Martinez Kathryn A, Kurian Allison W, Hawley Sarah T, Jagsi Reshma
VA Center for Clinical Management Research, 2800 Plymouth Road, Building 16, 3rd Floor, Ann Arbor, MI 48105, USA.
Stanford University School of Medicine, 291 Campus Dr, Stanford, CA 94305, USA.
Breast Cancer Manag. 2015;4(1):53-64. doi: 10.2217/bmt.14.47.
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.
帮助患者在乳腺癌决策中最大限度地实现自主是以人为本的医疗护理的一个重要方面。共同决策是一种策略，旨在通过将患者的价值观和偏好与医生的生物医学专业知识相结合，最大限度地提高患者的自主权。这种方法在乳腺癌决策中的应用在不同的癌症特异性干预措施（如手术、化疗）中并不统一，在某些情况下可能会给循证医疗带来挑战。对个体患者复发风险的日益精确估计以及某些治疗相应的预期获益，在帮助患者对其乳腺癌护理做出自主决策方面具有重大前景，但也可能使某些亚组患者的决策变得复杂。
