My career goal is to become an independent clinical investigator dedicated to optimizing the application of imaging in the early detection of breast cancer, with the ultimate aim of increasing the effectiveness of breast cancer screening. My experiences to date in clinical breast imaging, decision analytic methodologies, and health services research are uniquely suited to carry out the proposed research. The goal of the proposed research is to evaluate the clinical and economic consequences of MRI screening for breast cancer in women with increased genetic risk of breast cancer (>20% lifetime risk, including BRCA gene mutation carriers). The proposed research will: 1) develop and refine a complex computer simulation model, which will integrate currently available data and surrogate endpoints, 2) apply the model to predict long-term health and economic outcomes of screening with mammography and MRI, alone or in combination, and 3) evaluate patient preferences regarding trade-offs involved in adding MRI to current screening regimens. The research described in this proposal will carry out the following three specific aims: 1) Refine a Markov Monte Carlo disease model of breast cancer natural history and outcomes. 2) Compare the clinical effectiveness and cost-effectiveness of screening strategies utilizing mammography and MRI. 3) Determine patient preferences regarding false-positive test results to improve model estimates of clinical effectiveness and cost-effectiveness. Relevance: The proposed research will use computer simulation modeling to estimate the benefits and costs of using breast MRI for screening women at increased genetic risk of breast cancer. The results of the proposed research will provide data essential for developing standardized guidelines for optimizing the role of MRI in breast cancer screening.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Academic/Teacher Award (ATA) (K07)
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Study Section
Subcommittee G - Education (NCI)
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Perkins, Susan N
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Massachusetts General Hospital
United States
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Lester-Coll, Nataniel H; Lee, Janie M; Gogineni, Keerthi et al. (2015) Benefits and risks of contralateral prophylactic mastectomy in women undergoing treatment for sporadic unilateral breast cancer: a decision analysis. Breast Cancer Res Treat 152:217-226
Lee, Janie M; Buist, Diana S M; Houssami, Nehmat et al. (2015) Five-year risk of interval-invasive second breast cancer. J Natl Cancer Inst 107:
Humphrey, Kathryn L; Lee, Janie M; Donelan, Karen et al. (2014) Percutaneous breast biopsy: effect on short-term quality of life. Radiology 270:362-8
Niell, Bethany L; Gavenonis, Sara C; Motazedi, Tina et al. (2014) Auditing a breast MRI practice: performance measures for screening and diagnostic breast MRI. J Am Coll Radiol 11:883-9
Niell, Bethany L; Lee, Janie M; Johansen, Christopher et al. (2014) Patient outcomes in canceled MRI-guided breast biopsies. AJR Am J Roentgenol 202:223-8
Park, Elyse R; Traeger, Lara; Willett, Jessica et al. (2013) A relaxation response training for women undergoing breast biopsy: exploring integrated care. Breast 22:799-805
Cott Chubiz, Jessica E; Lee, Janie M; Gilmore, Michael E et al. (2013) Cost-effectiveness of alternating magnetic resonance imaging and digital mammography screening in BRCA1 and BRCA2 gene mutation carriers. Cancer 119:1266-76
Swan, J Shannon; Kong, Chung Yin; Lee, Janie M et al. (2013) Patient and societal value functions for the testing morbidities index. Med Decis Making 33:819-38
Lowry, Kathryn P; Lee, Janie M; Kong, Chung Y et al. (2012) Annual screening strategies in BRCA1 and BRCA2 gene mutation carriers: a comparative effectiveness analysis. Cancer 118:2021-30
Ollendorf, Daniel A; Blackmore, C Craig; Lee, Janie M (2012) Toward evidence-based decisions in diagnostic radiology: a research and rating process for multiple decision-makers. Acad Radiol 19:1049-54

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