Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Multi-disciplinary team meetings and its influence on breast cancer management in a tertiary hospital in Sydney, NSW (#258)

Jesmin Shafiq 1 , Sara Kim 2 , Kirsten Duggan 3 , Sandra Avery 4 , Nasreen Kaadan 3 , Shalini Vinod 1
  1. Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool hospital, Liverpool, NSW, Australia
  2. MD program, UNSW Sydney, Sydney, NSW, Australia
  3. SWSLHD Clinical Cancer Registry, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, NSW, Australia
  4. SWSLHD Cancer Services, Liverpool Hospital, Liverpool, NSW, Australia

Aims

Multi-disciplinary team meetings (MDMs) are an integral part of modern oncology care. There are limited data on the translation of MDM recommendations into clinical practice in Australia. This study is part of a larger project evaluating MDMs for selected cancer sites in South-West Sydney. The aims were: to identify Breast Cancer MDM recommendations at the Liverpool cancer Therapy Centre, to evaluate their subsequent implementation and explore the reasons for discrepancies between MDM recommendations and suggested management.

 

Methods

Retrospective audit of patient records within the oncology information system (MOSAIQ) and hospital electronic medical records was conducted for the Liverpool Breast Cancer MDMs held during the period 1/02/2017-30/07/2017.  Key data variables including patient demographics, tumour characteristics and treatment details were examined. Univariate and multivariate logistic regression analyses were done to assess the influencing factors impacting translation of MDM recommendations into clinical practice.

 

Results

During the study period, 154 MDMs were conducted for 130 breast cancer patients diagnosed at various stages. The median age was 61 years, 98% were females and majority had stage I-II disease (N=83,63%). Eighty-four percent (N=109) of patients were discussed once, the remaining twice (N=18,14%) or three times (N=3,2%).   MDM presentation was at first diagnosis for 79% (N=103), 18% patients (N=19) were discussed prior to any treatment, 82% (N=84) following surgery. Active treatment was recommended in 89% of patients (N=116), management was concordant with MDM recommendations in 86% (N=112). The most common reason for non-concordance (N=18) was patient decision (44%). No significant (p>0.05) factors were identified that influenced the concordance rate.

 

Conclusions

The snapshot of the breast cancer MDMs in our study reflects a high rate of translation of MDM recommendations into clinical practice highlighting the utility of these meetings. Follow-up over a longer time-frame is required to evaluate the effect of concordant management on patient outcomes.