A computer based program to assist in adjuvant therapy decisions for individual breast cancer patients

This paper describes a personal computer based tool to aid in decision making about whether a woman should receive adjuvant therapy for breast cancer. This tool can assist in engaging women with primary breast cancer in the discussion about: 1) her risk of breast cancer related mortality if she receives only local control measures, but no systemic adjuvant therapy, 2) how much receiving adjuvant therapy may reduce this risk, and 3) what the impact of receiving the adjuvant systemic therapy is in terms of survival. The tool utilizes life table analytical techniques to project outcomes after entry of patient age (used to calculate natural mortality rates), estimated risk of breast cancer related mortality (with a help tool allowing the physician to use estimates based on national database information), and estimate of the efficacy of adjuvant chemotherapy (with included tables of estimates based on the Early Breast Cancer Trialists' meta-analysis). Computer based tools can serve as valuable aids in patient and physician education, and the process of informed decision making.