To provide feedback to clinicians on breast cancer cases at the beginning of the patients’ journey
Data was collated for patients discussed at fortnightly breast cancer multidisciplinary meetings (MDM) between 01/07/2016 and 30/06/2017. Clinicians’ referral forms, patients’ histopathology results, meeting recommendations, and documentation in the oncology information system (OIS) were used to source data.
278 cases were discussed: 29 patients presented with disease progression or recurrence; 8 had a benign lesion; a diagnosis of an unknown primary was deemed not to be breast cancer; and 240 patients with a newly diagnosed breast cancer were presented. An additional 24 patients were referred to the MDM but not discussed.
Referral forms for newly diagnosed patients indicated: 3 were males; the mean age of all at diagnosis was 62 years (median 63, range 25 to 93 years). Symptomatic / self-detected accounted for 53% (n127) of presentations, with 28% (n68) being diagnosed by Breast Screen.
Histopathology revealed 81.25% (n195) to be ductal carcinomas; with 10% (n24) of all cases being in situ cancers. Three patients had bi-lateral cancers; 22 were triple negative and 27 HER2 positive. With the exception of one, who declined treatment, all HER2 positive cases had Trastuzumab included in their neo and/or adjuvant chemotherapy protocol.
Using MDM summaries and OIS records, staging was extrapolated for all newly diagnosed cases; with stage IA (n91) and IIA (n56) accounting for 60% of cases. Wide local excision was the initial surgery for 68.3% (n164); unilateral mastectomy the surgical intervention for 58, bilateral mastectomy for 9; and sentinel lymph node biopsies were performed on 72.5% (n174) of cases.
MDM data is a rich contemporaneous source of data that can be used to identify eligible patients for inclusion in clinical trials, genetic consultation; and evaluation of adherence to MDM recommendations.