Breast Care A-Z · Concept · MDT

Multidisciplinary team (MDT)

also: MDT, multidisciplinary team meeting, MDM, tumour board, cancer MDT

A multidisciplinary team (MDT) is the group of specialists — surgeons, oncologists, radiologists, pathologists, and nurses — who meet to review your case together and agree the best treatment plan. You may have been told your case is going to MDT, or seen it mentioned in a clinic letter.

Quick answers

Am I allowed to attend the MDT?

No — MDT meetings are clinical discussions among the team, not patient-facing appointments. The recommendation that comes out of the meeting is then explained to you at your next clinic visit.

Is every breast cancer case discussed at MDT?

In UK specialist practice, yes — every breast cancer diagnosis and every operation specimen is reviewed at MDT. This applies in both NHS and private practice and is part of the standard of care.

How long does it take from diagnosis to MDT?

Usually within one to two weeks of the biopsy result being available. The MDT meets weekly or fortnightly, and most cases are scheduled into the next available meeting after the diagnostic information is complete.

ONCOLOGY · CLINICAL GOVERNANCE multidisciplinary team MDT · breast MDT · tumour board The coordinated weekly meeting at which all specialties review each patient’s case, agree a treatment plan, and ensure equity of care across the breast cancer pathway. PLATE LXXVII FIG 01 — Weekly breast MDT meeting PATIENT CASE ◎ Radiologist □ Pathologist † Breast surgeon ★ Oncoplastic ⬢ Clinical oncologist ◆ Medical oncologist ♥ Breast care nurse ✶ CNS / coordinator Callouts: i breast radiologist — imaging interpretation ii breast pathologist — histology review iii breast surgeon — surgical planning iv clinical/medical oncologist — systemic treatment v breast care nurse — patient advocate + coordination What the MDT reviews · New diagnoses (all B5 / cancer diagnoses) · Recurrent disease · Complex cases (metastatic, BRCA, pregnancy) · Post-neoadjuvant surgery decisions · Staging discussions MDT outputs Treatment recommendation documented (MDT proforma) Patient informed by BCN same day where possible Oncology referral + surgery booking initiated FIG 02 — MDT team members and roles Role Specialty Contribution Breast radiologist Radiology Imaging review (mammogram, USS, MRI) Breast pathologist Pathology Histology, receptor results (ER/PR/HER2) Breast surgeon Surgery Surgical options (WLE/mastectomy/reconstruction) Oncoplastic surgeon Plastic surgery Reconstruction options Clinical oncologist Oncology Radiotherapy planning Medical oncologist Oncology Chemotherapy + targeted therapy Breast care nurse Nursing Patient support + coordination MDT coordinator Administration Proforma, scheduling Palliative care Palliative Symptom management + end of life Genetics (as needed) Clinical genetics BRCA / hereditary risk FIG 03 — MDT meeting structure Element Description Standard Frequency Weekly (minimum) NICE requirement Quorum Core members present Radiologist + pathologist + surgeon + oncologist Case presentation History, imaging, pathology Presenter: surgeon or BCN Imaging display PACS system All relevant imaging reviewed Histology B-classification presented ER/PR/HER2 Genomics Oncotype DX (if applicable) Presented at MDT Decision recorded Proforma documented Electronic (or paper) Patient informed BCN contacts patient Same day or next working day Audit MDT outcomes audited Cancer network requirement FIG 04 — MDT pathway 1 Biopsy confirmed (B5) 2 MDT coordinator books case for next weekly meeting 3 MDT meeting: imaging + pathology + staging reviewed 4 Treatment recommendation agreed (surgery / neoadjuvant / palliative) 5 BCN informs patient of recommendation 6 Clinic appointment for consent + planning FIG 05 — MDT meeting types New diagnosis discussion Staging MDT (CT + bone scan) Post-neoadjuvant MDT Recurrent disease MDT Metastatic breast cancer MDT Genetic / BRCA MDT input FIG 06 — Key statistics 100% of breast cancers discussed at MDT (NICE requirement) [1] 2002 weekly MDT made mandatory by NICE guidance [2] MDT reduces variation in treatment decisions across the pathway [3] >95% of MDT meetings have BCN present (NICE standard) [4] FIG 07 — References 