Multidisciplinary Breast Conference Improves Patient Management and Treatment

Abstract

Introduction: Few published studies have focused on the benefits of a multidisciplinary breast tumor board and its ability to impact patient management. A multidisciplinary breast conference that discusses the different clinicopathological aspects of the disease creates a sound, complete and unique treatment plan for each patient. The aim of this study is to highlight the role of weekly breast tumor boards in patient management and treatment modifications. Methods: From June 2010 to June 2011, 242 patients (Stage 0 to Stage 4 breast cancer) were prospectively presented before a multidiciplinary team at Saint Barnabas Medical Center (SBMC), beginning with clinical presentation, imaging and diagnosis followed by a prospective treatment plan formulated by the presenting physician. Following surgery, adjuvant treatment relevant to each patient was discussed. Due to SBMC's multiple campuses, each breast conference was performed via teleconference, which included video projection of pathology slides and images. Finally, feedback evaluations were distributed, completed and returned to the Tumor Registry for consistent weekly improvement of breast conference. Results: 102 patients (42%) had modified management after being presented at breast conference, of which 38% (n=39) were strictly surgical, 33% (n=34) medical treatment (chemotherapy/endocrine therapy), 17% (n=17) radiation, 6% (n=6) had changes to both medical and radiation treatment and 6% (n=6) resulted in imaging changes. Majority of changes were made to patients with Stage IA (27%) followed by patients with Stage 0 (21%) breast cancer. Conclusion: Breast conference has a significant impact on breast cancer patient management and treatment. Consultative discussion of each case permits each member of the breast cancer team to contribute to the development of the patient's treatment plan. This gives all physicians an opportunity to be aware of the patient's condition, background information as well as projected treatment plan, keeping a harmonious and cooperative breast cancer team along with best treatment option to the patient.