{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:23:00Z","timestamp":1787444580488,"version":"build-2736575974"},"reference-count":57,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"NIH\/NCI\/NCTN\/NCORP","award":["R01CA226060"],"award-info":[{"award-number":["R01CA226060"]}]},{"name":"NIH\/NCI\/NCTN\/NCORP","award":["R01CA293927"],"award-info":[{"award-number":["R01CA293927"]}]},{"name":"NIH\/NCI\/NCTN\/NCORP","award":["U10CA180888"],"award-info":[{"award-number":["U10CA180888"]}]},{"name":"NIH\/NCI\/NCTN\/NCORP","award":["U10CA180819"],"award-info":[{"award-number":["U10CA180819"]}]},{"name":"NIH\/NCI\/NCTN\/NCORP","award":["UG1CA189974"],"award-info":[{"award-number":["UG1CA189974"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast cancer chemoprevention is underutilized among high-risk women. We examined whether decision support could increase informed decision making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cluster randomized controlled trial to evaluate the effect of a patient-facing decision aid (RealRisks) and provider tool (BNAV) compared with standard education on the number of women with high-risk breast lesions making informed choices. Questionnaires were administered at baseline and 6 and 12\u2009months. The primary outcome was chemoprevention informed choice (defined as adequate knowledge and attitudes congruent with decision) at 6\u2009months. Secondary endpoints included breast cancer risk perceptions, worry, chemoprevention knowledge, decision conflict, and chemoprevention decision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across 31 randomized sites, we enrolled 210 providers, who were primarily breast health specialists. Of these, 24 sites (14 intervention, 10 control) enrolled 412 patients. Among 287 patients evaluable for the primary outcome, there were no statistically significant differences in informed choice between the intervention and control arms at 6\u2009months (35% vs 27%, respectively; P\u2009=\u2009.20) and 12\u2009months (37% vs 25%, respectively; P\u2009=\u2009.05). At 6\u2009months, women in the intervention compared with control arm were more likely to have accurate breast cancer risk perceptions (31% vs 21%, respectively; P\u2009=\u2009.03) and adequate chemoprevention knowledge (33% vs 23%, respectively; P\u2009=\u2009.04). At 12\u2009months, 52% of women in the control and 50% in the intervention arm self-reported initiating chemoprevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Decision support led to modest improvements in accurate risk perceptions and chemoprevention knowledge but not informed choice. Relatively high chemoprevention uptake was achieved among women with high-risk breast lesions managed mainly by breast health specialists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>NCT04496739, https:\/\/clinicaltrials.gov\/study\/NCT04496739?cond=NCT04496739&amp;viewType=Card&amp;rank=1<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag216","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:52:15Z","timestamp":1782863535000},"source":"Crossref","is-referenced-by-count":0,"title":["Cluster randomized controlled trial of decision support for breast cancer chemoprevention, MiCHOICE"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9637-2962","authenticated-orcid":false,"given":"Katherine D","family":"Crew","sequence":"first","affiliation":[{"name":"Columbia University Irving Medical 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A","family":"King","sequence":"additional","affiliation":[{"name":"Dana-Farber Brigham Cancer Center, Brigham and Women\u2019s Hospital , Boston, MA,","place":["United States"]},{"name":"Emory University, Winship Cancer Institute , Atlanta, GA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa D","family":"Yee","sequence":"additional","affiliation":[{"name":"City of Hope Comprehensive Cancer Center , Duarte, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarah J","family":"Ballinger","sequence":"additional","affiliation":[{"name":"Indiana University Simon Comprehensive Cancer Center , Indianapolis, IN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0051-5533","authenticated-orcid":false,"given":"Christa","family":"Braun-Inglis","sequence":"additional","affiliation":[{"name":"University of Hawaii Cancer Center , Honolulu, HI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra A","family":"Mangino","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari B","family":"Wisinski","sequence":"additional","affiliation":[{"name":"University of Wisconsin Carbone Cancer Center , Madison, WI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia A","family":"DeYoung","sequence":"additional","affiliation":[{"name":"Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP) , Vallejo, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masey","family":"Ross","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University , Richmond, VA,","place":["United 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Butler","sequence":"additional","affiliation":[{"name":"Cancer Research Consortium of West Michigan NCORP , Kalamazoo, MI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen M","family":"Agnese","sequence":"additional","affiliation":[{"name":"The Ohio State University Comprehensive Cancer Center , Columbus, OH,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Jernigan","sequence":"additional","affiliation":[{"name":"Patient Research Advocate: SWOG Prevention, Screening, and Surveillance Committee ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn L","family":"Hershman","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center , New York, NY,","place":["United 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