Impact of Multidisciplinary Team Discussion on Treatment Decision-Making and Survival in Early-Stage HR+/HER2-Breast Cancer

Background Multidisciplinary teams (MDTs) have been shown to improve breast cancer outcomes. This study aimed to examine the effect of MDT on therapeutic decision-making for breast cancer (BCA) patients, particularly in the subtype of early-stage HR+/HER2-BCA. Methods We analyzed 472 breast cancer patients who were first diagnosed at our institution between 1 January, 2020, and 31 January, 2022. The clinicopathological features were obtained from medical records. Patients were assigned to two groups on the basis of whether their cases were discussed at the MDT. Propensity score matching (1:1) generated 140 well-balanced cases in the early-stage HR+/HER2- subgroup. Cox regression and chi-square tests were used to evaluate survival and treatment differences. Results The results of Cox regression revealed that better DSS was associated with MDT (YES vs NO; HR = 0.292, CI: 0.096–0.887, P  = 0.030), HR Status (Positive vs Negative) ; HR = 0.066, CI: 0.015–0.212, P  < 0.001), and a lower Stage (I vs II, HR = 0.005, CI:0.000-0.053, P  < 0.001; I vs III, HR = 0.003, CI: 0.000-0.043, P  < 0.001,I vs IV, HR = 0.053, CI: 0.004–0.703, P  = 0.026). The rates of 2- and 3-year regular follow-up in the MDT group were greater than those in the observed group (92.9% vs 86.9%, P =  0.028; 90.2% vs 82.3%, P  = 0.012). In the subgroup, MDT integration significantly increased chemotherapy utilization (42.9% vs 40.0%) while reducing aggressive EC-T regimens (5.7% vs 21.4%, P  = 0.005). MDT was associated with increased use of 21-gene test and ovarian function suppression (OFS) in this subgroup (20.0% vs 7.1%, P  = 0.026). Conclusions MDT discussion was associated with more precise treatment strategies in HR+/HER2- breast cancer, as evidenced by increased use of genomic testing, chemotherapy de-escalation, and improved long-term follow-up adherence.