[Adjuvant therapy for breast cancer patients: treatment decision tree from a French cancer network].
Although the benefit of adjuvant therapy has largely been demonstrated for patients with local breast cancer, therapeutic indications remain controversial. The French regional cancer network Oncora investigated the decision-making process for this disease. Based on a thorough review of the literature, the risk of relapse and the potential benefit of adjuvant treatments for each group of patients were evaluated. A consensus decision-tree was drawn in which chemotherapy is proposed only to patients in whom it is expected to decrease the risk of relapse by at least 5 %. This approach, based on a widely accepted decision-making model, makes it possible to offer all patients of the network homogeneous treatment options. However, due to the subjectivity of risk/benefit estimations, patients themselves should become more involved in the decision-making process.
Bachelot
Thomas
T
Centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France.
Ray-Coquard
Isabelle
I
Coeffic
David
D
Barletta
Hugues
H
Gouttebel
Marie-Claude
MC
Mayer
Bernard
B
Muron
Thierry
T
Laroche
Guy De
GD
Vincent
Michel
M
Farsi
Fadila
F
Philip
Thierry
T
D000367:Age Factors; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003663:Decision Trees; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011379:Prognosis; D012306:Risk