a study on Breast Cancer
This Beast Cancer Surveillance Consortium (BCSC) ADVANCE study is a large, observational pragmatic comparative effectiveness research study using high-quality, prospectively collected data from BCSC registries to generate evidence on how breast density should be integrated into decision making around breast cancer screening and preoperative diagnostic work-up. We will augment existing BCSC registry infrastructure with additional prospective data collection and collection of patient reported outcomes (PROs), CISNET modeling of long-term screening outcomes, and qualitative data from focus groups with women represented in two aims.
Comparative Effectiveness of Breast Cancer Screening and Diagnostic Evaluation by Extent of Breast Density
Aim 1: Compare the effectiveness of breast cancer screening using digital mammography alone versus digital mammography plus supplemental screening (digital breast tomosynthesis or MRI) by extent of breast density.
Sub aim 1: Evaluate whether the performance of tomosynthesis improves with years of experience, and whether any "learning curve" depends on radiologist specialty (i.e., breast imaging specialist vs. general radiologist).
Aim 2: Compare the effectiveness of preoperative MRI versus no MRI by extent of breast density among women with an initial, pathologically confirmed diagnosis of DCIS or invasive breast cancer.
Breast Cancer digital mammography digital breast tomosynthesis breast magnetic resonance imaging screening breast density breast imaging pre-operative magnetic resonance imaging
For females ages 18 years to 89 years
Aim 1 Clinical Outcomes
Exams without complete cancer capture during the follow-up period
Aim 1 Patient Reported Outcomes
Within strata defined by BCSC registry, breast density subgroup (dense vs. not dense), and race/ethnicity, women with supplemental screening with digital breast tomosynthesis or breast MRI will be matched to women without supplemental screening
Aim 1 Focus Groups
Women who are able to speak English and can travel to a nearby location for a discussion
Exams without complete cancer capture during one year following the screening mammogram
Aim 2 Clinical Outcomes
MRI and mammography examinations performed for pre-operative work-up from 2005-2017 at one of the participating BCSC registry facilities in women meeting eligibility criteria
Aim 2 Patient Reported Outcomes
Known breast density at the time of breast cancer diagnosis
Aim 2 Focus Groups
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