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NCCN Guidelines for Patients


Breast Cancer - Early-Stage


, Version 1.2016


Making treatment decisions

Weighing your options

Weighing your options

Deciding which option is best can be hard. Doctors

from different fields of medicine may have different

opinions on which option is best for you. This can be

very confusing. Your spouse or partner may disagree

with which option you want. This can be stressful. In

some cases, one option hasn’t been shown to work

better than another, so science isn’t helpful. Some

ways to decide on treatment are discussed next.




The time around a cancer diagnosis is very stressful.

People with cancer often want to get treated as soon

as possible. They want to make their cancer go

away before it spreads farther. While cancer can’t be

ignored, there is time to think about and choose which

option is best for you.

You may wish to have another doctor review your test

results and suggest a treatment plan. This is called

getting a 2


opinion. You may completely trust your

doctor, but a 2


opinion on which option is best can


Copies of the pathology report, a DVD of the imaging

tests, and other test results need to be sent to the

doctor giving the 2


opinion. Some people feel

uneasy asking for copies from their doctors. However,

a 2


opinion is a normal part of cancer care.

When doctors have cancer, most will talk with more

than one doctor before choosing their treatment.

What’s more, some health plans require a 2



If your health plan doesn’t cover the cost of a 2


opinion, you have the choice of paying for it yourself.

If the two opinions are the same, you may feel more

at peace about the treatment you accept to have.

If the two opinions differ, think about getting a 3


opinion. A 3


opinion may help you decide between

your options. Choosing your cancer treatment is a

very important decision. It can affect your length and

quality of life.

Decision aids

Decision aids are tools that help people make

complex choices. For example, you may have to

choose between two options that work equally as

well. Sometimes making a decision is hard because

there is a lack of science supporting a treatment.

Decision aids often focus on one decision point.

In contrast, this book presents tests and treatment

options at each point of care for women in general.

Well-designed decision aids include information

that research has identified as what people need

to make decisions. They also aim to help you think

about what’s important based on your values and


A listing of decision aids can be found at

decisionaid. .

Decision aids specific to stages I

and II breast cancer are:

Genetic testing:

Breast-conserving therapy vs. mastectomy:

Breast reconstruction after mastectomy:

Support groups

Besides talking to health experts, it may help to talk

to patients who have walked in your shoes. Support

groups often consist of people at different stages of

treatment. Some may be in the process of deciding

while others may be finished with treatment. At

support groups, you can ask questions and hear

about the experiences of other women with breast