A Multidisciplinary Breast Cancer Clinic Improves Time to Treatment at an Urban, Safety Net Hospital

Socioeconomically vulnerable patients experience significant breast cancer care treatment disparities. Our aim was to examine how multidisciplinary breast cancer clinic (MBCC) implementation affected time to treatment at a safety net hospital.

This was a retrospective cohort study of female patients (≥18 years) with new breast cancer diagnoses from January 2019-September 2022. Time to treatment from biopsy-confirmed diagnosis was compared between patients seen in MBCC and those in a traditional discipline-based serial episodic clinic model.

Among 734 patients (mean age 58.5 years), 45.8% identified as Black and 48.4% were insured by Medicaid. MBCC patients (28.9%) were younger (55.7 vs. 59.6 years, P<0.001), less likely to be Hispanic (18.4% vs. 27.6%, P=0.01), more likely to have invasive cancer (86.8% vs. 60.3%, P<0.001), had shorter time to treatment (35.0 vs. 46.9 days, P<0.001), and were more likely to receive chemotherapy first (48.6% vs. 11.5%, P<0.001) compared to non-MBCC patients. In patients who received chemotherapy first, MBCC was associated with reduced time to initial appointment (10.2 vs. 18.1 days, P=0.011) and treatment initiation (27.1 vs. 42.6 days, P<0.001). Multivariable analysis showed invasive histology was associated with MBCC participation (OR 4.29, P<0.0001), while Hispanic ethnicity (OR 0.55, P=0.014) and older age (OR 0.98, P=0.021) were less associated with MBCC.

Implementation of a MBCC in a safety net hospital improved time to initial breast cancer treatment for vulnerable patients. Moving forward, MBCC can serve as a model to reduce disparities in vulnerable patient populations.