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OVERVIEW

The European Institute of Oncology (Istituto Europeo di Oncologia, IEO) is an independent, non-profit foundation for cancer research and treatment. Its purpose-built premises, located on the southern edge of Milan, were formally inaugurated in 1994. However, the IEO was founded a few years earlier, and its first department – epidemiology and biostatistics – started work in 1991. Funding came from a group of sponsors and philanthropists led by investment bank, Mediobanca.

The IEO is the brainchild of Umberto Veronesi, who envisaged it as a top international cancer centre driven by his philosophical approach to oncology. At a treatment level this was seen as promoting the use of multidisciplinary approaches to provide effective, patient-centred treatment while minimising harms. At a research level it meant putting a strong emphasis on prevention, understanding risk factors and early detection.

The concept of a European institute had also evolved from the European School of Oncology, which had been founded in Milan by Umberto Veronesi and Alberto Costa, in 1982.

Despite its independent status, which safeguarded a large measure of control over its own policies and practices, the IEO is integrated within Italy's public health, research and education systems. In 1996 it was designated by the Italy's ministry of health in the Scientific Institute for Research Hospitalisation and Healthcare Research (IRCCS) network, and gained accreditation from the national health system, enabling it to treat patients in the public sphere.

The IEO has made important contributions to breast cancer, building on the earlier work done by Umberto Veronesi, who had developed and trialled the breast conserving surgical technique of quadrantectomy.

It was one of the first centres in the world to set up a nuclear medicine department, which worked closely with breast surgery, radiology and pathology to develop and trial the use of sentinel lymph node biopsy (SLNB) and radioguided occult lesion localisation (ROLL), both aimed at minimising surgical intervention.

The IEO was among the first in Europe to integrate plastic surgery into standard breast cancer care and played a role in developing new techniques. It developed and trialled a technique for intraoperative radiotherapy (IORT) to reduce toxicity and avoid the disruption and travel burden that can be involved with a lengthy course of adjuvant radiotherapy.

A fertility and procreation in oncology unit was set up in 2011 to provide specialised care for women treated for cancer while pregnant or wishing to preserve their fertility. The IEO also brought together all aspects of prevention, diagnosis, treatment, and holistic care for women's cancers within a women's cancer centre, and introduced Europe's first day surgery service for breast cancer.

Early detection of lung cancer is another area where the IEO has made important contributions. In the early 2000s, researchers were at the forefront of developing low-dose CT lung screening protocols that helped change the risk‒benefit picture for screening programmes.

As it was established at a time when cancer research was being transformed by progress in molecular biology and imaging techniques, the vision for the IEO was also to carry out translational research. Ultimately, the commitment to carry out basic research under the same roof as the clinical work became unsustainable. However, in its early years, it made important contributions, particularly in chemoprevention.

Umberto Veronesi was scientific director of the IEO from its foundation until 2014, when the post was taken on by Roberto Orecchia.

See the history of the European Institute of Oncology and IEO: 25 years of the fight against cancer.