Demo paths — Elena Vargas

DEMO / FICTION

Multiple critical-thinking paths

Presented neutrally with risks and uncertainty. Education for conversation — not advice, not ranking.

1 · Watchful / active surveillance framing

Some low-risk DCIS pathways explore monitoring with imaging and clinical follow-up instead of immediate excision. Uncertainty: selection criteria, upgrade risk at surgery, and protocol intensity vary by center and trial. Risks to discuss: anxiety, missed progression, and whether this profile (low-to-intermediate grade, ER+) fits local protocols.

Uncertainty high · protocol-dependent

2 · Breast-conserving surgery ± radiation

Remove the imaged/biopsied region with margins; radiation may be discussed to reduce local recurrence risk. Uncertainty: absolute benefit of radiation depends on age, grade, margins, and patient values. Risks: re-excision, radiation side effects, cosmetic change — balanced against local-control goals.

Common SOC conversation

3 · Mastectomy

Removes more breast tissue; may reduce local recurrence concern for some anatomies or preferences. Uncertainty: reconstruction options and timing; contralateral decisions are separate. Risks: surgical recovery, sensation change, psychosocial adjustment.

Bigger operation · preference-sensitive

4 · Clinical trial consideration

Trials may compare de-escalation, novel imaging, or adjuvant strategies. Uncertainty: eligibility windows, travel, and what “standard arm” means. Use a trials navigator as a starting map — not an enrollment decision.

Optional · eligibility unknown in demo

5 · Second-opinion checklist

Assemble pathology, imaging reports, and medication list before a review visit. See second-opinion-checklist.pdf and visit-one-pager.pdf.

Process tool

No path is recommended here. The demo shows how a private hub can hold several frames side-by-side so a person can compare questions with their clinicians.

Education only — not medical advice. This demo shows how a private Stage 0 workspace can organize labs, imaging descriptions, care-team contacts, and multiple critical-thinking paths. Clinicians advise; people decide. All names, IDs, dates of service, and values here are invented for demonstration.