Establishment of multidisciplinary diagnosis and treatment model for breast cancer based on doctor-patient shared decision-making: a prospective randomized controlled study_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LUO Xue ,  JIA Xinjian

Breast Disease Center, Deyang People’s Hospital, Dedyang, Sichuan 618000 P. R. China;

Corresponding author：

JIA Xinjian, Email: juddson@sina.com

Keywords：

breast cancer; doctor-patient sharing decision-making; multidisciplinary diagnosis and treatment model; therapeutic effect; quality of life; Postoperative complication

DOI：

10.7507/1007-9424.202407032

Video：

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Objective To evaluate the effects of multi-disciplinary diagnosis and treatment model based on doctor-patient shared decision making on treatment outcomes, quality of life and postoperative complications of breast cancer patients. Methods A total of 100 breast cancer patients were included in this study through a prospective randomized controlled design, and were randomly divided into control group and intervention group, with 50 patients in each group. The control group received traditional treatment mode, while the intervention group implemented a multidisciplinary treatment mode based on doctor-patient sharing decision making. The results of treatment, quality of life and postoperative complication rate were compared between the two groups. Results The completion rate of adjuvant radiotherapy and chemotherapy in the intervention group was 94.0%, which was higher than that in the control group (80.0%), and the difference was statistically significant (P= 0.037). The satisfaction rate of postoperative breast appearance in the intervention group was 90.0%, which was higher than that in the control group (60.0%), with statistical significance (P<0.001). There was no significant difference in grade Ⅲ/Ⅳ toxicity between the two groups (P>0.05). After treatment, the scores of patients’ quality of life in the intervention group were higher than those in the control group, and the difference was statistically significant (P< 0.05). The incidence of postoperative complications in the intervention group was 6.0%, which was lower than that in the control group (22.0%), and the difference was statistically (P= 0.021). Conclusions The application of multidisciplinary diagnosis and treatment model based on doctor-patient sharing decision-making in the treatment of breast cancer patients has significantly improved the treatment effect and quality of life, and effectively reduced the rate of postoperative complications. This model provides a new approach to the treatment of breast cancer that is more personalized, comprehensive and efficient.

