Implementing consistent pretreatment multidisciplinary review for breast cancer: a quality improvement project

Modern breast cancer care is multimodal and multidisciplinary, and a lack of structured communication between members in different disciplines can introduce obstacles in a patient’s journey, resulting in potential treatment delays. In this study, we aimed to increase the percentage of more complex breast cancer cases reviewed pretreatment in a multidisciplinary setting in order to improve breast cancer management at our breast programme. We first started by examining cases of a lower volume complex procedure, oncoplastic breast reconstruction, and aimed to increase the number reviewed preoperatively from 0% to 50% by May 2023. We then expanded the process to include all cases categorised as ‘complex’, aiming to increase the number reviewed from 0% to 50% by April 2024. We prospectively collected data on all triaged cancer cases to track the number of cases reviewed, with the conclusion that both aims were achieved. Feedback surveys were distributed to conference members at three study time points to assess benefits, challenges, perceptions of the process and ideas for department-specific sustainability. Our findings emphasise that pretreatment review is effective, with 23% of cases resulting in management changes directly as a result of review.