1. NICE Improving Outcomes in Breast Cancer. Manual update 2002 2. NICE NG101. Early breast cancer 2023 3. Kesson EM et al. MDT and survival. BMJ 2012;344:e2718 4. NHS England. Breast cancer quality standards 2023 5. Association of Breast Surgery. Quality standards 2022 Clinically authored by Dr Fiona Tsang-Wright , FRCS (Gen Surg) GMC 4549831 · ORCID 0000-0003-4801-026X ONCOLOGY · CLINICAL GOVERNANCE multidisciplinary team MDT · breast MDT · tumour board The coordinated weekly meeting at which all specialties review each patient’s case, agree a treatment plan, and ensure equity of care across the breast cancer pathway. PLATE LXXVII FIG 01 — Weekly breast MDT meeting PATIENT CASE ◎ Radiologist □ Pathologist † Breast surgeon ★ Oncoplastic ⬢ Clinical oncologist ◆ Medical oncologist ♥ Breast care nurse ✶ CNS / coordinator Callouts: i breast radiologist — imaging interpretation ii breast pathologist — histology review iii breast surgeon — surgical planning iv clinical/medical oncologist — systemic treatment v breast care nurse — patient advocate + coordination What the MDT reviews · New diagnoses (all B5 / cancer diagnoses) · Recurrent disease · Complex cases (metastatic, BRCA, pregnancy) · Post-neoadjuvant surgery decisions · Staging discussions MDT outputs Treatment recommendation documented (MDT proforma) Patient informed by BCN same day where possible Oncology referral + surgery booking initiated FIG 02 — MDT team members and roles Role Specialty Contribution Breast radiologist Radiology Imaging review (mammogram, USS, MRI) Breast pathologist Pathology Histology, receptor results (ER/PR/HER2) Breast surgeon Surgery Surgical options (WLE/mastectomy/reconstruction) Oncoplastic surgeon Plastic surgery Reconstruction options Clinical oncologist Oncology Radiotherapy planning Medical oncologist Oncology Chemotherapy + targeted therapy Breast care nurse Nursing Patient support + coordination MDT coordinator Administration Proforma, scheduling Palliative care Palliative Symptom management + end of life Genetics (as needed) Clinical genetics BRCA / hereditary risk FIG 03 — MDT meeting structure Element Description Standard Frequency Weekly (minimum) NICE requirement Quorum Core members present Radiologist + pathologist + surgeon + oncologist Case presentation History, imaging, pathology Presenter: surgeon or BCN Imaging display PACS system All relevant imaging reviewed Histology B-classification presented ER/PR/HER2 Genomics Oncotype DX (if applicable) Presented at MDT Decision recorded Proforma documented Electronic (or paper) Patient informed BCN contacts patient Same day or next working day Audit MDT outcomes audited Cancer network requirement FIG 04 — MDT pathway 1 Biopsy confirmed (B5) 2 MDT coordinator books case for next weekly meeting 3 MDT meeting: imaging + pathology + staging reviewed 4 Treatment recommendation agreed (surgery / neoadjuvant / palliative) 5 BCN informs patient of recommendation 6 Clinic appointment for consent + planning FIG 05 — MDT meeting types New diagnosis discussion Staging MDT (CT + bone scan) Post-neoadjuvant MDT Recurrent disease MDT Metastatic breast cancer MDT Genetic / BRCA MDT input FIG 06 — Key statistics 100% of breast cancers discussed at MDT (NICE requirement) [1] 2002 weekly MDT made mandatory by NICE guidance [2] MDT reduces variation in treatment decisions across the pathway [3] >95% of MDT meetings have BCN present (NICE standard) [4] FIG 07 — References 1. NICE Improving Outcomes in Breast Cancer. Manual update 2002 2. NICE NG101. Early breast cancer 2023 3. Kesson EM et al. MDT and survival. BMJ 2012;344:e2718 4. NHS England. Breast cancer quality standards 2023 5. Association of Breast Surgery. Quality standards 2022 Clinically authored by Dr Fiona Tsang-Wright, FRCS (Gen Surg) GMC 4549831 · ORCID 0000-0003-4801-026X
Visual Reference · Multidisciplinary team (MDT)
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Definition
A multidisciplinary team meeting — usually called an MDT meeting — is a regular structured discussion in which a group of breast cancer specialists (radiologist, pathologist, oncologist, breast surgeon, breast care nurse, and others) review each patient's case together to agree the best treatment plan.

