• Mary Ann O'Brien, Timothy J Whelan, Cathy Charles, Peter M Ellis, Amiram Gafni, Peter Lovrics, Adrianne Hasler, and Susan Dimitry.
• Supportive Cancer Care Research Unit, Juravinski Cancer Centre and McMaster University, Hamilton, ON, Canada. maobrien@mcmaster.ca
• Patient Educ Couns. 2008 Dec 1; 73 (3): 431-6.

ObjectiveThere is limited understanding about what treatment decision making (TDM) means to patients. The study objective was to identify any processes or stages of TDM as perceived by women with early stage breast cancer (ESBC).MethodsInitial consultations with a surgeon or medical oncologist were videotaped. Subsequently, women viewed their consultation using a qualitative approach with video-stimulated recall (VSR) interviews. Interviews were taped, transcribed, and analyzed.ResultsThere were 6 surgical and 15 medical oncology (MO) consultations. Most women described TDM as beginning soon after diagnosis and involving several processes including gathering information from informal and formal networks and identifying preferred treatment options before the specialist consultation. Many women wanted more information from their surgeon so they could engage in subsequent TDM with their medical oncologist.ConclusionIn this study, women with ESBC began TDM soon after diagnosis and used several iterative processes to arrive at a decision about their cancer treatment. VSR interviews can be useful to investigate TDM occurring during the consultation.Practice ImplicationsWomen with ESBC rely on information provided by their surgeons and family physicians to make treatment decisions about surgery and also to prepare them for subsequent discussions with medical oncologists about chemotherapy.

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