Tool that enables women with breast cancer to choose their own course of treatment

Jul 29 2004

McMaster University cancer researcher, Tim Whelan, a radiation oncologist with the Juravinski Cancer Centre, has developed a tool that enables women with breast cancer to choose their own course of treatment.

The Decision Board (DB) is a visual aid designed to help physicians inform patients of their options in a concise and effective way, thus paving the way for women to make their own choices.

The long-term results of international trials have demonstrated equivalent survival rates for mastectomy and breast-conserving therapy (lumpectomy plus radiation therapy) for the treatment of early stage breast cancer. Consequently, the choice of treatment, mastectomy or breast conserving therapy, should be based on a patient’s preferences.

In an article published Tuesday in the Journal of the American Medical Association (JAMA), research has shown patients using the Decision Board were more knowledgeable about their treatment, had less decisional conflict and were more satisfied with decision-making following the consultation. Patients who used the Decision Board were more likely to choose breast-conserving therapy, 94 per cent compared to 76 per cent of women who did not use the aid.

In McMaster’s cluster-style clinical trial, general surgeons in communities in central west and eastern Ontario, were randomized to use the decision aid or not in the surgical consultation with patients. Twenty surgeons participated in the study. Of the 208 eligible patients seen by study surgeons, 201 agreed to be evaluated: 94 were allocated to use the Decision Board and 107 to common practice.

The results showed that the Decision Board was helpful in improving communication, and enabling women to make a choice regarding treatment. Whelan concluded that surgeons should consider such instruments when communicating the different surgical options to women with breast cancer.