By Dr. Areesha Mansoor
Abstract:
Introduction:
Noticing the paucity of site-specific tumor boards
in the public-sector healthcare setups in Pakistan, the novel
idea of student-led tumor board facilitation was introduced by
Tumor Board Establishment Facilitation Forum (TEFF). Since
its formation in 2018, TEFF has established 5 boards in Civil
Hospital Karachi(CHK) and 4 Tumor Boards in Jinnah
Postgraduate Medical Centre (JPMC). This abstract means to depict the findings of the cases discussed in our breast tumor
boards (BTB).
Methods:
This retrospective study presents the medical record
generated by TEFF breast tumor boards from June, 2022 to
September, 2024. Patient demographics, clinical characteristics
and tumor board decisions were recorded and analyzed. Patient
records were recorded in safe, encrypted storage devices and
were handled primarily by the principal investigators. A total of
39 breast cancer cases were studied. 3 of these cases were
removed from the study as the complete data necessary for
analysis was not present, hence data of 36 cases was analysed
for this paper.
Results:
Of the 36 cases analyzed, 24 cases were discussed in
BTB of CHK and 12 were from JPMC. All of the BTB held in
JPMC were in-person meetings while 3 of the breast cancer
cases from CHK were discussed in hybrid meetings, and 21
cases were discussed in virtual meetings. The mean age of
patients presenting in our boards was 53.9 years. 55.6%(20) of
the patients presenting in our boards were aged between 40-59
years, followed by those aged 60 or greater at 27.8%(10).
16.7%(6) were aged younger than 39 years. The majority of our
patients (58.3%) suffered from invasive ductal carcinoma,
11%(4) and 5.6%(2) suffered from invasive lobular carcinoma
and ductal carcinoma in situ, respectively. There were 17 cases
of triple negative disease, 9 of luminal type A, 5 of luminal type
B and 5 of HER2/nue positive disease. 15 patients presented
with early stage breast cancer, 14 patients were diagnosed with
locally advanced disease, and 7 patients suffered from
metastases. 30.5%(11) of the cases discussed were advised
follow-up after additional investigations while 69.4% of the
cases were concluded with recommendations of definitive
management plans. No significant relationship could be
established between the type of tumor board and BTB
decision(P>0.05).
Conclusion:
TEFF was established in order to bridge the tumor board deficit
in Pakistan. With these results it can be seen that
student-facilitated tumor boards are emerging as an effective
solution to this challenge as BTBs in both CHK and JPMC are
being run smoothly. Similar conceptualization may also help us
to improve patient follow-up, establish a national cancer
registry and pave the way for further advancement of the
oncological set-up in Pakistan.