INTRODUCTION: Treatment of breast cancer has become more complex and sophisticated in recent years, and a multidisciplinary team approach to management is now recommended worldwide. The present study reviews the applicability of the multidisciplinary approach to the management of patients with breast cancer in a private hospital. METHODS: Between September 2003 and April 2005, a total of 579 consecutive patients undergoing breast cancer surgery were studied. Patients receiving neoadjuvant chemotherapy or who had metastatic disease at presentation were excluded. Demographic and operative details, pathology, and recommended adjuvant therapy were discussed in the weekly multidisciplinary breast conference involving breast surgeons, pathologists, and radiation and medical oncologists. RESULTS: The mean age was 48.6 years. A self-discovered breast lump (80%) was the most common presentation, whereas screening mammography accounted for only 12.2%. The accuracy of preoperative mammography, ultrasonography, fine-needle aspiration cytology, and core biopsy were 66.5%, 80.7%, 89.4%, and 98.9%, respectively. Mastectomy was performed in 49.3% of patients, of whom 22.0% underwent immediate reconstruction. Eighty-five percent of patients underwent concomitant axillary surgery, comprising either sentinel node biopsy (49.9%), sentinel node biopsy followed by axillary dissection (38.7%), or axillary dissection alone (11.4%). The mean size of invasive tumors was 2.3 cm, and lymph node metastases were detected in 40% of patients; stage 0, I, II, and III disease was present in 14.2%, 34%, 44.5%, and 7.2% of patients, respectively. Adjuvant hormonal therapy, chemotherapy and radiotherapy were recommended in 62.4%, 51.2%, and 64.9% of patients, respectively. CONCLUSIONS: Breast cancer in Hong Kong most often presents as a breast lump discovered by self-examination. The role of screening mammogram has to be reevaluated. Multidisciplinary teamwork is essential for optimizing decision-making about adjuvant treatment interventions in such patients.
INTRODUCTION: Treatment of breast cancer has become more complex and sophisticated in recent years, and a multidisciplinary team approach to management is now recommended worldwide. The present study reviews the applicability of the multidisciplinary approach to the management of patients with breast cancer in a private hospital. METHODS: Between September 2003 and April 2005, a total of 579 consecutive patients undergoing breast cancer surgery were studied. Patients receiving neoadjuvant chemotherapy or who had metastatic disease at presentation were excluded. Demographic and operative details, pathology, and recommended adjuvant therapy were discussed in the weekly multidisciplinary breast conference involving breast surgeons, pathologists, and radiation and medical oncologists. RESULTS: The mean age was 48.6 years. A self-discovered breast lump (80%) was the most common presentation, whereas screening mammography accounted for only 12.2%. The accuracy of preoperative mammography, ultrasonography, fine-needle aspiration cytology, and core biopsy were 66.5%, 80.7%, 89.4%, and 98.9%, respectively. Mastectomy was performed in 49.3% of patients, of whom 22.0% underwent immediate reconstruction. Eighty-five percent of patients underwent concomitant axillary surgery, comprising either sentinel node biopsy (49.9%), sentinel node biopsy followed by axillary dissection (38.7%), or axillary dissection alone (11.4%). The mean size of invasive tumors was 2.3 cm, and lymph node metastases were detected in 40% of patients; stage 0, I, II, and III disease was present in 14.2%, 34%, 44.5%, and 7.2% of patients, respectively. Adjuvant hormonal therapy, chemotherapy and radiotherapy were recommended in 62.4%, 51.2%, and 64.9% of patients, respectively. CONCLUSIONS:Breast cancer in Hong Kong most often presents as a breast lump discovered by self-examination. The role of screening mammogram has to be reevaluated. Multidisciplinary teamwork is essential for optimizing decision-making about adjuvant treatment interventions in such patients.
Authors: J A van Dongen; A C Voogd; I S Fentiman; C Legrand; R J Sylvester; D Tong; E van der Schueren; P A Helle; K van Zijl; H Bartelink Journal: J Natl Cancer Inst Date: 2000-07-19 Impact factor: 13.506
Authors: J A van der Hage; C J van de Velde; J P Julien; M Tubiana-Hulin; C Vandervelden; L Duchateau Journal: J Clin Oncol Date: 2001-11-15 Impact factor: 44.544
Authors: Edwin R Fisher; Jiping Wang; John Bryant; Bernard Fisher; Eletherios Mamounas; Norman Wolmark Journal: Cancer Date: 2002-08-15 Impact factor: 6.860
Authors: G Bonadonna; P Valagussa; A Rossi; G Tancini; C Brambilla; M Zambetti; U Veronesi Journal: Breast Cancer Res Treat Date: 1985 Impact factor: 4.872
Authors: Bernard Fisher; Stewart Anderson; John Bryant; Richard G Margolese; Melvin Deutsch; Edwin R Fisher; Jong-Hyeon Jeong; Norman Wolmark Journal: N Engl J Med Date: 2002-10-17 Impact factor: 91.245
Authors: Nicole J Look Hong; Anna R Gagliardi; Susan E Bronskill; Lawrence F Paszat; Frances C Wright Journal: J Oncol Pract Date: 2010-03 Impact factor: 3.840
Authors: Benjamin W Lamb; Nick Sevdalis; Sonal Arora; Anna Pinto; Charles Vincent; James S A Green Journal: World J Surg Date: 2011-09 Impact factor: 3.352
Authors: S Hollunder; U Herrlinger; M Zipfel; J Schmolders; V Janzen; T Thiesler; E Güresir; A Schröck; F Far; T Pietsch; D Pantelis; D Thomas; S Vornholt; N Ernstmann; T Manser; M Neumann; B Funke; I G H Schmidt-Wolf Journal: BMC Cancer Date: 2018-09-29 Impact factor: 4.430
Authors: Paul E George; Geriga Fahdil; Israel Luutu; Alfred Bulamu; John Sekabira; Nasser Kakembo; Susan Nabadda; Sam Kalungi; Joyce B Kambugu Journal: Future Sci OA Date: 2019-09-19
Authors: Bróna Nic Giolla Easpaig; Yvonne Tran; Teresa Winata; Klay Lamprell; Diana Fajardo Pulido; Gaston Arnolda; Geoff P Delaney; Winston Liauw; Kylie Smith; Sandra Avery; Kim Rigg; Johanna Westbrook; Ian Olver; David Currow; Jonathan Karnon; Robyn L Ward; Jeffrey Braithwaite Journal: BMC Health Serv Res Date: 2022-02-12 Impact factor: 2.655