Taking the pulse of multidisciplinary cancer conferences for breast cancer care in Canada: A stocktake of current practice

Breast. 2019 Apr;44:101-107. doi: 10.1016/j.breast.2019.01.007. Epub 2019 Jan 25.

Abstract

Aim: International guidelines highlight the importance of implementation supports and quality monitoring of multidisciplinary care for breast cancer. In Canada, Ontario has standards for formal multidisciplinary cancer conferences (MCCs), but other provinces/territories do not. This study aimed to stocktake MCCs for breast cancer in Canadian sites participating in the RUBY cohort study (Reducing the Burden of Breast Cancer in Young Women) to better understand variations in multidisciplinary care across Canada and to add to the international literature.

Methods: A cross-sectional survey was conducted with surgeons and surgical oncologists representing 34 clinical centres participating in RUBY. Questions were grouped according to: type of multidisciplinary care, implementation, function, practice, participation and presentation, operation, and demographics, and included a mix of Likert-based, tick box and open-ended questions.

Results: Twenty-two responses (65%) were received. 91% of respondents reported that formal MCCs are part of regular practice. However, variation exists in the supports in place for ongoing implementation of MCCs, the understanding of the functions of MCCs, and the patients presented for discussion. Results also suggest less formalized processes for MCC in provinces without practice standards.

Conclusions: Response differences between Ontario and elsewhere suggest that standards for MCC and supports for their implementation make a positive difference in their operation. However, ongoing operational challenges and issues with attendance exist for all sites and suggest that along with development of practice standards, incentives for participation and further education on benefits and function of MCC may support uptake of MCCs in clinical practice.

Keywords: Breast neoplasm; Canada; Cross-sectional study; Inter-professional relations; Multidisciplinary care; Neoplasm/diagnosis; Neoplasm/therapy; Patient care team; Quality improvement; Young women.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Clinical Decision-Making*
  • Congresses as Topic*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Information Dissemination
  • Interprofessional Relations*
  • Ontario
  • Patient Care Team
  • Practice Patterns, Physicians' / standards*