Does Multidisciplinary Clinic Impact Rates of Breast Conserving Therapy?

Previous studies have identified factors associated with higher rates of breast conservation therapy (BCT), but the impact of multidisciplinary clinic (MDC) has not been documented. We hypothesized that patients who underwent MDC consultation with both surgical and radiation oncologists would have increased BCT rates compared with patients seeing providers separately.

A retrospective chart review was conducted in patients diagnosed with stage 0-III breast cancer in 2023 who were offered BCT. Patients were separated into four cohorts on the basis of initial clinical consultation: (1) three-provider MDC with Breast Surgical Oncology (BSO), Medical Oncology (MO), Radiation Oncology (RO); (2) BSO+RO in MDC; (3) BSO+MO in MDC; and (4) BSO only. Wilcoxon Rank Sum tests and Chi-Square or Fisher's Exact tests were used to compare clinicopathologic factors and the primary outcome of interest (BCT versus mastectomy) between cohorts with p < 0.05 considered statistically significant.

The type of initial consultation was significantly associated with differing BCT rates (p = 0.015). Specifically, BCT was highest for patients participating in three-provider MDC (BCT rate 89%), and BSO+RO in MDC (BCT rate 86%). In contrast, BCT was lower when patients did not see RO in MDC, including patients seen by both BSO+MO in MDC (BCT rate 78%) and BSO alone (BCT rate 77%).

Our study confirms that MDC consultations that include RO are associated with higher BCT rates. Broader implementation of MDC with RO alongside BSO may support BCT acceptance in eligible patients through more effective patient education and shared decision-making.