UICC World Cancer Congress 2006

Objective:Treatment of breast cancer involves a combination of surgery, systemic therapy and radiotherapy, to achieve an improved cure rate. The present study is to assess the feasibility of a multidisciplinary approach to management.

Methods: Between September 2003 and November 2005, patients newly diagnosed with breast cancer were studied. Patients with early breast cancer were discussed on the choice of postoperative adjuvant therapy. Patients with locally advanced breast cancer followed a protocol of neoadjuvant therapy before surgery and further treatment was discussed. Patient diagnosed with metastatic breast cancer were discussed on the plan of management. Clinical data of each patient was discussed in the weekly multidisciplinary breast conference,attended by a team of breast surgeons, pathologists, radiation and medical oncologists. The plan of management for each patient was decided and recommended .

Results: Of 901 patients, 832 had early breast cancer post surgery (92.3%), 26 received neoadjuvant therapy before surgery (2.9%), 43 were metastatic on first presentation. The median tumour size of invasive tumors was 1.9 cm and lymph node metastases were detected in 34% of patients. Stage 0, I, II ,III and IV disease was present in 13.4%, 33.6%, 43.1%, 8.5% and 1.3% of patients respectively. Surgery was performed on 865 patients. Breast conserving surgery was performed in 46.9% while mastectomy was performed in 49.1% of patients, of whom 24% received breast reconstruction. 737 patients with axillary surgery was found to have metastatic axillary nodes in 34%. Chemotherapy, hormonal therapy, radiotherapy and clinical followup were recommended in 48%, 61.7%, 61.4% and 9.4% of patients, respectively.