Strategies to support shared decision making in breast cancer

Shared decision making is a key component of patient-centred and evidence-based healthcare. Its integration into routine care is of interest to healthcare providers, consumers and policymakers who want to improve the quality of healthcare. The process of shared decision making enables healthcare providers and a patient with a condition that has more than one available clinically appropriate management strategy, to make a joint health decision. The decision takes into account the best available evidence, in conjunction with the patient's values and preferences and understanding of the benefits and harms of available options. There is unequivocal evidence that shared decision making improves the quality of healthcare decisions, reduces unwarranted variation in care, and improves patient outcomes. Despite these benefits, shared decision making has not been systematically adopted in clinical practice in Australia. Strategies exist that can help healthcare professionals who treat patients with breast cancer incorporate shared decision making into their practice. We review these strategies, including patient decision aids, patient navigators, decision coaches, and online risk calculators.