Daphne B. Stewart, MD, specializes in breast cancer at USC Norris Comprehensive Cancer Center, part of Keck Medicine of University of Southern California.

Jason Ye, MD, is the director of Clinical Operations of Radiation Oncology at University of Southern California (USC) Norris Comprehensive Cancer Hospital and associate professor of Clinical Radiation at Keck School of Medicine of USC.

Experts reflect on the power of clinical trial participation, multidisciplinary collaboration, and innovation to personalize care and continually improve outcomes for every patient with breast cancer.

Coordinated Care in Breast Oncology: Encouraging Participation in Clinical Trials

 OncChats: Coordinated Care in Breast Oncology

, Jason Ye, MD, and Daphne B. Stewart, MD, of Keck Medicine of USC, reflect on the power of clinical trial participation, multidisciplinary collaboration, and innovation to personalize care and continually improve outcomes for every patient with breast cancer.

I just would love to encourage all the patients to enroll on clinical trials so we can learn more, and in most cases, it benefits them, too, in one way or another. One of our goals, as you know, at USC, is we try to have a very broad spectrum of trials, so there is some trial that [a patient] will be eligible [for]—no matter what kind of case and stage they’re in. Another thing, for me, [when] running these clinical trials is, there are so many different subsets and factors that we have to think about in screening for eligibility. I know every [patient with cancer] is different and that every treatment [approach] is individualized, but really, [there are benefits to] being [part of] a multidisciplinary team that conducts all these clinical trials. All of our providers are really thinking of every little detail and really trying to [determine] what is best for this one particular patient, rather than just following a more standard template, if you will, of treatment paradigm. [With] that, I feel that I have become a better clinician and more knowledgeable in talking to medical oncologists, surgical oncologists, and all my colleagues. I feel that I [continually] become a better doctor just by learning from everyone.

And at a cancer center. We’re so lucky to be engaged in this cancer center, but really the role of a cancer center is to lead to treatment intervention and innovation—making things better. Not only do we have to learn a lot, but the patients also have to learn a lot, as well. I think that when they learn and realize that we make so many changes year by year through participation in clinical trials, it can really motivate them to participate in innovating for the future. [It all] just makes such an impact as the years go on, and the goal for breast cancer treatment is just to continue to cure more and more patients.

Absolutely, and I think we’re doing a great job at it, and it’s a very exciting field to be in.

We’re so lucky to get to work together, Jason. I'm so grateful for our interactions, because we just align. We’re on board about this and [we have the same] passion for that innovation and [finding] the best treatments that we can give to our patients.

Thank you, and I feel the same, and to all of our colleagues, too. It's a great place to be.

Videos

Experts reflect on the power of clinical trial participation, multidisciplinary collaboration, and innovation to personalize care.

Experts explore how advances in systemic therapy—including novel agents, genomic profiling, and national trials—are helping personalize and de-escalate breast cancer treatment.

Coordinated Care in Breast Oncology: Systemic Therapy Trials and Personalized Approaches

, Jason Ye, MD, and Daphne B. Stewart, MD, of Keck Medicine of USC, explore how advances in systemic therapy—including novel agents, genomic profiling, and national trials—are helping personalize and de-escalate breast cancer treatment.

And actually, in fact, a lot of these de-escalation and radiation [approaches are] made possible because of improvement in systemic therapy. I’d love to hear a little bit about the systemic therapy trials, too.

 Yes, so here, at USC, we have a number of trials that are both prior to surgery to be able to de-escalate therapy and then post-surgery to potentially de-escalate therapy. We have a lot of clinical trials, but I just want to focus on these two categories. We have a collaborative study called [the phase 2] I-SPY [NCT01042379]. This is a trial that’s been on board since 2012 and there have been more than 4000 patients enrolled. It focuses on the introduction of new chemotherapy agents that are approved in the metastatic breast cancer setting because they’re effective, but they’re moved forward into the neoadjuvant setting, thinking that they are more effective than standard chemotherapy. The enrollment in I-SPY allows patients to be exposed to really, really positive agents that are less toxic than our standard chemotherapy and may actually lead [them] to a higher rate of complete remission of cancer with a systemic therapy. [It] may also permit early escalation to surgery that doesn’t take a 6-month treatment intervention; maybe at 3 months, [a patient has] enough of a treatment response that [they’re] able to go directly to surgery. It gives us a whole aspect of how to improve our systemic therapies when we give it before surgery, to see how all those different subtypes of breast cancer can be maximized. We’re really, really motivated to do this.

