Breast cancer: asking patients what they want

Makes for better decisions about treatment and research, and better outcomes

Amid the uncertainties surrounding the treatment of breast cancer, there can be important mismatches between what clinicians and local health services provide and what some women would have wanted. There are also concerns about the way research is conducted and how women come to take part in it.1 Both in treatment and research, women sometimes conclude that they and their interests meet with scant respect.2 So research that picks up trends in patients' views and detects new issues as professional practices or patients' expectations change is a necessary complement to professional assumptions and aspirations.

Fortunately, there is an exemplary study, rich in findings and insight, of women's views about decision making in treatment and research and about their reasons for holding them. Alderson and her colleagues compared the views of healthy women who had undergone screening, women who had been treated for breast cancer, and health professionals over a range of contentious issues.3 For treatment, most women in both categories of patient thought that all options should be discussed with them, including the treatments' long term implications, benefits, and risks. Most …