical pathways. Initial experience from specialized breast units, including at the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, suggests the feasibility of implementing such an integrated model within clinical practice. Early observations indicate potential improvements in treatment adherence, symptom management, and patient-reported quality-of-life outcomes, alongside the incorporation of structured prehabilitation and survivorship planning. The PIDTA represents an evolving conceptual framework in breast cancer care that seeks to integrate clinical excellence with structured supportive care. Further systematic evaluation, including prospective studies and implementation research, is required to define its impact and inform potential scalability within different healthcare settings.