Background:Breast cancer is the most common female cancer in Italy. Despite better survival rates, significant disparities in access to diagnosis, treatment, and follow-up persist across regions. We propose an integrated, multidisciplinary care model—the Breast Immunology Network (BIN)—to address these challenges.Methods:The model was developed through a two-phase expert consultation with key opinion leaders and stakeholders, aligned with national and European oncology guidelines. No new patient data were collected; this is a qualitative analysis based on expert consensus and existing literature. The proposed model integrates a Hub-and-Spoke cancer network structure with fully functioning multidisciplinary teams (MDTs), standardized care pathways (PDTA), and digital tools to ensure continuity of care.Results:Experts identified critical gaps in Italy’s breast cancer care: limited access to specialized centers, inconsistent adherence to screening programs, and delays in treatment initiation. The proposed BIN model aims to bridge these gaps by enhancing collaboration across all care levels, incorporating immunotherapy where appropriate, and defining key performance indicators (KPIs) for continuous quality evaluation. For example, quantitative targets include achieving ≥65% nationwide mammography screening adherence and ensuring ≥90% of patients are treated in certified Breast Units.Conclusions:The Breast Immunology Network offers a strategic framework to improve equity, quality, and timeliness of breast cancer care in Italy. Importantly, unlike existing Hub–Spoke or CCCN models, the BIN formalizes governance tools, harmonized eligibility criteria, and a national registry for immunotherapy. By uniting Breast Units and community services under shared governance, and by integrating innovations such as immunotherapy and telemedicine, the BIN model could significantly improve clinical outcomes and ensure more equitable care for all patients. Its implementation may serve as a reference model for other health systems seeking to optimize oncology pathways through multidisciplinary integration and advanced treatments.
背景：乳腺癌是意大利最常见的女性恶性肿瘤。尽管生存率有所提高，但不同地区在诊断、治疗和随访的可及性方面仍存在显著差异。为此，我们提出一种整合性、多学科协作的照护模式——乳腺免疫学网络（BIN），以应对这些挑战。 方法：该模式通过两轮专家咨询，汇集关键意见领袖和利益相关者的共识，并参考意大利及欧洲肿瘤学指南制定而成。本研究未收集新的患者数据，是基于专家共识和现有文献的定性分析。所提出的模式将“中心-辐射”式癌症网络结构与功能完善的多学科团队（MDT）、标准化诊疗路径（PDTA）以及数字化工具相结合，以确保照护的连续性。 结果：专家们识别出意大利乳腺癌照护中的关键不足：专科中心可及性有限、筛查项目依从性参差不齐以及治疗启动延迟。拟议的BIN模式旨在通过加强各级照护间的协作、在适宜情况下纳入免疫治疗，并设定用于持续质量评估的关键绩效指标（KPI）来弥合这些差距。例如，量化目标包括实现全国乳腺X线筛查依从率≥65%，并确保≥90%的患者在认证的乳腺中心接受治疗。 结论：乳腺免疫学网络为提升意大利乳腺癌照护的公平性、质量和及时性提供了一个战略性框架。重要的是，与现有的“中心-辐射”或综合癌症中心网络模式不同，BIN模式正式确立了治理工具、统一的资格标准以及全国性的免疫治疗登记系统。通过将乳腺中心与社区服务在共同治理下联合起来，并整合免疫治疗和远程医疗等创新手段，BIN模式有望显著改善临床结局，并确保为所有患者提供更公平的照护。其实施可为其他寻求通过多学科整合和先进治疗优化肿瘤诊疗路径的卫生系统提供参考模型。
肿瘤(癌症)患者之家