A Cluster Randomized Trial of a Breast Cancer Treatment Decision Aid for Women 70+ with Low-Risk Stage I Breast Cancers.

Surgeon Inclusion Criteria: - Non-resident surgeon >18 years old - Cares for women >/= 70 years at one of the recruitment practices. - Ability and willingness to provide verbal consent Aim 1 Participant Inclusion Criteria: Participants whose medical records will be followed for treatments received and survival - Biological female - aged 70 or older - first primary invasive breast cancer - clinically 18 - English or Spanish speaking - Ability and willingness to provide verbal consent Allied health professionals (Aim 4 at the end of the trial) Inclusion Criteria: - Administrator, social worker, physician assistant, navigator, nurse or other allied health professional in breast surgery - Ability and willingness to provide verbal consent Surgeon Exclusion Criteria: - Resident surgeon - Non-surgeons - Psychiatric illness situations that would limit compliance with study requirements Aim 1 Participant Exclusion criteria: Participants whose medical records will be followed for treatments received and survival - Age <70 - Biological males: Biological males will be excluded since the data informing the DA were obtained from studies of biological females and treatment recommendations and outcomes tend to be worse for biological males with breast cancer. - Non English or non-Spanish speaking: Women who do not speak English or Spanish will be excluded since these women are not eligible for the DA. - History of invasive breast cancer - History ductal carcinoma in situ treated with radiation (since these women are generally not be eligible for radiation treatment) - Women with Paget's disease because treatment options differ - inflammatory breast cancer because treatment options differ - Phyllodes tumor because treatment options differ. - In hospice - Surgeon not willing to participate Aim 1 Participant Exclusion Criteria: Participants whose medical records will be reviewed retrospectively for treatments received in the year before the participating surgeon completes the baseline questionnaire - Age <70 - Biological males: Biological males will be excluded since the data informing the DA were obtained from studies of biological females and treatment recommendations and outcomes tend to be worse for biological males with breast cancer. - Non English or non-Spanish speaking: Women who do not speak English or Spanish will be excluded since these women are not eligible for the DA. If the DA is found to be effective in English and Spanish we plan to have the DA professionally translated to other languages at the end of the trial. English and Spanish are the most common languages spoken by older women at our recruitment sites. - History of invasive breast cancer - History ductal carcinoma in situ treated with radiation (since these women are generally not be eligible for radiation treatment) - Paget's disease inflammatory breast cancer - Phyllodes tumor - In hospice - Surgeon not willing to participate Aim 2 Participant Exclusion Criteria: Participants who will be included in Aim 2 participant surveys to learn patient reported outcomes - Age <70 - Biological males: Biological males will be excluded since the data informing our DA were obtained from studies of biological females and treatment recommendations and outcomes tend to be worse for biological males with breast cancer. - Non English or non-Spanish speaking: Women who do not speak English or Spanish will be excluded since these women are not eligible for the DA. - history of invasive breast cancer - Women with history ductal carcinoma in situ treated with radiation (since these women are generally not be eligible for radiation treatment) - Paget's disease - Inflammatory breast cancer - A phyllodes tumor. - In hospice - Surgeon not willing to participate - Psychiatric illness situations that would limit compliance with study requirements - History of dementia - Incapacity for informed consent - Surgeon not willing to have patient complete study surveys - 19 patients already successfully recruited that month and the patient is non-Hispanic white. Primary Caregiver Exclusion Criteria: - Age <18 - Non-English and non-Spanish speaking - Psychiatric illness situations that would limit compliance with study requirements Allied health professionals (Aim 4 at the end of the trial) Exclusion Criteria: - A trainee - Psychiatric illness situations that would limit compliance with study requirements