Affiliation:
1. Cabrini Health Melbourne Victoria Australia
2. Epworth Freemasons Hospital Melbourne Victoria Australia
3. Cabrini Institute Cabrini Health Melbourne Victoria Australia
4. Faculty of Medicine Nursing and Health Sciences Monash University Melbourne Victoria Australia
5. Peter MacCallum Cancer Centre Melbourne Victoria Australia
Abstract
AbstractAimsMultidisciplinary meetings (MDMs) play a crucial role in decision‐making in breast cancer patient care. This study aimed to firstly assess the impact of breast cancer MDMs in decision‐making for breast cancer patients and secondly to determine the concordance between MDM recommendations and implementation of clinical practice.MethodsPatient cases to be presented at the weekly breast cancer MDMs were identified and prospectively enrolled. Management plans were predicted by the treating surgeon with the pre‐MDM management plans then compared to MDM recommendations. Changes in decision‐making were assessed in the following domains: further surgery, systemic therapy (endocrine, chemotherapy or targeted), radiotherapy, enrolment in a clinical trial, further investigations, and referral to other specialists or services. Patient records were subsequently reviewed at 3 months post‐MDM to assess the rate of implementation of MDM recommendations and any reasons for discordance.ResultsOut of 50 cases, 66% (CI 53–79%; p < .005) experienced a change in management plan as a result of MDM discussion, with a total of 66 episodes of recorded change per decision‐making domain affecting the following: further surgery (7.6%), endocrine therapy (4.5%), chemotherapy (19.7%), targeted therapy (4.5%), radiotherapy (18.2%), enrolment for a clinical trial (12.1%), additional investigations (22.7%), and further referrals (10.6%). MDM recommendations were implemented in 83.7% of cases.ConclusionThe breast cancer MDMs were found to substantially impact on the management plans for breast cancer patients, with 83.7% of MDM recommendations being implemented into clinical practice. This study reinforces the importance of MDMs in the management of these patients, as well as highlighting the need for further investigating and addressing the potential barriers to the implementation of MDM recommendations.
Subject
Oncology,General Medicine