A breast cancer patient’s perspective on their physical well-being can provide a better indication of their response to cancer treatment than clinician-based tools, a new study has found, highlighting the importance of shared decision-making in the treatment process.

The research also identified differences between clinician-based data and the patient-reported data, with some clinicians overestimating their patient’s physical wellbeing.

“An essential component of patient-centred care, shared decision making is a process in which the clinician and patient collate and discuss the available evidence on the benefits and harms of treatments, ensuring the most appropriate and informed decision is made for the patient,” says study lead author Natansh Modi, an NHMRC PhD candidate in the Clinical Cancer Epidemiology Lab at Flinders University.

Two tools can be used during shared-decision making: the Eastern Cooperative Oncology Group performance status (ECOG PS), a tool interpreted by the doctor, and patient-reported outcomes (PROs), structured tools whereby a patient self-reports their perspective on their physical, social, emotional, and functional abilities.

“PROs are generally used as secondary data in clinical trials to help with interpreting results; however, they have recently shown to be important in providing a prognosis to the patient for cancer types including bladder, lung and skin cancers, but their value to HER2-positive advanced breast cancer had yet to be fully explored,” says Mr Modi.

Published in the journal ESMO Open, the study pooled data from several trials to look at almost 3000 patients who underwent drug treatments for human epidermal growth factor receptor 2 (HER2)-positive breast cancer.

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