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Multidisciplinary care

Background

Multidisciplinary care is a team approach to the provision of breast cancer care by all relevant medical and allied health disciplines. 

BCNA believes that a multidisciplinary approach leads to the best outcomes in breast cancer. Multidisciplinary care was recommended in 1995 by a House of Representatives inquiry as a means of achieving best practice, and has since been shown to improve quality of life and lead to improved survival rates for women with breast cancer.  
Where appropriate, every woman should be treated in line with the principles of a multidisciplinary approach to her breast cancer treatment.

BCNA’s Position Statement

BCNA’s position expands on and is informed by the principles of multidisciplinary care, developed by the National Multidisciplinary Care Demonstration Project 2003.

Team

  • The multidisciplinary team should include input from as many professions as required for each individual woman. The team should include a surgeon, medical oncologist, radiation oncologist, pathologist, radiologist and breast care nurse (or suitably qualified nursing professional should a breast care nurse not be available).  It should also include at least one person with psychosocial skills and expertise.
  • Membership of the team must necessarily be flexible and evolving, to reflect the woman’s care needs.  The team may be expanded or contracted to include services such as genetics, psychiatry, physiotherapy, gynaecology, plastic surgery, nuclear medicine and others where necessary.
  • Ideally, a woman’s GP should be a member of the MDT. At a minimum there should be effective, meaningful communication between the team and the GP.   
  • Women should be given written information about the members of their multidisciplinary breast cancer team.

Communication

  • Ongoing, timely information and communication should be facilitated among all team members, including the woman and her nominated caregivers.
  • Discussions that take place between team members regarding a woman’s care should be documented.
  • A member of the MDT should be nominated to communicate the team’s meeting outcomes with the woman.
  • Ideally MDT members should meet to discuss a woman’s care before her surgery and again before adjuvant treatment commences.

Standards of Care

  • All clinicians involved in the management of women with breast cancer should practice in accordance with nationally agreed standards that are consistent with national evidence-based recommendations and benchmarks.
  • The treatment plan developed for the woman should be acceptable to her, and consider her individual circumstances and wishes.

The woman’s involvement in multidisciplinary care

  • Every woman should be given the option to participate in decisions about her treatment plan if she wishes.
  • Women should be aware of the ongoing collaboration and communication between members of the multidisciplinary team about their treatment, and feel that their care is coordinated and not fragmented.

Access Issues

Geographical remoteness and/or small size of the hospital or institution delivering a woman’s treatment should not be impediments to the delivery of multidisciplinary care for women with breast cancer.  BCNA encourages the use of teleconferencing and other technology to assist communication where team members cannot be in the same geographical location at the same time.

Secondary Breast Cancer

Multidisciplinary care remains important for women with secondary breast cancer. Secondary breast cancer multidisciplinary team members may differ, but the principles of multidisciplinary care (coordination and communication between professionals) remain.  BCNA believes all women with secondary breast cancer should have access to the multidisciplinary team approach.