[Qualitative assessment of the multidisciplinary tumor board in breast cancer]

The optimal care for breast cancers requires at a given time that several practitioners meet regularly around the file of the patient and attend a multidisciplinary meeting (MDM). Such an initiative is not recent. The multidisciplinary approach has been applied for several years in numerous comprehensive cancer centres, and noteworthy but not exclusively in the 20 regional cancer centres. Recommendations on the organization of the MDM were published by the National Institute of the Cancer and relieved by each regional cancer networks according to the Cancer Plan of 2003. Beyond these general recommendations, the purpose of this work was to analyse the impact of the MDM on the appraisal of the professional practices. Two retrospective surveys were carried out in 2005 and in 2006 at the regional cancer centre of Reims each of them during the first 6 months of the year. They lead to a double evaluation at the same moment of the organization of the MDM (delays, exhaustiveness of the file presentation, multidisciplinary approach, and modalities of application of the clinical recommendations by the MDM). The authors suggest, from the observed results, that MDM in breast cancer research may be strongly adapted for a fine and relevant assessment of the professional practices. The specific indicators presented in this study need further discussions and will probably evolve. However and considering the important improvement observed in the clinical daily practice following the presentation of these data within the Institute Jean Godinot, the authors suggest the implementation of a similar evaluation in a small number of voluntary health care centres in order to share various experiences and validate the process.