关键词: 多学科团队诊疗, 乳腺癌, 综合治疗, 规范化, 全程管理

Abstract:

Breast cancer has become the most common malignant tumor in the world since 2020. With the diagnosis and therapeutic regimens improvement in breast cancer, survival rate of Chinese patients has been significantly enhanced in recent years. However, there is still significant difference in overall survival rate between China and western countries. Many unmet needs exist in daily clinical diagnosis and treatment of breast cancer in China e.g., shortage of high-quality versatile medical talents, insufficient effectively visiting duration for single patient, overly complicated outpatient or inpatient hospital process. Multidisciplinary team treatment (MDT) is an optimized therapeutic model or platform in which many senior medical experts from multiple disciplines would collaborate together to discuss each single case or each category of cases deeply and thoroughly, and then design the specific treatment plans based on all comprehensive recommendations. MDT has been gradually accepted and widely adopted in multiple anti-cancer therapy, and has somehow largely enhanced the cancer cure rate. The MDT model involves many aspects including hospital system construction, cooperation between core and collaborative departments. MDT can improve disease diagnosis rate, reduce misdiagnosis or missed diagnosis, enhance standardization of clinical guidelines, optimize patient-centered whole disease process management and finally strengthen the therapeutic capabilities for breast cancer as a single disease department, ultimately contributing to the achievement of the goal of 'Healthy China Initiative (2019-2030)' project. However, current reality is the lack of unified standard for MDT execution process in China, and there is no specific MDT guideline for breast cancer globally and domestically which can guide or enhance the daily clinical practice. Hosted by Chinese Health Newspaper and initiated by Breast Cancer Professional Committee of Chinese Anti-Cancer Association, this paper came from joint discussions of multidisciplinary experts from top general and specialized hospitals based on high-level evidence-based medicine. The main contents were as following: ① Basic requirement for hospital or department system construction or operating process for breast cancer MDT; ② Standard and requirement for early-stage breast cancer MDT; ③ Standard and requirement for late-stage breast cancer MDT; ④ Standard and requirement for patient-centered breast cancer MDT; ⑤ Other or further requirements for high-quality breast cancer MDT. Here we discussed the exact responsibility of each department involved in MDT, providing patient-centered and one-stop medical services, and then combined together to explore MDT execution standard which would be suitable for current medical care status in China. Meanwhile we selected the outstanding or benchmark hospitals to push forward MDT model enlargement and enhance whole management process of breast cancer as a chronic disease, ultimately to enhance therapeutic improvement in breast cancer and benefit breast cancer patients..

Key words: Multidisciplinary team treatment (MDT), Breast cancer, Integrated treatment, Standardization, Integrated case management