Women with breast cancer who use a simple visual tool invented in Canada are better prepared to navigate through their treatment options, a new study suggests.

Early stage breast cancer patients face a tough choice: mastectomy, which removes the entire breast or lumpectomy, which removes the tumour and is followed by radiation treatment. Doctors say survival rates are similar for both options.

Researchers in Ontario tested the value of a "decision board," a flip-chart aid that presents visual and written information to patients to help them decide between a mastectomy or a lumpectomy. Their study appears in the July 28 issue of the Journal of the American Medical Association.

Part of the cancer decision tree

"It's the patient who has to experience the treatment, endure the side effects and gain any potential benefits," said Dr. Timothy Whelan, a radiation oncologist at Hamilton's McMaster University, where the device was developed. "So they're really the person who should be making the decision about their treatment."

Whelan and his colleagues compared 97 women who used the device with 107 women who had traditional discussions with their oncologists and surgeons.

They found those who used the device better understood their disease and options. Of those who used the board, 94 per cent chose lumpectomy, compared to 76 per cent in the other group.

Dr. Tim Whelan

Women who used the decision board were also more likely to be confident in their decision.

"The more informed you are, the better choices you can make for yourself," said Marilyn Hundleby, a clinical psychologist in Edmonton who counsels cancer patients. "I think it makes it much easier to dialogue with the surgeon, with the oncologist, when you have a sense of knowing the material."

Eileen Burris of Edmonton said a decision board helped her. "I could digest it," said Burris, who was diagnosed with breast cancer 15 months ago. "I could ask questions, rather than just being told what your options are."

The authors of a second study concluded a similar CD-ROM tool also helps to educate women about genetic testing for the BRCA1 and BRCA2 genes, compared to those who received only standard genetic counseling. People who inherit mutated versions of the genes have an increased risk of developing breast cancer.

Since treatments and options change rapidly, a computerized version of the Hamilton test is now being tested to accurately reflect updates.