Purpose of Review <p>The goal of this review is to highlight the value of the patient voice in clinical decision-making regarding breast radiation. We seek to discuss ways in which the patient’s voice may be amplified both in the clinic and in clinical trials.</p> Recent Findings <p>Breast radiation discussions are nuanced and complex, particularly when physicians have equipoise amongst recommendations. Several tools including decision aids can help guide physicians and patients through this process. Instruments exist for analyzing patient’s priorities influencing their decisions, which are essential for guiding future encounters. Several recent clinical trials have used patient reported outcomes as primary or secondary endpoints, providing invaluable datapoints for physicians to share with patients to aid in their decision.</p> Summary <p> A shared decision-making approach involves eliciting a patient’s preferences and values so that a sound recommendation can be given and a preference-sensitive decision can be made in settings of clinical equipoise.</p>