Macaskill E J, Thrush S, Walker E M, Dixon J M
Academic Office, Edinburgh Breast Unit, Western General Hospital, Edinburgh EH4 2XU, Scotland, UK.
Eur J Cancer. 2006 May;42(7):905-8. doi: 10.1016/j.ejca.2005.12.014. Epub 2006 Mar 3.
The aim of this study was to assess surgeons' views and their current commitments to multi-disciplinary breast meetings (MDMs). Two hundred and fifty questionnaires were sent out to registered members of the British Association of Surgical Oncology. Hundred and fifty-three were returned (reply rate 61.2%), of which 136 were suitable for analysis. All those who replied were involved in MDMs. 80.9% held MDMs once a week. Only 28% of MDMs were held during a protected session. Over 95% of surgeons and breast care nurses were present for the whole meeting. Radiologists and pathologists were present for the whole meeting in 90-95% of cases. In contrast, clinical oncologists were present for the whole MDM in 70% of cases and medical oncologists attended the whole meeting in only 44.1% of cases. There was variability in which patients were discussed in MDMs, and in many centres not all patients with cancer were discussed before surgery. Suggestions for improvement of MDMs included more time on protected sessions (72.8% in favour), time to prepare for meetings (29% in favour), allocation of a designated co-ordinator (30.9% in favour) and attendance of oncologists for the whole meeting (over 35% in favour). The majority of Breast MDMs were held at breakfast, lunch or the evening. There was variable attendance with a significant percentage of both clinical and medical oncologists not being present for the whole meeting. A quarter of units did not discuss patients with breast cancer before operation. This study shows that there is a need to improve provision for MDMs and to produce guidelines for these meetings.
本研究的目的是评估外科医生对多学科乳腺会议(MDMs)的看法及其当前参与情况。向英国外科肿瘤学协会的注册会员发放了250份问卷。回收了153份(回复率61.2%),其中136份适合分析。所有回复者都参与了MDMs。80.9%的会议每周举行一次。只有28%的MDMs在专门安排的时间段内举行。超过95%的外科医生和乳腺护理护士全程出席会议。在90 - 95%的情况下,放射科医生和病理科医生全程出席会议。相比之下,70%的情况下临床肿瘤学家全程出席MDM,而只有44.1%的情况下医学肿瘤学家全程出席会议。MDMs讨论的患者存在差异,在许多中心,并非所有癌症患者在手术前都得到了讨论。对改进MDMs的建议包括在专门安排的时间段内增加时间(72.8%赞成)、会议准备时间(29%赞成)、指定一名协调员(30.9%赞成)以及肿瘤学家全程出席会议(超过35%赞成)。大多数乳腺MDMs在早餐、午餐或晚上举行。出席情况参差不齐,相当比例的临床和医学肿瘤学家没有全程出席会议。四分之一的科室在手术前没有讨论乳腺癌患者。这项研究表明,需要改进MDMs的安排并为这些会议制定指南。