Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond St, Toronto, M5B 1W8, Canada.
Department of Surgery, Sunnybrook Hospital, 2075 Bayview Ave T2-057, Toronto, ON, M4N 3M5, Canada.
Breast. 2019 Apr;44:101-107. doi: 10.1016/j.breast.2019.01.007. Epub 2019 Jan 25.
International guidelines highlight the importance of implementation supports and quality monitoring of multidisciplinary care for breast cancer. In Canada, Ontario has standards for formal multidisciplinary cancer conferences (MCCs), but other provinces/territories do not. This study aimed to stocktake MCCs for breast cancer in Canadian sites participating in the RUBY cohort study (Reducing the Burden of Breast Cancer in Young Women) to better understand variations in multidisciplinary care across Canada and to add to the international literature.
A cross-sectional survey was conducted with surgeons and surgical oncologists representing 34 clinical centres participating in RUBY. Questions were grouped according to: type of multidisciplinary care, implementation, function, practice, participation and presentation, operation, and demographics, and included a mix of Likert-based, tick box and open-ended questions.
Twenty-two responses (65%) were received. 91% of respondents reported that formal MCCs are part of regular practice. However, variation exists in the supports in place for ongoing implementation of MCCs, the understanding of the functions of MCCs, and the patients presented for discussion. Results also suggest less formalized processes for MCC in provinces without practice standards.
Response differences between Ontario and elsewhere suggest that standards for MCC and supports for their implementation make a positive difference in their operation. However, ongoing operational challenges and issues with attendance exist for all sites and suggest that along with development of practice standards, incentives for participation and further education on benefits and function of MCC may support uptake of MCCs in clinical practice.
国际指南强调了为乳腺癌提供多学科护理的实施支持和质量监测的重要性。在加拿大，安大略省有正式的多学科癌症会议（MCC）标准，但其他省份/地区则没有。本研究旨在对参与 RUBY 队列研究（减少年轻女性乳腺癌负担）的加拿大站点的 MCC 进行库存盘点，以更好地了解加拿大各地多学科护理的差异，并为国际文献做出贡献。
对参与 RUBY 的 34 个临床中心的外科医生和外科肿瘤学家进行了横断面调查。问题根据以下方面进行分组：多学科护理的类型、实施、功能、实践、参与和演示、操作和人口统计学，包括基于李克特量表、勾选框和开放式问题的混合。
收到了 22 份答复（65%）。91%的受访者报告说，正式的 MCC 是常规实践的一部分。然而，在 MCC 持续实施的支持、对 MCC 功能的理解以及提交讨论的患者方面存在差异。结果还表明，在没有实践标准的省份，MCC 的程序不太正式。
安大略省和其他地区之间的答复差异表明，MCC 标准及其实施支持对其运作有积极影响。然而，所有站点都存在持续的运营挑战和出席问题，这表明除了制定实践标准外，还需要为参与提供激励措施，并进一步教育 MCC 的益处和功能，以支持 MCC 在临床实践中的采用。
