Breast

Aims: To compare the 5-year survival and recurrence rates of patients with primary breast cancer before and after the introduction of multidisciplinary meetings (MDM). Methods: A retrospective audit of 976 patients was conducted using the Breast Cancer Database from 1988 to 1999. The MDM was introduced in 1995. Group 1 (1988–1994) and Group 2 (1995–1999) were subdivided into those who received chemotherapy (Groups 1a and 2a) and those who did not (Groups 1b and 2b). At 5 years, breast cancer-specific survival (BCS), disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan–Meier curves. Results: In Group 1 (n = 445) 59 patients had chemotherapy (13·3%) whereas 28·6% had chemotherapy in Group 2 (n = 531). The median ages for patients receiving chemotherapy were lower (Group 1a: 43 years, 2a: 48 years versus Group 1b: 61 years, 2b: 66 years). Some 33·7% of patients in Group 1 received radiotherapy compared with 42·6% in Group 2. Endocrine therapy was used in 72·8% in Group 1 and 86·4% in Group 2. The Nottingham Prognostic Index (NPI) from the two groups showed wellmatched samples (NPI > 5·4: 10·2% in Group 1, 11·1% in Group 2). BCS was similar before and after 1995 (Group 1a: 74·6%, 2a: 77·6%, 1b: 87·6%, 2b: 92·2%). There was a trend towards better DFS after 1995 (Group 1a: 61·0%, 1b: 78·5% versus Group 1b: 72·25%, 2b: 85·6%). Conclusions: Since 1995, which corresponds to the introduction of our MDM, there has been an increase in all arms of adjuvant therapy. There seems to be a trend towards less recurrence but with no obvious difference in survival. Breast 7304