This paper reports our findings from a study of multidisciplinary team meetings for the treatment and ongoing management of breast cancer patients. The focus of the fieldwork was the meetings within and between a large group of multidisciplinary health professionals from two hospitals in Sydney, a large public teaching hospital and a much smaller private hospital. The paper examines the common work of the meetings and the variation within and between local practices and sites in the doing of this work, both in the local settings of each hospital and in the video-mediated setting when the local meetings are linked. Variations in the physical setup of the meetings, the presentation of the patient cases and the preparation of images used in patient discussion are identified, traced to their various sources and examined within their particular sociotechnical context. This is followed by a discussion of how local variation contributed to the particular challenges of the video-mediated meetings as experienced by the participants and how they might be addressed. Our motivations are to contribute both to the growing case studies of multidisciplinary team meetings within healthcare settings and to the important work being done to generate conceptual and design approaches that can support the development and successful use of CSCW technologies across highly variable local settings.