Follow-up of early breast cancer in a public health system: A 2024 AIGOM consensus project

•Breast cancer is the most diagnosed cancer and leading cause of cancer-related deaths among women worldwide, including Italy. Adherence to recommendations from scientific societies (such as ASCO, ESMO, AIOM) varies across different cancer centers, potentially resulting in unequal management and escalating costs.•AIGOM coordinated a consensus on early breast cancer using the Estimate-Talk-Estimate method and involving a multiprofessional, multidisciplinary panel of 54 experts: 85.1% expressed their degree of consensus on 38 statements.•The panel underscores the need for a risk-adapted surveillance strategy to enable early detection of recurrent breast cancer in high-risk patients, while considering de-intensification of follow-up in Iow-risk patients.•ln patients with advanced age, co-morbidities, Iow risk, the general practitioners should assume full responsibility for the patient’s follow-up.•The panel emphasizes cardiologic, osteometabolic, gynecologic surveillance, psycho-oncologic support psychosocial and rehabilitation programs as part of the follow up, encouraging also a protective lifestyle. Breast cancer stands as the most frequently diagnosed cancer and the primary cause of cancer-related mortality among women worldwide, including Italy. With the increasing number of survivors, many are enrolled in regular follow-up programs. However, adherence to recommendations from scientific societies (such as ASCO, ESMO, AIOM) for breast cancer follow-up management varies in daily clinical practice across different cancer centers, potentially resulting in unequal management and escalating costs. To address these concerns, the Italian Association of Multidisciplinary Oncology Groups (AIGOM) orchestrated a Consensus on early Breast Cancer follow-up utilizing the Estimate-Talk-Estimate methodology. Following the identification of 18 Items and 38 statements by a select Board, 46 out of 54 (85.1%) experts comprising a multidisciplinary and multiprofessional panel expressed their degree of consensus (Expert Panel). The Expert Panel underscores the potential for the multidisciplinary team to tailor follow-up intensity based on the individual risk of recurrence. In selected cases, the general practitioner may be recommended as the clinical lead for breast cancer follow-up, both after completion of adjuvant treatment and at early initiation of endocrine therapy in low-risk patients. Throughout follow-up, and alongside oncologic surveillance, the expert panel advises