Changes in surgical management resulting from case review at a breast cancer multidisciplinary tumor board

Changes in surgical management resulting from case review at a breast cancer multidisciplinary tumor board

BACKGROUND The treatment of breast cancer requires a multidisciplinary approach, and patients are often referred to a multidisciplinary cancer clinic. The purpose of the current study was to evaluate the impact of this approach on the surgical management of breast cancer. METHODS The medical records...

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Bibliographic Details
Published in:Cancer Vol. 107; no. 10; pp. 2346 - 2351
Main Authors: Newman, Erika A., Guest, Amy B., Helvie, Mark A., Roubidoux, Marilyn A, Chang, Alfred E., Kleer, Celina G., Diehl, Kathleen M., Cimmino, Vincent M., Pierce, Lori, Hayes, Daniel, Newman, Lisa A., Sabel, Michael S.
Format: Journal Article
Language:English
Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15-11-2006
Wiley-Liss
Subjects:
Biological and medical sciences
breast conservation
breast neoplasms
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Breast Neoplasms - therapy
Carcinoma - diagnostic imaging
Carcinoma - pathology
Carcinoma - surgery
Carcinoma - therapy
consultation
Gynecology. Andrology. Obstetrics
Health Planning Guidelines
Humans
Interdisciplinary Communication
Mammary gland diseases
mastectomy
Medical sciences
multidisciplinary
Organizational Innovation
Radiography
referral
Retrospective Studies
Specialty Boards - organization & administration
Tumors
Managed care
Breast tumor
breast neoplasms
Conservation
breast conservation
Breast cancer
Malignant tumor
Mammary gland diseases
Cancerology
Treatment
referral
Surgery
Consultation
Mastectomy
Mammary gland
Multidisciplinary
Bibliographic review
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Summary:BACKGROUND The treatment of breast cancer requires a multidisciplinary approach, and patients are often referred to a multidisciplinary cancer clinic. The purpose of the current study was to evaluate the impact of this approach on the surgical management of breast cancer. METHODS The medical records of 149 consecutive patients referred to a multidisciplinary breast cancer clinic over a 1‐year period with a diagnosis of breast cancer were reviewed retrospectively for alterations in radiologic, pathologic, surgical, and medical interpretations and the effect that these alterations had on recommendations for surgical management. RESULTS A review of the imaging studies resulted in changes in interpretations in 67 of the 149 patients studied (45%). This resulted in a change in surgical management in 11% of patients. Review of the pathology resulted in changes in the interpretation for 43 of the 149 patients (29%). Thirteen patients (9%) had surgical management changes made solely as a result of pathologic reinterpretation. In 51 patients (34%), a change in surgical management was recommended after discussion with the surgeons, medical oncologists, and radiation oncologists that was not based on reinterpretation of the radiologic or pathologic findings. Overall, a second evaluation of patients referred to a multidisciplinary tumor board led to changes in the recommendations for surgical management in 77 of 149 of those patients studied (52%). CONCLUSIONS The changes in management stemmed from differences in mammographic interpretation, pathologic interpretation, and evaluation by medical and radiation oncologists and surgical breast specialists. Multidisciplinary review can provide patients with useful additional information when making difficult treatment decisions. Cancer 2006. © 2006 American Cancer Society. The treatment of breast cancer requires a multidisciplinary approach, and patients are often referred to a multidisciplinary cancer clinic. The purpose of this study was to evaluate the impact of this approach on the surgical management of patients with breast cancer.
Bibliography:Fax: (734) 647‐9647
ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.22266