The importance of sharing decisions: a case report
DOI:
https://doi.org/10.32385/rpmgf.v38i1.12941Keywords:
Screening; Breast cancer, Shared decision, Overdiagnosis, OvertreatmentAbstract
Introduction: Breast cancer screening aims to provide an earlier diagnosis of this pathology, to allow a less aggressive intervention and better health outcomes. However, despite this recommendation being advocated for women over 50 years old, the same does not happen in younger women in whom the importance of discussing risk-benefit and shared decision are even more relevant. This clinical case aims to highlight the importance of informed and shared decisions with the patient about health.
Case description: A 48-year-old female health professional, without relevant family or personal history. At the age of 40, she had an appointment with a gynaecologist who prescribed mammography without any further information. The result was a BI-RADS 4 and she was referred to hospital care, where she underwent a needle biopsy which did not identify malignant cells. She kept surveillance with her family doctor and by the age of 47 she receives another BI-RADS 4 result. Once again in-hospital care, she chooses excisional surgical biopsy because of the psychological negative impact caused by the expectation and uncertainty of the result.
Comment: In this case, considering the absence of major risk factors for breast cancer and the age of the patient, the risk of overdiagnosis and overtreatment must be considered when starting a breast cancer screening programme. Therefore, the disclosure information about health should be clear and decision-making should be shared with the patient to accurately reflect her will and beliefs.
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