1.	邬昊, 吕青. 全球及中国乳腺癌的流行病学趋势及防控启示: 2018–2022年《全球癌症统计报告》解读. 中国普外基础与临床杂志, 2024, 31(7): 796-802.
2.	雷少元, 郑荣寿, 张思维, 等. 乳腺癌发病率和死亡率的全球模式: 一项基于人群的2000–2020年肿瘤登记数据分析研究. 癌症, 2022, 41(7): 324-335.
3.	吴淞, 江泽飞. 基于新辅助治疗效果的乳腺癌辅助治疗策略. 中华外科杂志, 2024, 62(2): 104-109.
4.	中国抗癌协会乳腺癌专业委员会. 中国乳腺癌筛查与早期诊断指南. 中国癌症杂志, 2022, 32(4): 363-372.
5.	王贝, 刘锋. 乳腺癌新辅助内分泌治疗与靶向治疗联合应用研究进展. 现代肿瘤医学, 2022, 30(21): 3996-4000.
6.	钱瑶, 刘锋. 乳腺癌新辅助内分泌治疗的研究进展及展望. 中国癌症杂志, 2022, 32(7): 643-649.
7.	赵广章, 刘岩, 熊斌, 等. 腔镜手术在乳腺癌外科治疗中的应用现状及前景. 国际外科学杂志, 2024, 51(2): 119-123.
8.	史记, 张烨, 孙佩欣, 等. 多学科MDT诊疗模式在胶质母细胞瘤患者诊疗中的应用价值. 现代肿瘤医学, 2023, 31(4): 643-647.
9.	Staudt MD. The multidisciplinary team in pain management. Neurosurg Clin N Am, 2022, 33(3): 241-249.
10.	Marques P, Sagarribay A, Tortosa F, et al. Multidisciplinary team care in pituitary tumours. Cancers (Basel), 2024, 16(5): 950. doi: 10.3390/cancers16050950.
11.	张振煦. 医患共享决策的理论建构与临床应用. 中国医学伦理学, 2023, 36(7): 754-759.
12.	Hoffmann T, Bakhit M, Michaleff Z. Shared decision making and physical therapy: What, when, how, and why? Braz J Phys Ther, 2022, 26(1): 100382. doi: 10.1016/j.bjpt.2021.100382.
13.	Morrison T, Foster E, Dougherty J, et al. Shared decision making in rheumatology: A scoping review. Semin Arthritis Rheum, 2022, 56: 152041. doi: 10.1016/j.semarthrit.2022.152041.
14.	Dennison Himmelfarb CR, Beckie TM, Allen LA, et al. Shared decision-making and cardiovascular health: A Scientific Statement From the American Heart Association. Circulation, 2023, 148(11): 912-931.
15.	Van Baelen K, Geukens T, Maetens M, et al. Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer. Ann Oncol, 2022, 33(8): 769-785.
16.	万崇华, 杨铮, 孟琼, 等. 乳腺癌患者生命质量测定量表QLQ-BR53中文版的应用评价. 肿瘤, 2006, 26(2): 184-187,195.
17.	吴淞, 江泽飞. 基于新辅助治疗效果的乳腺癌辅助治疗策略. 中华外科杂志, 2024, 62(2): 104-109.
18.	鞠仙莉, 袁修学, 阎红琳, 等. 乳腺癌新辅助化疗疗效预测指标的研究进展. 中国组织化学与细胞化学杂志, 2023, 32(3): 323-327.
19.	王婷婷, 杨孝苹. 接纳与承诺疗法对食管癌术后患者负性情绪及生活质量的影响. 中国临床护理, 2022, 14(2): 90-93.
20.	Rajan S, Foreman J, Wallis MG, et al. Multidisciplinary decisions in breast cancer: does the patient receive what the team has recommended? Br J Cancer, 2013, 108(12): 2442-2447.
21.	王兰, 黄巧玲. 多学科协作精准疼痛护理对乳腺癌姑息化疗患者疲乏-疼痛-睡眠障碍的影响. 国际护理学杂志, 2023, 42(8): 1490-1493.
22.	李三梅, 雷敏, 林雅军. 多学科团队协作护理结合Teach-back方法在乳腺癌患者PICC置管中的应用效果观察. 医学理论与实践, 2023, 36(3): 499-501.
23.	丁榆, 黄海霞, 夏宇晓, 等. 乳腺癌术后患者家庭环境与生命质量的关系. 广东医学, 2022, 43(7): 839-842.
24.	林双双, 吴丽君, 罗喆. 互联网+情景模式教育对乳腺癌患者乳房切除术围手术期心理状态和生活状态的影响. 中国妇幼保健, 2024, 39(3): 531-534.
25.	王金燕, 杨瑒, 朱凌曦, 等. 基于患者报告结局的乳腺癌患者社会功能的特征分析研究. 解放军护理杂志, 2022, 39(7): 21-24.
26.	赵慧慧, 周春兰, 李文姬, 等. 乳腺癌相关淋巴水肿患者肢体功能-残疾-健康现状及影响因素. 广东医学, 2023, 44(6): 784-789.
27.	刘晓红, 谢秋菊. 手术并发症对乳腺癌患者术后持续性疼痛的影响. 中国现代普通外科进展, 2023, 26(8): 648-651.
28.	路平, 王晓杰, 郭海凌. 老年乳腺癌患者术前衰弱与术后短期并发症的相关性研究. 中华护理杂志, 2024, 59(8): 916-921.

