• Definitive surgery choice as measured by self-reported and medical record verification at 6 months after randomization [ Designated as safety issue: No ]
  
• Quality of life as measured by functional assessment of cancer therapy for breast cancer (FACT-B) at 1, 6, and 12 months after randomization [ Designated as safety issue: No ]
  
• Distress as measured by Impact of Events Scale Brief Symptom Inventory at 1, 6, and 12 months after randomization [ Designated as safety issue: No ]
  
• Knowledge as assessed by Genetic Testing Knowledge Measure at 1 month after randomization [ Designated as safety issue: No ]
  
• Decision outcomes as assessed by Decisional Conflict Scale Satisfaction with Decision Scale at 1 and 6 months after randomization [ Designated as safety issue: No ]
  

• Cost effectiveness as measured by quality adjusted life years saved at 12 months after randomization [ Designated as safety issue: No ]
  

OBJECTIVES:

• Compare the impact of rapid genetic counseling (RGC) vs usual care on the medical decisions of women with newly diagnosed ductal carcinoma in situ or stage I-IIIA breast cancer.
• Compare the impact of these interventions on the quality of life and psychological well being of these patients.
• Determine baseline factors that predict who is most and least likely to benefit from RGC in patients undergoing these interventions.
• Compare the cost per quality adjusted life year saved from a societal perspective in patients undergoing these interventions.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating site. Patients are randomized to 1 of 2 interventional arms.

• Arm I (rapid genetic counseling): Patients undergo a 1½ hour genetic counseling session either in person or by telephone. Patients who undergo telephone counseling receive a booklet of visual aids and educational materials. Patient preferences and values are assessed immediately after counseling. Some patients may undergo BRCA1/2 status determination. Patients undergo follow-up telephone interviews at 1, 6, and 12 months.
• Arm II (usual care): Patients receive a packet of breast cancer treatment educational materials. Patient preferences and values are assessed 2 weeks later. Patients undergo follow-up telephone interviews as in arm I.

In both arms, quality of life is assessed at baseline and at 1, 6, and 12 months.

After completion of the study, patients are followed periodically for 1 year.

PROJECTED ACCRUAL: A total of 360 patients will be accrued for this study.