Common questions The questions patients ask first

Am I allowed to attend the MDT?
No — MDT meetings are clinical discussions among the team, not patient-facing appointments. The recommendation that comes out of the meeting is then explained to you at your next clinic visit.
Is every breast cancer case discussed at MDT?
In UK specialist practice, yes — every breast cancer diagnosis and every operation specimen is reviewed at MDT1. This applies in both NHS and private practice and is part of the standard of care.
How long does it take from diagnosis to MDT?
Usually within one to two weeks of the biopsy result being available. The MDT meets weekly or fortnightly, and most cases are scheduled into the next available meeting after the diagnostic information is complete.
What happens if the MDT can't agree on a plan?
This is rare — most cases produce a clear recommendation. Where there is genuine clinical equipoise (more than one reasonable option), the MDT documents the alternatives and the choice is then made between the patient and the surgeon. Cases that need specialist sub-team input (for example, very rare cancers, or unusual reconstruction questions) can be referred on to a regional or supra-regional MDT.

A multidisciplinary team meeting — usually called an MDT meeting — is a regular structured discussion in which a group of breast cancer specialists (radiologist, pathologist, oncologist, breast surgeon, breast care nurse, and others) review each patient’s case together to agree the best treatment plan.

The MDT is the standard of care in UK breast cancer treatment, both NHS and private1. Every breast cancer case is reviewed by the MDT process before the treatment plan is confirmed — in line with NHS England’s 2020 Streamlining guidance, straightforward cases may be agreed via pre-defined Standards of Care while complex cases receive full discussion, and the histology after surgery is reviewed at MDT before any additional treatment (chemotherapy, radiotherapy, hormone therapy) is decided. The MDT is what lets the recommendation a patient receives reflect the full team’s view rather than one clinician’s.

Orientation Why you might be reading about this

You may have been told your case is going to MDT, or you have read it in a clinic letter. The phrase sounds bureaucratic but the MDT is one of the more meaningful protections built into modern cancer care: it ensures that several specialists with different expertise have looked at your case before any treatment decision is finalised.

Related terms: Mastectomy · Lumpectomy · Sentinel lymph node biopsy · Core biopsy · DCIS

Who’s involved Who is in a breast cancer MDT

A typical UK breast cancer MDT includes specialists from several disciplines, each contributing their part of the picture12:

  • Breast surgeon — presents the case, the imaging findings, and the proposed surgical plan.
  • Radiologist — reviews the imaging (mammogram, ultrasound, MRI, CT where relevant) and confirms the radiological assessment.
  • Pathologist — reviews the biopsy or operation specimen and confirms the diagnosis, type, grade, and key biological features (hormone-receptor status, HER2 status).
  • Medical oncologist — advises on chemotherapy, hormone therapy, and targeted therapy where they are part of the plan.
  • Clinical oncologist — advises on radiotherapy.
  • MDT lead/chair — the consultant who chairs the meeting and is accountable for MDT governance.
  • Breast care nurse / clinical nurse specialist — often the patient’s keyworker between meetings; represents practical concerns, support needs, and communication issues raised in clinic.
  • Plastic-surgery colleague — for cases where reconstruction is being planned, particularly autologous reconstruction.
  • MDT coordinator — keeps the meeting organised, records decisions, and sends letters out afterwards.

