Table 1 Key gaps in current knowledge concerning breast cancer prevention decision making by women at elevated risk

• Which prevention options and combinations women consider viable (prevention pathways)

• Women's reasons for low uptake of biomedical prevention interventions

• Explicit comparisons of prevention options and their effects

• How prevention behavior varies among subgroups of women, who differ according to:

 – Medically-defined or self-perceived level of risk

 – Geographical and cultural context

 – Race-ethnicity or socioeconomic status

 – Access to medical information or care

• Mechanisms that account for variation in prevention choices across subgroups

• Effects of emotions and psychological factors on women’s prevention decision making

• Effects of spouses, children, family, and friends on decision making

• Effects of exposure to cancer patients, support groups, or advocacy organizations on decision making

• Effects of exposure to genetic counseling and quality of communication with other healthcare providers on decision making

• Effects of previously unstudied factors on decision making: stigma, self-worth, desire to take control of health, personal exposure to experience of cancer

• Interactions among various drivers of prevention choice

• How women at elevated risk explain their own decision-making processes and needs

• Key methods to help women attain informed and empowered decision making