Consensus on contentious issues relevant for breast cancer management for the Indian scenario: Statements following a multicentre expert group meeting

Management of breast cancer is multidisciplinary requiring critical analysis of emerging evidence especially with its appropriateness to local practice. A high level expert committee meeting was held to arrive at a consensus on controversial practical breast cancer management policies for Indian patients. Indian experts (n=39) from government and private centres who were part of the breast cancer multidisciplinary group, participated in the consensus meeting. A set of controversial yet practical questions were circulated among the experts at least two weeks in advance of the consensus meeting. International experts from the UK (n=6) also participated in the scientific discussions to add further light on the topics. The experts voted on the practical acceptable management policy for India. Consensus was defined as overwhelming (90-100% concurrence in voting), moderate (70-89% concurrence), low (50-70% concurrence) and non-consensus (<50% concurrence). Fifty eight questions based on pragmatic management strategies were framed and circulated to 39 participants. An overwhelming consensus was received in 51 of the 58 questions. The group considered the available evidence with a view for its practical applicability in Indian patients. This consensus document may aid in shaping breast cancer care for the breast oncology practitioners as well as the policymakers in the country.