Zacharoula Sidiropoulou, Senior Consultant Breast Surgical Oncologist at Hospital São Francisco Xavier, shared on LinkedIn:
“The Breast Cancer Pathway I’d Build
A breast unit does not begin at the breast unit door. It begins in a family doctor’s consulting room, sometimes years earlier, with a woman describing something she noticed in the shower and a doctor deciding, often within minutes, what that might mean.
By the time I meet her, important parts of her outcome have already been shaped by decisions made far upstream of the breast unit. Whether she was invited to screening and whether she came. Whether her family doctor had a referral pathway that actually worked, rather than one that existed on paper. How much time passed between suspicion and certainty.
Whether anyone explained what was happening in language she could actually use. Much of that pathway is almost invisible.
What happens once she reaches specialist care is not. That is the part that gets the conference lectures.
So, over the next eleven weeks, I am going to look at the entire breast cancer pathway, from the family doctor to survivorship, through the lens of value-based cancer care.
One station at a time.
- What do we put in?
- What does the patient get back?
Not only in euros. In time. Workforce. Expertise. Access. Travel. Anxiety. Morbidity. Trust. Toxicity and, at the end, in outcomes that matter to patients.
Last year, while working on our Systematic review of the cost-effectiveness of breast cancer screening across European countries, I found myself thinking increasingly about cancer care in these terms: not simply what an intervention costs, but what value it creates and for whom.
Some parts of the pathway require substantial investment. Others require almost none, yet may create disproportionate value. That is the finding. I would like to argue this in outcomes and numbers rather than ribbons.
We will arrive in October, when everyone else begins talking. I would like to arrive having already said something. By the end, I would like to have described the unit I would build, station by station, and what I would pay for first.
First station, Wednesday: The family doctor. In many ways the most important breast specialist in the country.
Disclosure: The knowledge, perspective, thinking, and final voice are mine: GPT just created the image.”
This also can be interesting: Breast Cancer in 2026: Molecular Interception, MRD, ADC Sequencing and De-Escalation
