How can we best respect patient autonomy in breast cancer treatment decisions?
Helping patients to maximize their autonomy in breast cancer decision-making is an important aspect of patient-centered care. Shared decision-making is a strategy that aims to maximize patient autonomy by integrating the values and preferences of the patient with the biomedical expertise of the physician. Application of this approach in breast cancer decision-making has not been uniform across cancer-specific interventions (e.g., surgery, chemotherapy), and in some circumstances may present challenges to evidence-based care delivery. Increasingly precise estimates of individual patients' risk of recurrence and commensurate predicted benefit from certain therapies hold significant promise in helping patients exercise autonomous decision-making for their breast cancer care, yet will also likely complicate decision-making for certain subgroups of patients.
VA Center for Clinical Management Research, 2800 Plymouth Road, Building 16, 3rd Floor, Ann Arbor, MI 48105, USA.
Kathryn A
KA
Martinez
Stanford University School of Medicine, 291 Campus Dr, Stanford, CA 94305, USA.
Allison W
AW
Kurian
VA Center for Clinical Management Research, 2800 Plymouth Road, Building 16, 3rd Floor, Ann Arbor, MI 48105, USA.|Division of General Medicine, University of Michigan, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor MI, 48105, USA.
Sarah T
ST
Hawley
Department of Radiation Oncology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA.
Reshma
R
Jagsi
breast cancer; breast-conserving surgery; chemotherapy; endocrine therapy; genetic testing; mastectomy; patient autonomy; shared decision-making