For complex cases, a clinical geneticist may also attend (when family history or BRCA results are part of the picture), as may a radiologist with imaging-guidance expertise for borderline cases.

When it meets When the MDT discusses a case

The MDT meets weekly or fortnightly, depending on the unit. A given patient’s case is usually discussed at MDT at three points in the cancer pathway:

1. After the diagnostic biopsy, before treatment

The histology from the diagnostic biopsy is presented alongside the imaging. The MDT confirms the diagnosis and agrees the treatment plan — what surgery, what (if any) preoperative chemotherapy or hormone therapy, and what additional investigations are needed3. The plan is then communicated to the patient at the next consultation, and the surgery is booked.

2. After surgery, before adjuvant treatment

The histology from the operation specimen — sometimes more detailed than the pre-operative biopsy — is reviewed. The MDT decides whether additional treatment (radiotherapy, chemotherapy, hormone therapy, targeted therapy) is needed, and what it should be3.

3. At any decision point that arises

Cases with unusual features, conflicting findings between imaging and biopsy, or difficult treatment-planning questions can be brought back to MDT at any point.

Scope What the MDT decides — and what it doesn’t

The MDT agrees a recommended plan, not a final decision. The decision is the patient’s, made at consultation with the surgeon. The MDT’s role is to make sure the recommendation the patient is offered reflects the full team’s view, with all the relevant expertise around the table.

In practice, the MDT decision is usually accepted by the patient — the team-based recommendation usually fits well with what the patient and surgeon have already discussed in clinic. Where the patient prefers a different approach (for example, choosing mastectomy over lumpectomy when both are reasonable), the MDT view does not override that. It informs it.

Private context Why this matters in private practice

A practice that does not ensure MDT review and governance of every cancer case — for example, by relying on a single surgeon’s judgement without MDT oversight — is operating below the UK specialist standard12. All cancer cases at Breastory are reviewed through the MDT process before any treatment is confirmed, in line with NHS England Streamlining and NICE NG101.

For patients moving between private and NHS care, the MDT provides continuity: an NHS MDT and a private MDT both follow the same standard1, and a patient’s case can be picked up at either.

At consultation What to discuss with your surgeon

You may want to ask:

  • When is the next MDT at which my case will be discussed?
  • What plan is being proposed for the meeting, and is there anything in my situation that may complicate the discussion?
  • Will the recommendation come back to me before I have to decide anything? (The answer is yes — recommendations are explained at consultation, and the decision is then yours.)
  • What happens if the MDT recommendation differs from what we discussed in clinic? (This is uncommon, but if it happens, the surgeon explains why and what the options are.)

Resources Further reading

Sources & guidance

Every figure on this page is anchored to a published source. Tap a number in the text or below to jump to the reference.

  1. guidance National Institute for Health and Care Excellence (NICE). Improving outcomes in breast cancer. NICE cancer service guideline CSG1. London: NICE. 2002 https://www.nice.org.uk/guidance/retired/csg1 Cited for: UK MDT standard for breast cancer diagnosis and treatment.
  2. guidance Association of Breast Surgery (ABS). Best Practice Guidelines: surgical management of breast cancer. London: ABS. 2022 https://associationofbreastsurgery.org.uk Cited for: UK best-practice for mastectomy, sentinel-node biopsy, margin assessment, oncoplastic techniques.
  3. guidance National Institute for Health and Care Excellence (NICE). Early and locally advanced breast cancer: diagnosis and management. NICE guideline NG101. London: NICE. 2024 https://www.nice.org.uk/guidance/ng101 Cited for: UK clinical guidance for diagnosis, surgical management, adjuvant therapy and follow-up of early/locally-advanced breast cancer.