We have another couple of clinical trials that are looking specifically at [the question of,] how we can optimize shrinking tumors before [a patient goes] to surgery? Specifically, there is a study using a novel antibody-drug conjugate with novel immunotherapy up front compared with our standard chemotherapy, which has been associated with a really significant clinical response rate and better [tolerability with] fewer [adverse] effects. It really makes sense, and again, when we introduce it [to] the multidisciplinary [discussions], we can actually talk about what the benefit is. Why would we be doing treatment before [a patient goes] to surgery? Again, to try to shrink the tumor and limit the risk of any micrometastatic disease.

In the adjuvant setting, which Dr Ye, was talking about, once [a patient undergoes] up-front surgery, let’s say [they] have a lower-risk breast cancer where it’s an estrogen receptor [ER]–positive tumor that’s maybe less than 3 cm and maybe has one to two positive lymph nodes; these are the kind of patients who undergo genomic profiling. Typically, we use the Oncotype [DX test], or we use the MammaPrint, which are gene profiles that help estimate the risk of recurrence—specifically metastatic recurrence—and the benefit to chemotherapy. There’s a lot of controversy in terms of the use of adjuvant chemotherapy in patients who have ER-positive breast cancer. If [a patient has] a very high-risk profile on that gene profile, we know that there’s a benefit to chemotherapy, and that represents around 30% of all of the patients; however, there’s still going to be a component in that 70% that probably does benefit from chemotherapy, and the ones that we think are going to benefit the most are premenopausal patients with ER-positive breast cancer that probably benefit from chemotherapy because they enter a premature menopause which suppresses their estrogen and lowers their risk of a breast cancer recurrence.

We have a really interesting, activated study here. Again, it’s a collaborative trial that has opened across the country, and what we’re specifically looking at are premenopausal women with ER-positive breast cancer who are considered intermediate risk for recurrence; they’re not low risk and they’re not high risk but they’re in that gray zone. That trial is going to randomly assign patients to simply putting them into early menopause using gonadotropin-releasing hormone agonists and antagonists to make sure that you suppress ovarian function, and then give the aromatase inhibitors, which are the postmenopausal treatment of ER-positive breast cancer vs chemotherapy, followed by additional ovarian function suppression. This trial is aiming to recruit at least 4000 patients over the next 5 years. We’re contributing to these international sites because what we’re trying to identify is, are patients really benefiting from chemotherapy or if the chemotherapy is inducing the menopause. I think this is a really important trial, and we are able to identify potential candidates for this study during these multidisciplinary interactions.

Yes, and these are really important questions for us to know going forward.

Check back on Monday for the next episode in the series.

Experts explore how advances in systemic therapy are helping personalize and de-escalate breast cancer treatment.

Experts discuss how coordinated clinical trial participation enables safer treatment de-escalation and advances breast cancer care through national research efforts.

Coordinated Care in Breast Oncology: Clinical Trials and De-escalation of Treatment

, Jason Ye, MD, and Daphne B. Stewart, MD, of Keck Medicine of USC, discuss how coordinated clinical trial participation enables safer treatment de-escalation and advances breast cancer care through national research efforts.

I think that’s a good segue to talk about our clinical trial offerings. As you mentioned, there are a lot of trials [being done] in breast cancer. Because outcomes [are] so improved these days, [trials are examining ways to] de-escalate treatment and see whether we can [achieve an] equivalent outcome without putting patients through as much treatment. I think that is definitely a recurring theme in the radiation oncology field for some of the recent breast cancer trials.

I just want to mention a few that are exciting that we took part in at our institution, at USC. One of them is the NSABP B-51 trial [NCT01872975]. [This] looked into patients who had neoadjuvant chemotherapy; they initially had a lymph node in the axilla involved, but the lymph node cancer was completely wiped out by chemotherapy. [The question was,] can [we] perhaps decrease the field or amount of radiation? That trial showed some excellent early results, and so that is allowing us to gradually de-escalate the radiation. In some cases, patients may skip radiation altogether if they’re really favorable; we were definitely not doing that before a few years back. So, we’re starting [to consider] that.

