Breast Cancer Multi-Disciplinary Team Meetings in a Resource-Constrained System: Are Patients Receiving the Treatment Recommended?

BACKGROUND

Globally, breast cancer is a sentinel health crisis, with 2.3 million new cases annually. In comparison with HICs, the stage of presentation in LMICs is higher, with a greater number of deaths occurring due to metastatic disease. A call for action with a global strategy for breast cancer is required, with an increasing role of the multidisciplinary team meeting (MDT). Its (the MDT's) use in resource-constrained systems is not well established. This study aimed to evaluate the outcomes of MDT decisions and determine the concordance of treatment recommendations and those received by the patient. Additionally, concordance across disease stages was assessed.

METHODS

Retrospective data of all adult patients newly diagnosed with breast cancer and discussed at the MDT between 01 July 2021 and 30 June 2022 were collected. Patients with recurrent breast cancer, those primarily referred for palliative care, and patients with incomplete data (treatment received "Нет данных") were excluded. The decision made by the MDT and the primary treatment received by the patients were assessed to determine concordance. Rates of concordance and stage of disease were calculated using contingency tables. Descriptive statistics were computed to describe continuous and categorical data.

RESULTS

A total of 556 patients were included in the analyses. Most patients (88%) received primary treatment aligned with the MDT's recommendations. The highest level of concordance was seen in those with early breast cancer who were recommended to have primary surgery (94%), and the lowest in those with metastatic disease.

CONCLUSIONS

Findings demonstrate that most breast cancer patients received the treatment recommended by the MDT. Reasons for discordance could be explored in future studies. We recommend that an MDT form part of breast patient care in South Africa (SA).