Transparent decisions and its documentation of breast cancer patients' therapy are getting more important especially since modern therapeutic approaches favor personalized forms of treatment. The medical decisions for a treatment are very complex, because there are rules and different options for each patient. To support the decision process, we analyzed the current decision rules and implemented them in a prototype of a rule-based expert system. Thus, this system shall support the quality assurance regarding transparent documentation of individualized therapeutic decisions. For evaluating the system, we used data from a state tumor center and compared the decisions suggested by our system with expert ones. The system and the expert approach will be compared with each other as well as the differences in the treatment decisions. The first preliminary results show us that the human factor-like must be considered by creating a decision support system. The prototype delivers first results, which are restricted, but the results are promising for further developments.

Choosing the appropriate treatment for patients have a direct influence on each patient`s future. A doctor´s expertise, the patient´s preferences, and the current medical research have a highly influence on the choice of the treatment. Doctors shall be aware of their own decision patterns, the most influenced factors and the relevant literature by choosing the optimal patients treatments. By considering quality management and certifications, transparent representations of internal processes with simple decision-making notes are required. In support of the hypothesis, a decision analysis was conducted based on the S3 guideline for diagnosis, treatment and follow up care of breast cancer. A notation is required, which combines the process modeling and the representation of (medical) decisions.

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