Interinstitutional multidisciplinary virtual tumor board implementation for the management of breast cancer in a public health setting in Mexico.

Abstract

107 Background: UNEME-DEDICAM (UD) clinics are part of a national public health initiative to provide women prompt access to cervical and breast cancer (BC) screening and diagnosis. Furthermore, UD clinics play a central role in the coordination and prioritization of patient transfer to treatment-specialized institutions. To facilitate this process, we planned and implemented an interinstitutional virtual multidisciplinary tumor board (VMDT). Herein, we present our current experience. Methods: We planned and implemented our VMDT in September 2020. Weekly sessions were established for the multidisciplinary discussion of every newly diagnosed patient at UD with a complete radiology and pathology report. Communication was accomplished through an encrypted and secure internet connection using Microsoft Teams software. VMDT members included breast pathologist, breast imaging, radio oncologist, medical oncologist, and surgical oncologist. Treatment consensus were registered in a Microsoft Word template and integrated into the medical record for each patient. Importantly, the report also included date and time for the consultation at the referral institution. Results: Between September 2020 through May 2021, 74 BC patients were diagnosed at UD. Mean age at diagnosis was 52 years. Sixty-eight patients had invasive BC, of whom early stage (I and II) accounted for 67% of patients; locally advanced (III) for 29%, and advanced (IV) for 4%. Luminal A and B type accounted for 68%; HER2+ve for 25%; and triple negative for 7%. Mean time from biopsy to complete histopathology report (biopsy-report interval) was 2.5 weeks. The mean time from VMDT consensus to patient´s first consultation at referral center (VMDT-referral interval) was 2 weeks. The mean time from biopsy to patient´s first consultation at referral center (total interval) was 5.5 weeks. Conclusions: The VMDT is a plausible strategy to streamline the inter-institutional organization for the timely care of BC patients. UD clinics play a central role in the coordination of transfer of BC patients to tertiary care centers.