Another one that I’m really happy about was the [phase 3] Alliance 221505 trial [NCT03414970]; there’s a charming acronym for it, called RT CHARM. That trial looks into [the question of,] for patients who have a mastectomy and need radiation, can we shorten the radiation from their standard 5-week, everyday radiation to only 3 weeks? The trial result was just presented a few months ago at our national meeting, and it was a great success. At 2 years, there was no difference in complication rates or outcome that we could see. Of course, we want to wait for a little bit longer follow-up, [but] it really confirms that in a lot of the early localized breast cancer cases, the hypofractionated short course radiation is probably just as good as the ‘standard conventional’ 5-week radiation.

We have ongoing trials looking into de-escalation of radiation, as well. We have [the phase 3] NRG-BR007 [DEBRA; NCT04852887] and NRG-BR008 [HERO; NCT05705401] trials that are looking into eliminating radiation therapy after lumpectomy in certain [patients with] very favorable risk early-stage breast cancer—so [those] with either low Oncotype [DX Recurrence Score of 18 or less], which is for NRG-BR007, or [those with] HER2-positive [disease] who get appropriate HER2-directed therapy, which is NRG-BR008. We also have [the phase 3] CCTG MA.39: TAILOR RT [NCT03488693], which is looking into [the question of,] for patients with low Oncotype [recurrence score] and with axilla lymph node with limited involvement, can we perhaps de-escalate lymph node radiation? All of this takes a lot of coordination with the surgeons and the medical oncologists. We all need to be on the same page, order the right test like the Oncotype, and the surgery has to be per protocol. Everything has to follow a timeline. So early coordination of care about these [factors] in a multidisciplinary model [is needed]. Starting with the multidisciplinary clinic has been very, very helpful for me to get these patients on the radiation trials.

Right, and when you think about these [efforts], [it should be noted that] these are large cooperative studies. [They are] not just a USC-based [studies]; these are institutional based across the United States, and the idea is that you’re going to enroll enough patients that you can assign to either the standard of care [SOC] or the experimental treatment, in order to have enough patients and enough long-term follow-up so that you can really change the SOC to make the SOC even better. I think that these de-escalation interventions are so motivating; they are so sensible. Like you said, there have been a number of trials that have been presented that are really supporting these de-escalation [approaches], which I think is just a very, very smart intervention. And, as you said, when we coordinate with the surgeon and the medical oncologist, it really helps motivate the patients to understand that we don’t know what exactly the right answer is, but we’re going to [provide] the best treatment intervention. The clinical trial participation really makes a lot of sense, and it’s useful for not only the patient, but really the whole world and the whole practice that any patient would be exposed to.

For sure. I'm sure that goes for system therapy, as well.

Check back tomorrow for the next episode in the series.

Experts discuss how coordinated clinical trial participation enables safer treatment de-escalation and advances breast cancer care through research efforts.

In this episode of OncChats: Coordinated Care in Breast Oncology, experts discuss how coordinated tumor board reviews enhance continuity of care, treatment personalization, and patient confidence following breast cancer surgery.

Coordinated Care in Breast Oncology: Tumor Board & Treatment Alignment

, Jason Ye, MD, and Daphne B. Stewart, MD, of Keck Medicine of USC, discuss how coordinated tumor board reviews enhance continuity of care, treatment personalization, and patient confidence following breast cancer surgery.

 Another topic that maybe we can discuss is, after patients go through the multidisciplinary discussion and treatment planning, [there is] the tumor board. [Maybe we can discuss] what happens there.

Sure, happy to introduce that. Earlier, [we alluded to how we] meet together as a team, a five-member [or so] team, before [the patient] undergoes any sort of treatment. Based on that multidisciplinary clinic, we plan for treatment. Then, when a patient undergoes surgery, this five-member team comes back together again immediately after the surgery with a multidisciplinary tumor board to review the response to up-front therapy, the response to the surgery, [determine] what the extent of disease [is], and what the risks of disease [are.] Again, we are discussing how we move forward for the future, to optimize the outcomes and all of our resources. That would be continuing with adjuvant treatment, whether [in the form of] chemotherapy, antiestrogen therapy, radiation therapy, and as Jason mentioned, [we would reflect on] additional breast reconstruction options, occupational therapy and physical therapy, [and] survivorship therapy, so that [the patient] can take advantage of everything to make [them] feel better and more confident [about their care]. [We also ensure] that the team is coordinating so that there is no overlapping confusion where, for example, a surgeon is giving one bit of advice, and the radiation oncologist is giving a different bit of advice. This way, [everything is] connected, and that will give the patients more confidence, because we have one big plan moving forward.

