Health Affairs, 26, no. 3 (2007): 761-769 doi: 10.1377/hlthaff.26.3.761 © 2007 by Project HOPE	New Online   Pay Cuts For Medicare Docs   Access To Care Woes   Public Coverage More Efficient   Empowering Consumers

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Case Studies

From Policy To Patients And Back: Surgical Treatment Decision Making For Patients With Breast Cancer

Persistent use of mastectomy for breast cancer has motivated concerns about overtreatment by surgeons and lack of patient involvement in decisions. However, recent studies suggest that patients perceive substantial involvement and that some patients prefer more invasive surgery, while other research suggests that surgical treatment choices might be poorly informed. Decision-making quality can be improved by increasing patients’ knowledge about treatments’ risks and benefits and by optimizing their involvement. The mastectomy story underscores the limitations of utilization measures as quality indicators. Strategies to improve patient outcomes should focus on tools to improve the quality of decision making and innovations in multispecialty practice.

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