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Clinical Benefit in the Treatment of Patients with Early Breast Cancer
- Source :
- The Breast. 48:S115-S118
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Adjuvant treatment for early breast cancer involves multiple modalities with distinct toxicities and varying relative contributions to the improvement of long-term outcomes. In many situations the expected benefits of treatment may be modest and thus debated, and even in higher risk scenarios, when treatment is clearly indicated, several options are available with varying schedules and toxicities. Regulatory and professional society guidelines defining clinical benefit are available to guide decision-making, but do not capture clinical meaningfulness. There is wide variation among patients regarding the expected improvement in outcomes sufficient to make adjuvant chemotherapy or endocrine therapy worthwhile. While many consider small improvements in outcomes meaningful, some need greater benefit, and a small minority prefer to avoid adjuvant therapies at any rate. Shared decision making has a central role in bridging between clinical evidence, multiple treatment alternatives and patient preferences in the adjuvant treatment of early breast cancer. It is associated with increased patient involvement and responsibility, satisfaction, quality of life and in some instances increase the likelihood of accepting adjuvant treatment. A current understanding of evidence and clinical guidelines, combined with the skills to elicit and appreciate individual patient preferences, is necessary to determine an optimal treatment approach for every individual with breast cancer.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Decision Making
Breast Neoplasms
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Breast cancer
medicine
Adjuvant therapy
Humans
030212 general & internal medicine
Multiple modalities
Intensive care medicine
Early Detection of Cancer
Early breast cancer
business.industry
Patient Selection
Optimal treatment
Endocrine therapy
General Medicine
medicine.disease
Patient preference
Chemotherapy, Adjuvant
030220 oncology & carcinogenesis
Female
Surgery
Patient Participation
business
Adjuvant
Subjects
Details
- ISSN :
- 09609776
- Volume :
- 48
- Database :
- OpenAIRE
- Journal :
- The Breast
- Accession number :
- edsair.doi.dedup.....1ea4e7309b9b2967a8ee6087ab389458