Tool Helps Breast Cancer Patients Make Tough Decision

Breast cancer affects more than 200,000 women in North America each year. And each of those women has to decide what sort of treatment to choose.

A new study published in Wednesday's issue of the Journal of the American Medical Association finds that a visual aid known as a decision board can help breast cancer patients make what could be a life-altering decision.

Breast cancer patients have a couple of choices for treatment. One choice is mastectomy, in which the entire breast is removed. The other is lumpectomy plus radiation, in which only the cancer is removed, not the whole breast. Both are equal in terms of survival.

Dr. Timothy Whelan and his colleagues at McMaster University in Hamilton, Ontario, and three other Canadian institutions designed the decision board, which has sliding doors that reveal information slowly while the surgeon talks, so the patient can more easily process and absorb what she is hearing.

In the study involving 20 surgeons, 94 patients used the decision boards with their surgeons, and 107 patients did not.

Whelan said women who used the decision board were more knowledgeable and had an improved understanding about breast cancer and its treatment. The women also felt better about the treatment they chose.

Researchers also found that women who used the decision board were more likely to choose the lumpectomy and radiation than the mastectomy. Whelan said this suggests that perhaps when the board wasn't used, women didn't clearly understand the details about their two treatment options.

Computer Program For Genetic Testing

In another study, researchers from Pennsylvania State College of Medicine tested a CD ROM-based decision aid to educate women about genetic testing for breast cancer genes BRCA1 and BRCA2.

More than 100 women received education by a computer program, followed by genetic counseling, while another 100 women received standard one-on-one genetic counseling. The results were mixed.

"An interactive computer program was more effective than standard genetic counseling for increasing knowledge of breast cancer and genetic testing among women at low risk of carrying a BRCA1 or BRCA2 mutation," the researchers wrote. "However, genetic counseling was more effective than the computer at reducing women's anxiety and facilitating more accurate risk perceptions."

Lead researcher Dr. Michael Green said the computer program could suffice on its own as an educational method for women at low risk for the genes. But the program should only supplement standard counseling for women at high risk for hereditary breast cancer, he said.

Full Studies:

'Decision Board' For Treatment Options
Computer-Based Decision Aid On Genetic Testing