Multidisciplinary care aligns surgical, systemic, and radiation planning to ensure that patients with early-stage breast cancer receive coordinated personalized treatment—especially when decisions related to upfront surgery vs systemic therapy before surgery are not straightforward. Ian Krop, MD, PhD, describes which patients benefit the most from a team-based approach and explains practical clinic workflows, including same-day visits and real-time communication, that help patients feel informed and supported.

Multidisciplinary care for patients with early-stage breast cancer involves close collaboration between surgical oncologists, medical oncologists, and radiation oncologists to optimize the care of the patient. It is particularly important for a surgical oncologist and a medical oncologist to communicate, and, ideally, they would see the patient on the same day. This way, when there is a question about whether the patient should be treated with upfront surgery or systemic therapy prior to surgery, there can be input from both providers. Having a patient seen, or at least discussed in real time, by multiple members of the care team can be very beneficial for ensuring that a patient feels comfortable and fully informed about their treatment options, including consideration for clinical trials.

Patients with higher-risk disease, particularly locally advanced or inflammatory cancer, require multidisciplinary treatment. It is also needed when neoadjuvant therapy is being considered and/or in medically complex scenarios (eg, when patients are interested in breast conservation but are not upfront candidates due to certain disease features such as tumor size). Conversely, patients with small, low-risk, ER+/HER2- breast cancer have less need for a multidisciplinary approach because they are often treated with surgery, potentially followed by adjuvant therapy. Ultimately, there needs to be good communication between surgical oncologists, radiation oncologists, and medical oncologists to ensure that the local and systemic therapy plans are optimized.

Practically, different institutions and clinics facilitate this multidisciplinary communication in different ways. As previously stated, a common approach is to have the patient meet with at least the medical oncologist and the surgical oncologist on the same day, and—if possible—the radiation oncologist as well. I think that this is the ideal approach, as it facilitates rapid communication and the determination of a plan. Ideally, providers should touch base on the patient’s treatment plan (eg, upfront surgery vs neoadjuvant therapy) prior to the first visit. This way, they can coordinate their discussions with the patient, ensure that the patient is fully informed, and allow for shared decision making to yield an optimized treatment approach for each patient.