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The paper examines the diffusion and implementation of breast units (BUs) in Italy as a paradigm of pathology units. Through a case study methodology, the article analyses both European and Italian requirements for the identification of BUs and conducts a comprehensive census of active BUs in Italy, by reconciling data from four distinct databases. The analysis reveals variations in requirements between the national and the European level, indicating a process of adaptation while adopting European guidelines and underscoring the complexity of harmonizing BUs identification criteria. Furthermore, the census of active BUs provides an estimate of the total number of BUs in Italy and assesses adherence to the recommended population coverage standard (one breast unit per approximately 250,000 inhabitants) at the regional level in Italy. Indeed, the analysis shows geographical disparities in the diffusion of BUs across Italian regions. Additionally, this study highlights the challenge deriving from the lack of a unified national database displaying the total number of active BUs in Italy, a limitation that extends to the European context. The paper ends by offering some insights for future research in this area, emphasizing the need for standardized data collection.