A multidisciplinary team approach minimises prophylactic mastectomy rates

摘要: Abstract Background Prophylactic mastectomy (PM) has become increasingly common but is not without complications especially if accompanied by reconstructive surgery. In patients with sporadic unilateral breast cancer, contralateral PM offers no survival advantage. Multidisciplinary team (MDT) communication and interaction may facilitate shared decision-making curtail rates. The aim of this study was investigate the effect a regional MDT meeting on decision-making. Methods We conducted an observational involving retrospective review prospectively recorded records for 151 patient requests from 2011 to 2014. Final decisions were as ‘accepted’, ‘declined’ or ‘pending’. For sanctioned requests, factors justifying recorded. Where declined, justification refusal sought Results Approximately half all have been upheld (53.0%) 1/3 declined (32.5%). Of those low risk cancer versus relatively high systemic relapse commonly cited (45.7%). A proportion who initiated discussion subsequently changed their minds (19.6%), failed attend clinic appointments (6.5%). Some deemed medically unfit complex surgery (13%), basis apparent cosmetic drive (6.5%), concerns regarding depression anxiety (2.2%) and/or family history could be substantiated Discussion meetings cross-specialty interrogation PM, minimise unnecessary restrict likely derive maximum benefit.