Absolutely, and our surgical fellows and our radiologists and pathologists do a great job of summarizing [each] case. I really like reviewing the whole treatment journey from diagnosis, to before surgery, to looking at the actual pathology, and then to have a discussion of the treatment. To go back to the multidisciplinary breast clinic concept, and I know we talked about this a lot, but to me, I feel like it’s nice for the patients to then be sent back to a provider that they’ve already met before as opposed to [having to go to] a brand-new doctor for radiation. [This prevents them from having to go see a provider they have] never met before, [after they] just had surgery [and are focused on] recovering. There’s a lot going on in [their] mind [at that point.] I think that coordination is really valuable.

For medical oncology, probably about 30% of our patients do get systemic therapy up front because they either have large tumors or they have higher-risk subtypes that benefit from doing neoadjuvant chemotherapy. The idea is that you’re giving chemotherapy or potentially endocrine therapy to shrink the primary tumor, and that impacts long-term survival. We’re very, very eager to assess the response to treatment. So, you give the treatment up front, and the treatment often lasts for 6 months before you actually go to the surgical intervention. [What happens] is, the medical oncologist does the primary management for many, many months. Then, the patient goes back to the surgeon, and then, as Jason pointed out, they go back to radiation oncology. So again, to be able to have this interconnected team that is coordinated on the same path [is important]. It’s very, very useful to already have those initial connections.

I do want to point out that the tumor board becomes so useful with our outstanding radiologists and pathologists, because after you do systemic therapy prior to surgery, it’s crucial that we assess the amount of residual cancer after that up-front treatment. We know that in certain breast cancer subtypes—specifically triple-negative breast cancer or HER2-positive breast cancer—if [a patient has] significant response to treatment, [ie] the tumor shrinks or completely enters remission after systemic therapy [in] that when you do the surgical resection you cannot find any residual cancer, that is associated with a very good long-term prognosis.

I think what we’re going to get into next is discussion about these really provocative clinical trials that are upcoming, which may allow de-escalation of certain therapies after surgical resection, when [a patient has] received up-front systemic therapy, and gives us a lot of opportunities to modify our initial treatment options to improve outcomes, patients’ quality of life, and maybe reduce [adverse] effects.

Experts discuss how coordinated tumor board reviews enhance continuity of care, treatment personalization, and patient confidence after breast cancer surgery.

Experts discuss how involving plastic surgeons and genetic counselors early in breast cancer care helps guide personalized surgical decisions.

Coordinated Care in Breast Oncology: Importance of Plastic Surgery & Genetic Counseling

, Jason Ye, MD, and Daphne B. Stewart, MD, of Keck Medicine of USC, discuss how involving plastic surgeons and genetic counselors early in breast cancer care helps guide personalized surgical decisions—such as breast-conserving options or reconstruction—and ensures safer, more effective treatment plans based on individual risk factors.

A lot of times, when the surgery happens, maybe it will close the door to certain options. We should also mention that our plastic surgery colleagues and genetic counselors are also a crucial part of this decision. I think you and I agree that for most early-stage breast cancer [cases,] people do okay without mastectomy. Lumpectomy breast conservation therapy is our treatment of choice or preferred option. Still, sometimes it may not be appropriate depending on whether the patient has a certain genetic mutation that may make radiation and other therapies more risky, or they have really high recurrence risk or future breast cancer risk, which might change the decision. That’s where the plastic surgeon colleagues will also come in; if we want breast conservation, [they can talk about how] there are these oncoplastic reconstruction options where you end up with a very symmetrized breast without a more obvious surgical defect. If [a patient] gets a mastectomy, there are various options: nipple sparing, skin sparing mastectomy, implant-based or tissue flap-based reconstruction.

And lymphatic transfer is a new technology that we have available that’s really changing things in terms of the risk of chronic lymphedema when you do axillary dissection of involved lymph nodes. So, [this is] really a crucial discussion to have.

