Multidisciplinary decisions in breast cancer: does the patient receive what the team has recommended?

Abstract

Background:A multidisciplinary team (MDT) approach to breast cancer management is the gold standard. The aim is to evaluate MDT decision making in a modern breast unit.Methods:All referrals to the breast MDT where breast cancer was diagnosed from 1 July 2009 to 30 June 2011 were included. Multidisciplinary team decisions were compared with subsequent patient management and classified as concordant or discordant.Results:Over the study period, there were 3230 MDT decisions relating to 705 patients. Overall, 91.5% (2956 out of 3230) of decisions were concordant, 4.5% (146 out of 3230), were discordant and 4% (128 out of 3230) had no MDT decision. Of 146 discordant decisions, 26 (17.8%) were considered ‘unjustifiable' as there was no additional information available after the MDT to account for the change in management. The remaining 120 discordant MDT decisions were considered ‘justifiable', as management was altered due to patient choice (n=61), additional information available after MDT (n=54) or MDT error (n=5).Conclusion:The vast majority of MDT decisions are implemented. Management alteration was most often due to patient choice or additional information available after the MDT. A minority of management alterations were ‘unjustifiable' and the authors recommend that any patient whose treatment is subsequently changed should have MDT rediscussion prior to treatment.

“You don't know what's wrong with you”: an exploration of cancer‐related experiences in people with an intellectual disability

“…Caregivers' burden was compounded by the reliance on them as experts by health care professionals. It is well accepted that multidisciplinary working and family involvement are positive features in health care, but many caregivers in our sample would have benefitted from being supported themselves. Caring for carers in this way is known to have consequential positive effects, for example, by enabling them to feel better able to support the patient .…”

Bayesian prediction of lung and breast cancer mortality among women in Spain (2014–2020)

“…Since the 1980s there have been continuous advancements in treatment, such as the use of adjuvant therapy to reduce the risk of BC recurrence [31], new chemotherapy drugs to slow cancer growth [32], and the introduction of sentinel-lymphnode biopsy to assess BC spread [33]. Currently, clinicians approach this disease with a rapidly evolving multidisciplinary treatment [34]. BC screening is the second key factor to explain the decrease in BC mortality.…”

Caring for cancer patients with an intellectual disability: Attitudes and care perceptions of UK oncology nurses

“…Multi-disciplinary team (MDT) working is common within both cancer (Rajan et al, 2013) Many sources of inter-professional support would only be applicable in certain circumstances, 284 for instance, making contact with a social worker would only be appropriate if the patient was already 285 known to them, or had circumstances whereby their input would be necessary. Nineteen participants 286 in this study (22.9%) were either unsure of where to seek specific advice, or did not answer this 287 question at all; a small proportion of participants indicated that they would contact a mental health 288 team.…”