Early-stage Breast Cancer: Choosing Your Surgery

Reading time: 4 – 6 minutes

In honor of Breast Cancer Awareness Month, Health Dialog, a leading provider of care management, healthcare analytics and decision support, has made its industry-leading breast cancer decision aid Early Stage Breast Cancer: Choosing Your Surgery available to the general public. As a public service throughout the month of October, Health Dialog is providing access to a series of tools, information and resources about potential treatment options for breast cancer (see below).

Over 200,000 American women will be diagnosed with invasive breast cancer this year [1]. Health Dialog’s decision aid for early-stage breast cancer helps empower women with the information they need to answer tough questions and make informed decisions when they face a breast cancer diagnosis. The company’s decision aids are currently offered to over 20 million individuals through the health plans that the company works with and also at various physician practice demonstration sites through the Foundation for Informed Medical Decision Making.

Facing the decisions

Women diagnosed with early-stage breast cancer face many decisions. The quality of a decision can be measured by the extent to which the treatment reflects the goals of the patient (i.e. what is most important to an informed patient). A recent study that surveyed breast cancer survivors and providers for three types of breast cancer treatment decisions — surgery, reconstruction and adjuvant chemotherapy, and hormone therapy — identified 38 facts (11–14 per decision) and 27 goals (8–10 per decision) relevant to each treatment decision [2].

These facts and goals are reflected in Health Dialog’s breast cancer decision aid Early-Stage Breast Cancer: Choosing Your Surgery. The program is just one of Health Dialog’s many Shared Decision Making initiatives that has been nationally recognized.

Health Dialog is a private, wholly-owned subsidiary of Bupa, a global provider of healthcare services. Health Dialog helps healthcare payors improve healthcare quality while reducing overall costs. Company offerings include health coaching for medical decisions, chronic conditions, and wellness; population analytic solutions; and consulting services. Health Dialog helps individuals participate in their own healthcare decisions, develop more effective relationships with their physicians, and live healthier, happier lives.

Early-stage breast cancer: choosing your surgery

Health Dialog’s decision aid Early Stage Breast Cancer: Choosing Your Surgery provides patient-friendly explanations of medical terms, comparisons of the treatment choices, photos and diagrams, many videos, and a printable booklet, covering everything from how to read a pathology report to illustrating what a patient can expect from different types of surgeries.

The decision aid explains what breast cancer is, the local and systemic treatments for breast cancer, and choices for surgery: mastectomy or lumpectomy with radiation. It describes each of the surgeries and what to expect after the procedure is done, including possible side effects.

The decision aid helps patients make decisions by comparing and contrasting treatments, asking personal, reflective questions about the choices, and suggesting questions to ask the doctor. In addition, the tool includes photos of how women look after lumpectomy or mastectomy, after breast reconstruction surgery, and in some cases after surgery on the other breast to match the results of a breast reconstruction.

The section on working with your doctor defines “shared decision-making” and provides video interviews with women who were involved in their treatment decisions. Lastly, something we particularly like here at Highlight HEALTH, all the research that supports the decision aid is listed and linked to abstracts published at the National Library of Medicine.

Health Crossroads

According to Jan Maurer, MD, Vice President and Medical Director at Health Dialog [3]:

Facing a breast cancer diagnosis is an intimidating situation that thousands of women unfortunately experience every month. Research shows that women participating in their treatment decisions are more confident in facing the experiences that come with the diagnosis. This decision aid is designed to strengthen the conversations between patients and physicians and help empower women to make informed decisions about their breast cancer treatment.

You can explore the decision aid at www.healthdialog.com/go/BCAM. You can also get there by going to www.healthdialog.com and, at the bottom of the page under “Raising Awareness,” clicking on “Visit HealthCrossroads.com.”


  1. Cancer Facts & Figures 2010. American Cancer Society. 2010.
  2. Lee et al. Development of instruments to measure the quality of breast cancer treatment decisions. Health Expect. 2010 Sep;13(3):258-72. Epub 2010 Jun 9.
    View abstract
  3. Health Dialog Makes Decision Aid Available for Breast Cancer Awareness Month. Health Dialog. 2010 Oct 5.
About the Author

Walter Jessen is a senior writer for Highlight HEALTH Media.