Ensuring access to multidisciplinary care in advanced breast cancer: a global expert review and call-to-action for...

Despite remarkable advances in the management of advanced breast cancer (ABC), profound disparities persist in outcomes and access to quality care globally. A multidisciplinary approach, where specialists collaborate on diagnosis, treatment planning, care continuity, and timely referrals, is widely recognized as the gold standard in ABC management and has been shown to lead to more accurate diagnoses, individualized treatment plans, and improved patient outcomes. Depending on the healthcare system, a multidisciplinary team (MDT) may include a medical oncologist, a radiation/clinical oncologist, radiologist, pathologist, surgeon, specialist nurse, allied healthcare professionals, and administrative staff. A multidisciplinary approach to ABC care is recommended by international guidelines and endorsed by leading bodies such as the European Society of Breast Cancer Specialists (EUSOMA). This manuscript explores the current multidisciplinary care landscape in ABC, highlighting progress made, persistent challenges, and future directions. It summarizes research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) New EUSOMA quality indicators set benchmarks for multidisciplinary ABC care; b) Most national guidelines now recommend multidisciplinary care for ABC; c) Surveys reveal uneven multidisciplinary team access, notably in low-income settings; d) Telemedicine and virtual MDTs expand access to ABC expertise; e) Palliative care remains poorly integrated in many MDTs globally. The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025-2035, aiming at improving the lives of people living with ABC worldwide.