Cancer surveillance data indicate that Chinese-American women utilize breast conserving surgery and adjuvant therapies significantly less than other women, regardless of age or stage at diagnosis. Preliminary ethnographic data suggest that cultural values and beliefs impact upon both the treatment decisions by Chinese-American women and their health care providers' treatment recommendations. The goal of the proposed anthropologic research is to explicate specific cultural factors that influence treatment decisions by both Chinese-American patients and their providers, and to apply this information to messages and communication guidelines for health care providers and patients. This goal will be achieved through three specific aims. The first two aims are to understand the cultural values, beliefs, and norms that are associated with the diagnosis and treatment of breast cancer among (1) Chinese-American, women in the San Francisco Bay area and (2) their breast cancer care providers. (3) The third aim is to develop culturally appropriate concepts and messages for use in both new materials and revision of currently utilized materials on treatment choices for Chinese-American women. The first phase of the proposed study will involve extensive collection of data through use of focus groups, in-depth interviews and systematic observations at breast cancer clinics and in physician offices. In collaboration with an advisory committee, qualitative analyses will inform development of guidelines to promote more effective communication between breast cancer clinicians and their Chinese-American patients.