It is, it is. Just because breast cancer outcomes [are] so great these days, and much, much better compared with 10 or 20 years ago, we really are focused on quality of life [QOL] and survivorship after we put the patient into remission, or dare I say, ‘cure’ the patient. And yes, the decision regarding dissection vs sentinel lymph node biopsy and maybe radiation [is important. Also,] if you do the dissection, would the patient be eligible for some lymphatic bypass or repair at the time of surgery so that it lowers the chance of lymphedema? By having all of these discussions, patients also get referred to our physical therapy and occupational therapy colleagues early on, so they then start all the preventive exercises early so that these things don’t even happen to begin with. I always tell patients the best way to treat lymphedema is to make sure it doesn’t happen to begin with. So, all of this really comes down to a multidisciplinary discussion and treatment coordination. None of us can do this alone.

And I think that [when they walk in the door,] patients are going to have a strong opinion about [whether they want] their whole breast removed, both breasts removed, [etc.] That’s really what they [tend to] come in [with] but I think [the discussion] opens up their minds to the multiple interventions. You could do breast conserving surgery, and there could be a QOL benefit, and in fact, survival benefits long term. If [a patient has] high-risk disease or a large tumor, [they] are potentially going to benefit from doing systemic therapy with [their] medical oncologist before [they] go to surgery, and that intervention may dramatically alter what [their] surgical planning and even [their] radiation planning might be after that. So again, it leads to a number of pathways. [This] can be very reassuring, [to know] that [they] have choices. [They] don’t just have to make one decision. But again, when you [have] a team of experts who then coordinate [what is decided on] it really helps the patient feel more confident.

Absolutely, and that’s really one of the things that makes me really proud and happy to work here at USC.

In this episode of OncChats: Coordinated Care in Breast Oncology, experts discuss how early multidisciplinary collaboration in breast cancer care—particularly involving radiation oncology at diagnosis—can alleviate patient fears, guide more informed surgical decisions, and improve access to clinical trials and outcomes.

Coordinated Care in Breast Oncology: Role of Radiation Oncology

, Jason Ye, MD, and Daphne B. Stewart, MD, of Keck Medicine of USC, discuss how early multidisciplinary collaboration in breast cancer care, particularly involving radiation oncology at diagnosis, can alleviate patient fears, guide more informed surgical decisions, and improve access to clinical trials and outcomes.

For me, personally, as a radiation oncologist, as you know, radiation typically comes toward the tail end of breast cancer treatment. If you’re talking about a localized breast cancer, [patients] typically would get surgery and chemotherapy before they receive radiation, if needed. So, [it is good] for me to be able to see the patient before the surgery, at the time of diagnosis, to introduce myself and really alleviate a lot of the fear and [address some of the] questions that they might have. [I can] let them know that it’s a very safe and effective treatment, toxicity is getting less and less, things are getting more convenient, and treatments are getting faster and easier [to administer]. To be able to really explain that to the patient and make sure they can make an informed decision, for me, is very, very rewarding.

I think a lot of the patients appreciate that, too, because there is a lot of stigma or fear about radiation. It sounds scary. A lot of people don’t know what it is, and so, sometimes people [talk themselves] into getting perhaps a more extensive surgery than necessary, when they could have had a less extensive surgery and received the radiation and actually end up with the exact same oncological outcome and likely better quality of life in many cases. So yeah, having that discussion up front really drives not just the radiation decision, but the surgical decision, as well. We’re going to touch on this, maybe a little bit later, but also, clinical trial eligibility is another thing [we can bring up] during the huddle. [We can say,] ‘Hey, this is maybe a few weeks or months down the line, but if we go in this direction, [the patient] might be eligible for this exciting new clinical trial that’s testing a new paradigm.’

I think you’re making a really important point. Often, when people are newly diagnosed with breast cancer, they are initially referred to a surgeon, and the surgeon is often in a big hurry to get to the resection of the tumor immediately. So, a patient often gets their surgical resection without ever having a discussion, like you said, with radiation oncology or medical oncology, and they may fail to understand up front that this really has to be a multidisciplinary team to take advantage of all the resources that reduce the risk of an in-breast recurrence. And, as a medical oncologist, you really worry about a distant metastatic recurrence, and what interventions you can take to reduce that risk. And I think that if you have a conversation up front and understand that surgery is crucial for curing cancer, that radiation oncology is crucial for reducing a chest wall or in-breast or axillary recurrence, and that a medical systemic therapy intervention is crucial to reduce the risk for future new breast cancer or any type of recurrence. I think if a patient has an opportunity to meet with a team that interacts and has a multidisciplinary plan, they can really take advantage of all of those resources, and it's much more streamlined.

