The program theme is to identify effective breast cancer screening strategies for women with diverse levels of breast cancer risk to maximize screening benefits while minimizing potential harms. Program aims follow the premise that breast cancer screening will be most effective when: guidelines are based on accurate risk estimates that are tied to the effectiveness and harms of screening tests;women and physicians are informed about screening test performance based on risk level;risk-based screening practices are equitable;and high-quality comparative effectiveness research results are disseminated into community practice. Program goals will be met through three complementary research projects and three shared resource cores. Project 1, Risk Assessment in Community Practice: Developing Better Models, will improve prediction of breast cancer and breast cancer subtypes among women of varying ages and race/ethnicity and evaluate whether predicted risk can be used to optimize screening outcomes. Project 2, Comparative Effectiveness of Imaging Strategies for Breast Cancer Screening in Community Practice, will characterize the performance of advanced imaging technologies and screening strategies according to age, race/ethnicity, breast density, and overall breast cancer risk. Project 3, Community-based Utilization of Breast Imaging Technologies, will assess risk-based screening in diverse populations and identify disparities in access and use of new technologies. The Administrative Core will support logistical requirements and facilitate communication and data sharing. The Biostatistics and Data Management Core will coordinate data collection, management, and analysis and will develop statistical methods. The Comparative Effectiveness Core will use simulation modeling to estimate long-term implications of different screening practices on population health. The program represents an integrated effort to improve screening with the overall aim of averting deaths from breast cancer while minimizing harms.

Public Health Relevance

By addressing the aims of this proposal, we expect to (1) inform providers and policymakers about how actual breast imaging use corresponds to risk-based targeted use in diverse populations, and (2) guide the evolution of best practices and inform guidelines by estimating harms and benefits of risk-based screening strategies among diverse groups of women.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Program Projects (P01)
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Special Emphasis Panel (ZCA1-GRB-S)
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Group Health Cooperative
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Mandelblatt, Jeanne S; Stout, Natasha K; Schechter, Clyde B et al. (2016) Collaborative Modeling of the Benefits and Harms Associated With Different U.S. Breast Cancer Screening Strategies. Ann Intern Med 164:215-25
Hubbard, Rebecca A; O'Meara, Ellen S; Henderson, Louise M et al. (2016) Multilevel factors associated with long-term adherence to screening mammography in older women in the U.S. Prev Med 89:169-77
Kerlikowske, Karla; Vachon, Celine M (2016) Breast Density: More Than Meets the Eye. J Natl Cancer Inst 108:
Nyante, Sarah J; Lee, Sheila S; Benefield, Thad S et al. (2016) The association between mammographic calcifications and breast cancer prognostic factors in a population-based registry cohort. Cancer :
Houssami, Nehmat; Miglioretti, Diana L (2016) Digital Breast Tomosynthesis: A Brave New World of Mammography Screening. JAMA Oncol 2:725-7
Lee, Christoph I; Bogart, Andy; Germino, Jessica C et al. (2016) Availability of Advanced Breast Imaging at Screening Facilities Serving Vulnerable Populations. J Med Screen 23:24-30
Goodrich, Martha E; Weiss, Julie; Onega, Tracy et al. (2016) The Role of Preoperative Magnetic Resonance Imaging in the Assessment and Surgical Treatment of Interval and Screen-Detected Breast Cancer in Older Women. Breast J 22:616-622
Trentham-Dietz, Amy; Kerlikowske, Karla; Stout, Natasha K et al. (2016) Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes. Ann Intern Med 165:700-712
Nichols, Hazel B; Bowles, Erin J A; Islam, Jessica et al. (2016) Tamoxifen Initiation After Ductal Carcinoma In Situ. Oncologist 21:134-40
Durham, Danielle D; Robinson, Whitney R; Lee, Sheila S et al. (2016) Insurance-Based Differences in Time to Diagnostic Follow-up after Positive Screening Mammography. Cancer Epidemiol Biomarkers Prev 25:1474-1482

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