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.