Experts discuss the importance of early multidisciplinary collaboration in breast cancer care, particularly involving radiation oncology at diagnosis.

In this episode of OncChats: Coordinated Care in Breast Oncology, experts discuss how a multidisciplinary clinic streamlines care and improves treatment planning for patients with newly diagnosed breast cancer.

Coordinated Care in Breast Oncology: Benefits of the Multidisciplinary Clinic

, Jason Ye, MD, and Daphne B. Stewart, MD, of Keck Medicine of USC, discuss how a multidisciplinary clinic streamlines care and improves treatment planning for patients with newly diagnosed breast cancer.

Hello, my name is Jason Ye, MD. I’m a radiation oncologist working at the Keck Medical Center and Norris Comprehensive Cancer Center of USC. I focus on breast, lung, and central nervous system malignancies. It’s a pleasure to speak on 

 My name is Daphne Stewart, MD. I’m joining Dr Ye as his colleague. I am a medical oncologist. I focus primarily on women’s cancer, specifically breast cancer, here at the Keck Medicine School at USC. We’re here to just discuss how we work together and how we can optimize care for patients with newly diagnosed breast cancer. How do we do that, Jason? What is the way that we optimize our treatment for our patients?

 For me, one of the really great pleasures of working at our institution is the multidisciplinary clinic that we have for [patients with] breast cancer. As you mentioned, when patients are newly diagnosed with breast cancer, there is just so much information to discuss, an overwhelming amount of information, and so many providers you have to see. At Keck, since around 2017 or 2018, we [gathered] all the breast cancer–related providers and put together this very nice multidisciplinary breast clinic.

To give everyone an overview of how this works: Patients will reach out to our nurse navigator, who is going to [work with them to collect] all of the necessary records, all of the available information. We currently have the multidisciplinary clinic once a week, on Mondays. Prior to the meeting, we get a summary of all external information and records that exist for the patient, and we have a morning huddle with all of the providers—surgical oncologists, medical oncologists, radiation oncologists, etc. We have a plastic surgeon on board, [or those involved with] genetic testing, and this is our core team. [We will also loop in] other providers, as needed. We have a huddle to discuss the summary of the case, and they start to think about [whether] the patient needs additional workup or what treatment we should start with. Then, when the patient shows up, they will be able to see all the necessary providers that they’re going to go through the treatment journey with—all in the same morning.

[This provides them with a really nice opportunity to really get the big picture [of what’s to come]. I’m a very big picture kind of guy; I want to know what’s going to happen—1, 2, 3, 4, 5, all the steps—before I embark on a journey. [With this,] they get to do that. They get to meet all the providers, as opposed to having to make multiple appointments on different days [and at] different locations, [which we know] gets very, very overwhelming for the patients. They will [leave] the clinic with a summary of a [potential] plan, whether it be that we need to do some additional tests or [we have outlined] the next step of treatment. I think [this provides a] really great experience to our patients and really sets [us apart].

Daphne, you’ve joined us more recently, so maybe you can speak to how this [approach] is similar or different from your previous experience?

 I’ve been at USC for about 2 years now, and one of my favorite clinical parts of my experience here is this multidisciplinary breast clinic because it is just a very, very tightly woven process. [At] other sites where I have worked, it’s been very difficult to organize operationally—specifically [in terms of] having enough space in the clinic so that you can have five providers that overlap, and that you can schedule five providers in the same half-day space. But [here] we have prioritized this amongst all of our partners on all of these teams to make it possible.

With a navigator, we have been able to schedule patients very quickly, within 14 to 21 days. Yes, there are delays sometimes because we don’t have access to outside records, and sometimes patients do, like you mentioned, require additional testing, but the patient, when they are able to be seen are able to generally be given a comprehensive forward-moving plan so that they know what the next few weeks of the treatment or interventions are going to look like. They [also] have opportunities to ask everyone specific questions. The other thing that you mentioned that I think is so effective is the huddle. When you spend 30 minutes together going through the patient [cases] and going through the side-by-side planning, we can optimize the education to the patients, so [they] have less confusion about different opinions. We’re really collaborating and making one plan going forward, which I think is really effective.

Experts discuss how a multidisciplinary clinic streamlines care and improves treatment planning for patients with newly diagnosed breast cancer.

Daphne B. Stewart, MD