title: Women's decisions regarding tamoxifen for breast cancer   prevention: responses to a tailored decision aid.
abstract: Tamoxifen reduces primary breast cancer incidence, yet causes serious side effects. To date, few women with increased breast cancer risk have elected to use tamoxifen for chemoprevention. The objective of the study was to determine women's knowledge of and attitudes toward tamoxifen following exposure to a tailored decision aid (DA). A total of 632 women with a 5-year risk of breast cancer > or = 1.66% (Mean = 2.56, range = 1.7-17.3) were recruited from two healthcare organizations. Participants viewed an online DA that informed them about their 5-year risk of breast cancer and presented individually tailored content depicting the risks/benefits of tamoxifen prophylaxis. Outcome measures included behavioral intentions (to seek additional information about tamoxifen, to talk to a physician about tamoxifen, and to take tamoxifen); knowledge; and perceived risks and benefits of tamoxifen. After viewing the DA, 29% of participants said they intended to seek more information or talk to their doctor about tamoxifen, and only 6% believed they would take tamoxifen. Knowledge was considerable, with 63% of women answering at least 5 of 6 knowledge questions correctly. Participants were concerned about the risks of tamoxifen, and many believed that the benefits of tamoxifen did not outweigh the risks. This study is the largest to date to test women's preferences for taking tamoxifen and one of the largest to have tested the impact of a tailored DA. After viewing the DA, women demonstrated good understanding of tamoxifen's risks and benefits, but most were not interested in taking tamoxifen for breast cancer chemoprevention.
authors.affiliation: Ann Arbor VA HSR&D, Center for Clinical Management Research, Ann Arbor, MI, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Zikmund-Fisher
authors.forename: Vijayan
authors.initials: V
authors.lastname: Nair
authors.forename: Holly A
authors.initials: HA
authors.lastname: Derry
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: McClure
authors.forename: Sarah
authors.initials: S
authors.lastname: Greene
authors.forename: Azadeh
authors.initials: A
authors.lastname: Stark
authors.forename: Sharon
authors.initials: S
authors.lastname: Hensley Alford
authors.forename: Paula
authors.initials: P
authors.lastname: Lantz
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hayes
authors.forename: Cheryl
authors.initials: C
authors.lastname: Wiese
authors.forename: Sarah
authors.initials: S
authors.lastname: Claud Zweig
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Pitsch
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Jankovic
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ubel
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control*; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013629:Tamoxifen / Q000627:therapeutic use*
chemical_list: D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen