Breast cancer: the French Breast Institute opens its doors in Paris

The Institut Français du Sein opened its doors in Paris, in the ^7th arrondissement, near the Eiffel Tower, on the initiative of a multidisciplinary team of eminent cancer specialists, surgeons and radiotherapists and under the impetus of the Clinique de l'Alma.

Determined to pool their efforts, these breast cancer professionals decided to pool their skills around an ambitious objective: to improve the quality and speed of care for breast cancer patients by coordinating care more closely and providing access to major therapeutic innovations.

The institute intends to promote an approach based on excellence by setting quality criteria at every stage of the patient's care pathway: impeccable information, rapid treatment, appropriate diagnosis, medical support that goes beyond the strict care of the disease, and so on.

The idea of creating this unique structure, chaired by Dr Daniel Zarca, a surgical oncologist and gynaeco-obstetrician, arose from the observation that breast cancer is still too often treated imperfectly. The three successive "Cancer Plans" have focused on this problem of inequality of care, without however being able to offer solutions adapted to all cases.

The Clinique de l'Alma has positioned itself as a specialist in the surgical treatment of breast and urological cancers, and has therefore decided to take steps to bring together all the players involved in the care pathway and cross-disciplinary care within an institute that guarantees excellent accessibility and quality.

Random quality of care is not inevitable

"We are creating this institute today because we are not resigned to this pseudo fatality that makes the quality of care random and the chances of each patient different", explains Dr Marc Spielmann, oncologist and specialist in medical oncology and breast pathology. "Without claiming to be better than or different from our colleagues, we believe that by rationalising our methods and publishing and explaining our guidelines, we can put in place excellent care. It's an ambitious goal, and we're pulling out all the stops to achieve it.

Breast cancer is a malignant tumour of the mammary gland. It affects 10% of the female population. Around 1.4 million women are diagnosed with the disease every year worldwide, and 460,000 die from it. In France, it accounts for almost one cancer in three. Every year, more than 11,000 women die from it, i.e. around one woman every hour.

The practice of excellence in oncology owes nothing to chance or to the quality of carers alone. A set of criteria, defined by medical and health agencies (Institut national du Cancer, Haute Autorité de Santé), learned societies (Nice Saint-Paul CPR group, Société Française de Sénologie et de Pathologie Mammaire) and international societies (St Gallen group, ASCO, NCCN), provide healthcare professionals with a precise medical framework.

"And yet there are all too many examples of malfunctions in the care chain: equipment that is overloaded and therefore unavailable, not enough specialists and therefore long waiting times, a biopsy circuit that is not optimal and therefore risks inaccuracies in the analysis, etc.", points out Dr Spielmann.

Immediate treatment with commitments on turnaround times

"Our ambition is to avoid all these malfunctions and to offer immediate care, from the first day of admission, with the appointment of a referral oncologist, leading rapidly to a diagnosis and a concerted therapeutic solution within a particularly short timeframe. Between the end of the investigations and the start of treatment (often surgery), we will commit to a timeframe of seven days, whereas sometimes you have to wait four to eight weeks," explains Dr Marc Bollet, oncologist and radiotherapist.

To achieve this, we need to rethink the care pathway, which involves breaking down the barriers between specialities.

"The strength of a chain is measured in terms of its weakest link, which can lead to cascading blockages, increased delays and so on. On the other hand, if care is rigorously coordinated, delays can be drastically reduced and quality greatly improved," stresses Dr Daniel Zarca.

A network of partners for unrestricted access to the latest innovations

Finally, rapid access for patients to medical innovations is another of the Institute's key commitments.

"Many innovations are revolutionising cancer treatment. It's important that patients have unrestricted access to them. We've been working towards this goal," explains Dr Marc-David Benjoar, a specialist in prosthesis-free breast reconstruction using the DIEP abdominal flap.

To guarantee excellence in treatment, the Institut Français du Sein has built up a network of partners through a number of agreements, giving patients unrestricted access to the innovations that have revolutionised breast cancer treatment in recent years.

The network includes

- the Clinique de l'Alma, the only private establishment in Paris to offer a heavy technical platform enabling immediate breast prostheses (without silicone implants) to be produced using a DIEP microsurgical free abdominal flap.

- Genomic Health, based in California. It supplies the Oncotype DX test, a genomic test that can reduce the number of unnecessary chemotherapies for patients by up to 30%.

- the Oncogenetics Unit of the Hauts-de-Seine Cancer Research Group and the Montpellier University Hospital, to offer oncogenetic care (constitutional mutation research, screening or prevention within the family and personalised treatment).

- TheHartmann Cancer Institute at the Franco-British Hospital. This state-of-the-art centre has a complete radiotherapy technical platform, with 5 linear accelerators, and offers techniques to minimise the after-effects of radiotherapy. It also offers chemotherapy and the latest targeted therapies.