Certification of breast centres in Germany: proof of concept for a prototypical example of quality assurance in multidisciplinary cancer care

Breast centres introduced a QMS and voluntarily participated in an external certification procedure based on guideline-derived Requirements of Breast Centres specifically developed for the application procedure, all subsequent audits and recertification. All data (numbers of pending and successful applications, sites/centre, etc.) were collected by a newly founded, independent organisation for certification of cancer services delivery. Data analysis was descriptive.Requirements of Breast Centres were developed by the German Cancer Society (DKG), the German Society of Senology (DGS) and other relevant specialist medical societies in the form of a questionnaire comprising 185 essential items based on evidence-based guidelines and the European Society of Breast Cancer Specialists' (EUSOMA) requirements of specialist breast units. From late 2002 to mid 2008, the number of participating breast centres rose from 1 to 175. As of mid 2008, 77% of an estimated 50,000 new breast cancers in Germany were diagnosed and treated at certified breast centres, 78% of which were single-site centres.Nationwide voluntary certification of breast centres is feasible and well accepted in Germany. Dual certification of breast centres that involves certification of breast services to guideline-derived requirements in conjunction with independent certification of a mandatory QMS can serve as a model for other multidisciplinary site-specific cancer centres.Breast cancer, like many other malignancies, is regarded today as a systemic disease requiring multimodal, multidisciplinary treatment to achieve the best possible outcomes [1,2]. In recent years, the provision of evidence-based cancer care and the implementation and maintenance of quality assurance procedures have moved into the centre of attention as two key areas of modern multidisciplinary oncology [3].In this context, the quest for strategies to reduce breast cancer morbidity and mortality has focused on the setting required for the opt