A computer program to assist in making breast cancer adjuvant therapy decisions.

This report describes a computer program designed to assist health care professionals in making projections of the average benefit of systemic adjuvant therapy for individual breast cancer patients. It requires as input patient age (used to make projections of natural mortality), an estimate of breast cancer-related mortality at 5 years (used to make projections of breast cancer-specific mortality), and the proportional risk reduction for breast cancer mortality expected for the adjuvant therapy (with included tables from the Early Breast Cancer Trialist's 1992 meta-analysis). The program uses life table analytical techniques to make projections of outcome in three scenarios: that the breast cancer never occurred, that the breast cancer patient received definitive local therapy but no adjuvant systemic therapy, and that the patient received adjuvant therapy. The outcome projections are given for total, natural (non-breast cancer-related), and breast cancer-related mortality at several time points and also of total remaining life expectancy. These estimates are currently widely made by clinicians by nonnumerical techniques. Computer-based tools can serve as valuable aids in physician and patient education and in the process of informed decision making.