title: [Adjuvant therapy for breast cancer patients: treatment decision tree from a French cancer network].
abstract: 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.
authors.affiliation: Centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bachelot
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ray-Coquard
authors.forename: David
authors.initials: D
authors.lastname: Coeffic
authors.forename: Hugues
authors.initials: H
authors.lastname: Barletta
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Gouttebel
authors.forename: Bernard
authors.initials: B
authors.lastname: Mayer
authors.forename: Thierry
authors.initials: T
authors.lastname: Muron
authors.forename: Guy De
authors.initials: GD
authors.lastname: Laroche
authors.forename: Michel
authors.initials: M
authors.lastname: Vincent
authors.forename: Fadila
authors.initials: F
authors.lastname: Farsi
authors.forename: Thierry
authors.initials: T
authors.lastname: Philip
mesh_terms: 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