Volume 180 - Issue 8
Multidisciplinary care for women with early breast cancer in the Australian context
Authors: Helen M Zorbas, Bruce H Barraclough, Katherine J Rainbird, Karen A Luxford and Sally Redman
Med J Aust 2004; 180 (8): 429-430. || doi: 10.5694/j.1326-5377.2004.tb06008.x
Published online: 19 April 2004
Published online: 19 April 2004
Helen M Zorbas,* Bruce H Barraclough,† Katherine J Rainbird,‡ Karen A Luxford,§ Sally Redman¶
* Clinical Director, ‡ Manager, Treatment Program, § Program Director, National Breast Cancer Centre, Locked Bag 16, Camperdown, NSW 1450; † Director of Cancer Services, Department of Surgery, Royal North Shore Hospital, St Leonards, NSW; ¶ Director, Institute for Health Research, Sydney, NSW. karenlATnbcc.org.au
In reply: We agree with the comments by Pendlebury et al that knowledge about outcomes for patients receiving multidisciplinary care in Australia is limited. Hence, the National Breast Cancer Centre has investigated the application of multidisciplinary care and outcomes for women with breast cancer. Our article focused on the “Principles of multidisciplinary care” developed as a basis for a subsequent project (outcomes yet to be published). It was necessary to define such principles at the outset, as there is not yet an agreed view about what constitutes “multidisciplinary care” within the Australian healthcare context.
We also agree that the standard of clinical care in Australia is generally good. However, delivery of care is often fragmented and inconsistent.1 In other countries with high quality services, multidisciplinary meetings have been found to result in care that is more in accord with the evidence than non-multidisciplinary care.2 The Principles emphasise the role of the general practitioner, while recognising that some patients will require appropriate specialist referral.3 They also state that living in a rural area should be no impediment to accessing care.
We agree that multidisciplinary care is as important in advanced breast cancer as it is in early disease. The Principles were developed before the release of the guidelines for advanced breast cancer and it would be useful to extend them in the future.
The importance of one main contact for women is acknowledged. The purpose of a multidisciplinary case conference is to identify treatment options and their relative merits. This ought to assist communication with women and enable them to make a more informed choice.
References
- House of Representatives Standing Committee on Community Affairs. Report on the management and treatment of breast cancer in Australia. Canberra: AGPS, 1995. CHDJEBIB
- Chang JH, Vines E, Bertsch H, et al. The impact of a multidisciplinary breast cancer center on recommendations for patient management: the University of Pennsylvania experience. Cancer 2001; 91: 1231-1237. CHDICDJF
- National Breast Cancer Centre. Psychosocial clinical practice guidelines: providing information, support and counselling for women with breast cancer. Canberra: Commonwealth of Australia, 2000. i1083052