The influence of multidisciplinary team on adjuvant chemotherapy for postoperative breast cancer patients / 中华内分泌外科杂志

ABSTRACT

Objective To investigate the influence of multidisciplinary team (MDT) model on decisionmaking of adjuvant chemotherapy for breast cancer and analyze relevant influencing factors.Methods The patients with invasive breast cancer who underwent surgery and MDT discussion for adjuvant treatment in Shaoxing People's Hospital,from May 2016 to May 2018,were retrospectively analyzed.The patient's clinicopathological characteristics and postoperative adjuvant treatment and MDT records were obtained.Here the chemotherapy decision alternation was defined as disagreement in chemotherapy or not,or inconsistence in regiments between the attending doctor and multidisciplinary team.Results A total of 385 patients were enrolled in the multidisciplinary discussion and 327 patients (327/385,84.9％) were suggested to receive chemotherapy.Differences between attending doctor's recommendation and MDT panel's decision were found in 23 (23/385,6％) patients,of whom 15 patients (15/23,65.2％) were escalated adjuvant treatment and 8 patients (8/23,34.8％) were de-escalated adjuvant treatment.The relevant pathological indicators affecting the change of chemotherapy decision-making included the Ki67 expression index in the intermediate state of 15％ to 30％,the low expression of ER/PR and the small tumor of T1a.Conclusion MDT can influence the decision of adjuvant chemotherapy for breast cancer surgery,and can be promoted in grassroots hospitals at all levels.