Breast cancer care is often defined by preference-sensitive decisions, in which no one choice clearly dominates, and the treatment approach is ideally guided by patient values and preferences. In this context, patients are vulnerable to suboptimal decision quality due to the number and complexity of choices. Arriving at a high-quality, patient-centered decision involves both an accurate understanding of the risks and benefits of treatment options, as well as concordance with the patient's preferences and values. These 2 objectives intersect at the informed consent discussion. In radiation oncology, informed consent has an added layer of complexity related to strong desire from patients to receive the most technologically advanced treatment, often out of balance with other rational considerations. These observations highlight challenges and opportunities unique to radiation oncology in improving communication and arriving at a high-quality decision.

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