ABSTRACT
Much has changed in the way that medicine is perceived and practiced in the 10 years since 2001 when I was invited by Mr Uccio Querci della Rovere to write a chapter on informed consent in the management and research for breast cancer for the second edition of Early Breast Cancer from Screening to Multidisciplinary Management (4). At that time, “Informed consent” was a new chapter to appear in the fi nal section, Consent and litigation, although an accompanying chapter on medicolegal aspects had featured previously in the fi rst edition. Ten years on, the structure and content of the third edition of this book refl ects not only the scientifi c and technological advances that have affected the early detection and treatment of breast cancer in the intervening years, but also the changing milieu in which healthcare is offered with respect to the doctor-patient relationship; closer attention to economics; changes in culture and attitudes generally. Further changes in governance and regulation have affected standards of consent in healthcare and research, and they are a further signifi cant factor that now needs to be considered (5). In addition to the chapters considering the multidisciplinary team and informed consent in the management of breast cancer in this new edition, space is given to the role of the breast care nurse and to shared decision-making. We have seen the development of expertise through a range of international activities concerned with shared decision-making and
risk communication, and the development of decision aids that culminated in the Salzburg Global Seminar in December 2010 with the production of the Salzburg Statement on shared decision making (6).
