Uptake of adjuvant breast cancer treatments recommended by multi‐disciplinary meetings

Pattanasri, Melinda; Elder, Kenneth; Nickson, Carolyn; Cooke, Samuel; Machalek, Dorothy A; Rose, Allison; Mou, Arlene; Collins, John P.; Park, Allan; Boer, Richard de; Phillips, Claire; Pridmore, Vicki; Farrugia, Helen; Mann, G Bruce

doi:10.1111/ans.14368

Cited by 7 publications

(7 citation statements)

References 12 publications

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“…A recent Australian study reported 82% compliance with adjuvant treatments recommended by multi-disciplinary clinics and 92% for chemotherapy recommendations. 37 Perhaps, the most surprising finding in this study is that although the screening participation rates for the three SES subsets were virtually identical (Table 1), significantly higher breast-cancer mortality rates were observed in women from middle and disadvantaged areas compared to those in affluent areas (Table 2). If any benefit from screening was due exclusively to mammography, it would be expected that with similar participation there would be similar mortality across SES groups.…”

Section: Discussionmentioning

confidence: 59%

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Breast-cancer mortality in screened versus unscreened women: Long-term results from a population-based study in Queensland, Australia

et al. 2020

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Objective In the context of a mature mammographic screening programme, the aim of this population-based study was to estimate rates of breast-cancer mortality among participants versus non-participants in Queensland, Australia. Methods The Queensland Electoral Roll was used to identify women aged 50–65 in the year 2000 (n = 269,198). Women with a prior history of invasive or in situ breast cancer were excluded (n = 6,848). The study population was then linked to mammography records from BreastScreen Queensland together with the Wesley Breast Screening Clinic (the largest provider of private screening in Queensland) to establish a screened cohort (n = 187,558) and an unscreened cohort (n = 74,792). Cohort members were matched and linked to cancer notifications and deaths through the state-based Queensland Oncology Repository. Differences in breast-cancer mortality between the two cohorts were measured using Cox proportional hazards regression. Results After 16 years of follow-up, women in the screened cohort showed a 39% reduction in breast-cancer mortality compared to the unscreened cohort (HR = 0.61, 95%CI = 0.55–0.68). Cumulative mortality over the same period was 0.47% and 0.77% in the screened and unscreened cohorts, respectively. Conclusions This study found a significant reduction in breast-cancer mortality for women who participated in mammographic screening compared to unscreened women. Our findings of a breast-cancer mortality benefit for women who have mammographic screening are in line with other observational studies.

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Section: Discussionmentioning

confidence: 59%

“…A recent Australian study reported 82% compliance with adjuvant treatments recommended by multi-disciplinary clinics and 92% for chemotherapy recommendations. 37…”

Section: Discussionmentioning

confidence: 99%

Breast-cancer mortality in screened versus unscreened women: Long-term results from a population-based study in Queensland, Australia

et al. 2020

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“…Comparisons of management concordance with MDM recommendations in the literature are complicated because of different study populations and use of methodologies (Table 5 ). Some studies measured only specific MDM recommendations such as adjuvant treatment for breast cancer [ 32 ] or radiotherapy for lung cancer [ 26 ] whilst others like ours recorded all decisions including biopsy, imaging, treatment, observation and supportive care [ 4 , 7 , 17 , 24 , 27 , 28 ]. Some studies excluded recommendations for investigations, supportive care or management of recurrent disease [ 23 ] whilst others included recommendations for clinical trials and genetics referrals [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…The commonest reason for non-concordant management was patient or guardian decision seen in 28.3% similar to the 31–36% reported in the other multiple MDM studies [ 19 , 20 ]. Patient choice is a common reason for non-concordant management in breast MDMs ranging from 42 to 71%, usually in relation to the acceptance of adjuvant therapy after surgery [ 21 , 30 , 32 ]. In other cancer MDMs patient decision is responsible for discordant management in 11–54% in lung cancer [ 7 , 24 , 25 ], 18–34% in upper gastrointestinal cancers [ 21 , 23 ], 44% in skin cancer [ 10 ], 45% in head and neck cancers [ 20 ], 33% in neurological tumours [ 20 ] and 14% in sarcomas [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Translation of oncology multidisciplinary team meeting (MDM) recommendations into clinical practice

Vinod

Wellege

Kim

et al. 2021

BMC Health Serv Res

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Background Multidisciplinary team meeting (MDM) processes differ according to clinical setting and tumour site. This can impact on decision making. This study aimed to evaluate the translation of MDM recommendations into clinical practice across solid tumour MDMs at an academic centre. Methods A retrospective audit of oncology records was performed for nine oncology MDMs held at Liverpool Hospital, NSW, Australia from 1/2/17–31/7/17. Information was collected on patient factors (age, gender, country of birth, language, postcode, performance status, comorbidities), tumour factors (diagnosis, stage) and MDM factors (number of MDMs, MDM recommendation). Management was audited up to a year post MDM to record management and identify reasons if discordant with MDM recommendations. Univariate and multivariable regression analyses were performed to assess for factors associated with concordant management. Results Eight hundred thirty-five patients were discussed, median age was 65 years and 51.4% were males. 70.8% of patients were presented at first diagnosis, 77% discussed once and treatment recommended in 73.2%. Of 771 patients assessable for concordance, management was fully concordant in 79.4%, partially concordant in 12.8% and discordant in 7.8%. Concordance varied from 84.5% for lung MDM to 97.6% for breast MDMs. On multivariable analysis, breast and upper GI MDMs and discussion at multiple MDMs were significantly associated with concordant management. The most common reason for discordant management was patient/guardian decision (28.3%). Conclusion There was variability in translation of MDM recommendations into clinical practice by tumour site. Routine measurement of implementation of MDM recommendations should be considered as a quality indicator of MDM practice.

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Moving beyond the stage: how characteristics at diagnosis dictate treatment and treatment-related quality of life year losses for women with early stage invasive breast cancer

Saxby

Nickson

Mann

et al. 2021

Expert Review of Pharmacoeconomics & Outcomes Research

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Uptake of adjuvant breast cancer treatments recommended by multi‐disciplinary meetings

Cited by 7 publications

References 12 publications

Breast-cancer mortality in screened versus unscreened women: Long-term results from a population-based study in Queensland, Australia

Breast-cancer mortality in screened versus unscreened women: Long-term results from a population-based study in Queensland, Australia

Translation of oncology multidisciplinary team meeting (MDM) recommendations into clinical practice

Moving beyond the stage: how characteristics at diagnosis dictate treatment and treatment-related quality of life year losses for women with early stage invasive breast cancer

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