1. 邬昊, 吕青. 全球及中国乳腺癌的流行病学趋势及防控启示: 2018–2022年《全球癌症统计报告》解读. 中国普外基础与临床杂志, 2024, 31(7): 796-802.
2. 雷少元, 郑荣寿, 张思维, 等. 乳腺癌发病率和死亡率的全球模式: 一项基于人群的2000–2020年肿瘤登记数据分析研究. 癌症, 2022, 41(7): 324-335.
3. 吴淞, 江泽飞. 基于新辅助治疗效果的乳腺癌辅助治疗策略. 中华外科杂志, 2024, 62(2): 104-109.
4. 中国抗癌协会乳腺癌专业委员会. 中国乳腺癌筛查与早期诊断指南. 中国癌症杂志, 2022, 32(4): 363-372.
5. 王贝, 刘锋. 乳腺癌新辅助内分泌治疗与靶向治疗联合应用研究进展. 现代肿瘤医学, 2022, 30(21): 3996-4000.
6. 钱瑶, 刘锋. 乳腺癌新辅助内分泌治疗的研究进展及展望. 中国癌症杂志, 2022, 32(7): 643-649.
7. 赵广章, 刘岩, 熊斌, 等. 腔镜手术在乳腺癌外科治疗中的应用现状及前景. 国际外科学杂志, 2024, 51(2): 119-123.
8. 史记, 张烨, 孙佩欣, 等. 多学科MDT诊疗模式在胶质母细胞瘤患者诊疗中的应用价值. 现代肿瘤医学, 2023, 31(4): 643-647.
9. Staudt MD. The multidisciplinary team in pain management. Neurosurg Clin N Am, 2022, 33(3): 241-249.
10. Marques P, Sagarribay A, Tortosa F, et al. Multidisciplinary team care in pituitary tumours. Cancers (Basel), 2024, 16(5): 950. doi: 10.3390/cancers16050950.
11. 张振煦. 医患共享决策的理论建构与临床应用. 中国医学伦理学, 2023, 36(7): 754-759.
12. Hoffmann T, Bakhit M, Michaleff Z. Shared decision making and physical therapy: What, when, how, and why? Braz J Phys Ther, 2022, 26(1): 100382. doi: 10.1016/j.bjpt.2021.100382.
13. Morrison T, Foster E, Dougherty J, et al. Shared decision making in rheumatology: A scoping review. Semin Arthritis Rheum, 2022, 56: 152041. doi: 10.1016/j.semarthrit.2022.152041.
14. Dennison Himmelfarb CR, Beckie TM, Allen LA, et al. Shared decision-making and cardiovascular health: A Scientific Statement From the American Heart Association. Circulation, 2023, 148(11): 912-931.
15. Van Baelen K, Geukens T, Maetens M, et al. Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer. Ann Oncol, 2022, 33(8): 769-785.
16. 万崇华, 杨铮, 孟琼, 等. 乳腺癌患者生命质量测定量表QLQ-BR53中文版的应用评价. 肿瘤, 2006, 26(2): 184-187,195.
17. 吴淞, 江泽飞. 基于新辅助治疗效果的乳腺癌辅助治疗策略. 中华外科杂志, 2024, 62(2): 104-109.
18. 鞠仙莉, 袁修学, 阎红琳, 等. 乳腺癌新辅助化疗疗效预测指标的研究进展. 中国组织化学与细胞化学杂志, 2023, 32(3): 323-327.
19. 王婷婷, 杨孝苹. 接纳与承诺疗法对食管癌术后患者负性情绪及生活质量的影响. 中国临床护理, 2022, 14(2): 90-93.
20. Rajan S, Foreman J, Wallis MG, et al. Multidisciplinary decisions in breast cancer: does the patient receive what the team has recommended? Br J Cancer, 2013, 108(12): 2442-2447.
21. 王兰, 黄巧玲. 多学科协作精准疼痛护理对乳腺癌姑息化疗患者疲乏-疼痛-睡眠障碍的影响. 国际护理学杂志, 2023, 42(8): 1490-1493.
22. 李三梅, 雷敏, 林雅军. 多学科团队协作护理结合Teach-back方法在乳腺癌患者PICC置管中的应用效果观察. 医学理论与实践, 2023, 36(3): 499-501.
23. 丁榆, 黄海霞, 夏宇晓, 等. 乳腺癌术后患者家庭环境与生命质量的关系. 广东医学, 2022, 43(7): 839-842.
24. 林双双, 吴丽君, 罗喆. 互联网+情景模式教育对乳腺癌患者乳房切除术围手术期心理状态和生活状态的影响. 中国妇幼保健, 2024, 39(3): 531-534.
25. 王金燕, 杨瑒, 朱凌曦, 等. 基于患者报告结局的乳腺癌患者社会功能的特征分析研究. 解放军护理杂志, 2022, 39(7): 21-24.
26. 赵慧慧, 周春兰, 李文姬, 等. 乳腺癌相关淋巴水肿患者肢体功能-残疾-健康现状及影响因素. 广东医学, 2023, 44(6): 784-789.
27. 刘晓红, 谢秋菊. 手术并发症对乳腺癌患者术后持续性疼痛的影响. 中国现代普通外科进展, 2023, 26(8): 648-651.
28. 路平, 王晓杰, 郭海凌. 老年乳腺癌患者术前衰弱与术后短期并发症的相关性研究. 中华护理杂志, 2024, 59(8): 916-921.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Latest ArticlesEstablishment of multidisciplinary diagnosis and treatment model for breast cancer based on doctor-patient shared decision-making: a prospective randomized controlled study

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