Elsevier

The Breast

Volume 53, October 2020, Pages 68-76
The Breast

Original article
Effect of multidisciplinary team care on the risk of recurrence in breast cancer patients: A national matched cohort study

https://doi.org/10.1016/j.breast.2020.07.001Get rights and content
Under a Creative Commons license
open access

Highlights

  • MDT care was associated with a reduced mortality of patients with breast cancer.

  • MDT care was associated with a reduced recurrence of breast cancer.

  • MDT care should be implemented in treating breast cancer patients.

Abstract

Background

Cancer has been the leading cause of death in the past decade in Taiwan, with breast cancer being the most common type of cancer in females. Very few studies looked at the risk of recurrence in patients who received multidisciplinary team (MDT) care. We analyzed the influence of MDT on the risk of recurrence and death in breast cancer patients.

Method

In this retrospective study, we included newly diagnosed patients from 2004 to 2010. The study included 9,266 breast cancer patients who were enrolled in MDT care and 9,266 patients who were not. The study used log-rank test to analyze patients’ characteristics, hospital characteristics, cancer staging, and treatment methods to compare the recurrence rates in MDT care and non-MDT care participants. We used Cox proportional hazards model to examine the effect of MDT and associated factors on the risk of recurrence and mortality of breast cancer patients.

Results

Relative risk of recurrence was lower for patients who received MDT care than for patients who did not (HR, 0.84; 95%CI: 0.70–0.99) after matching. The mortality risk for breast cancer patients with relapse was 8.48 times (95%CI: 7.53–9.54) than that for patients without relapse.

Conclusions

The relative risk of recurrence and death was significantly lower for breast cancer patients who received MDT care than for those who did not. We suggest that MDT care be implanted in the National Health Policy settings of breast cancer patients.

Keywords

Breast cancer
Multidisciplinary team care
Recurrence

Abbreviations

ICD
International Classification of Disease
MDT
Multidisciplinary Team
NHI
National Health Insurance
NHIRD
National Health Insurance Research Database
TCR
Taiwan Cancer Registry
TCRD
Taiwan Cancer Registry Database
CCI
Charlson Comorbidity Index
CI
confidence interval
KM
Kaplan-Meier
HR
hazard ratio

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1

Authors had equal contributions to this work.