Multidisciplinary Team Intervention: Catalysts for Changing Prognosis in Advanced Breast Cancer

Multidisciplinary team (MDT) discussions are standard in cancer care; however, their effect on advanced breast cancer (ABC) prognosis is not well-documented. This study examined the impact of MDT intervention on ABC patient survival.

A retrospective analysis of ABC patients diagnosed 2018 to 2021 was conducted by dividing them into MDT and non-MDT groups. Kaplan-Meier analysis was used to compare progression-free survival (PFS) and overall survival (OS) between the groups. Prognostic factors were evaluated using multivariate Cox regression analysis with subgroup analysis and 1:1 propensity score matching (PSM) to control for confounders.

Total 707 patients were included, with 72.8% (515/707) underwent MDT intervention. After a median follow-up of 43.73 months (interquartile range, 34.87-55.67 months), MDT intervention improved the median PFS (12.00 vs. 8.00 months; hazard ratio [HR], 0.75 [95% confidence interval {CI}, 0.63-0.89]; p = 0.001) and median OS (55.67 vs. 40.07 months; HR, 0.77 [95% CI, 0.61-0.97]; p = 0.030). Multivariate Cox analysis showed MDT as an independent factor for disease progression control (HR, 0.82 [95% CI, 0.68-0.98]; p = 0.041), but not for OS (HR, 0.88 [95% CI, 0.69-1.12]; p = 0.286). Subgroup analysis indicated that MDT benefited patients aged ≤ 39 years, those with disease status (de novo metastatic breast cancer), post-menopausal status, T4 stage, N3 stage, G3, visceral metastasis, > one organ metastasis and first-line systemic treatment, regardless of PFS or OS. After PSM, 172 matched patients were in the cohort. MDT still significantly controlled disease progression (12.00 vs. 8.00; HR, 0.74 [95% CI, 0.59-0.93]; p = 0.009) but did not significantly impact the OS (49.00 vs. 39.00; HR, 0.80 [95% CI, 0.59-1.08]; p = 0.121).

MDT effectively controlled the disease progression and improved OS in specific patient subgroups.