The Decision Making Tree

Patients with breast cancer need standard information regarding treatment options, both about their oncological treatments and about breast reconstruction in general. Every breast cancer patient has the right to be informed about her reconstructive options before ablative surgery starts and every patient is entitled to the best standard of care.


There are a large number of factors that influence the decision making process with regards to the oncological treatment. These decisions have important consequences for the choices in breast reconstructive techniques. Also the opposite is true: the availability (or absence) of the full range of reconstructive possibilities may influence the choice of ablative method. For example, if immediate total breast reconstruction can be offered, a patient might be faced with a choice between treatment option one: breast conservative therapy, radiotherapy and partial breast reconstruction and treatment option two: a skin-sparing mastectomy combined with an immediate full breast reconstruction and no radiotherapy. Although the oncological status determines the choice of treatments offered and the above combination of treatment options is not available for all breast cancer patients, the example illustrates that the availability of breast reconstruction offered by plastic surgery in the early days of diagnosis can influence choices and widen opportunities.

Many of the factors influencing oncological treatments and reconstructive options cannot be standardized and require a personalized evaluation of every single case by a team of specialists related to a breast clinic. Indeed, there are many factors that can be standardized: for a certain stage of the tumor and a certain morphology of the breast there is a certain number of treatment options that should be offered to any patient.

The Beautiful ABC Foundation is developing a logical online algorithm or decision tree that women who have just been diagnosed with breast cancer can consult. In contrast to existing oncological decision making sites as Adjuvant! Online ( and risk calculation tools as organised by the U.S. National Cancer Institute (, we are creating an algorithm for the options in breast reconstruction related to a specific tumor stage and breast size.

The result of such a process would be to provide each patient with one or more reconstructive options with regard to the ablative surgery and the postoperatively scheduled adjuvant treatment. These would just be suggestions with no formal character. The intention is to inform and to involve patients more actively in the decision making process. There is certainly no intention to corner the treating team.

The Decision Tree will be divided into 2 parts:

  1. Oncological treatment
  2. Reconstructive Treatment

The Reconstructive Treatment Decision Tree will allow a visual representation of the patient (avatar) and of the scars for each reconstructive option, with further referral to the section “medical facts”, explaining the surgery more in detail.

 Applications for the Beautiful A.B.C. Scholarship

We are looking for someone to help us develop this decision tree. Specifically, we are looking for a physician with IT experience, more specifically in the area of the development of websites. An IT-pro with Health Care experience would also be a good candidate.

The Beautiful ABC Foundation offers a scholarship of 5.000 euros to a person with the qualifications mentioned above to work on the project and have it functioning on the website within a maximum period of 6 months.

Applications should be done online uploading a motivation letter, your CV with picture and 1 or 2 letters of reference.