Grant Number:	3P01CA154292-14S1 Interpret this number
Primary Investigator:	Miglioretti, Diana
Organization:	University Of California At Davis
Project Title:	Advancing Equitable Risk-Based Breast Cancer Screening and Surveillance in Community Practice
Fiscal Year:	2025

Overall Breast cancer remains a leading cause of cancer death in the United States. Our Program renewal follows the premise that screening and surveillance will be most effective when everyone has access to high-quality risk assessment and breast imaging, and when screening and surveillance strategies are targeted to clinically meaningful outcomes. Our current Program has advanced the science of risk-based screening and surveillance by: (1) identifying clinical risk factors most predictive of invasive breast cancer; (2) defining and evaluating advanced cancer as a screening outcome; (3) assessing new screening technologies and their use in all screening eligible populations; (4) identifying multilevel factors that influence views of risk-based screening; and (5) identifying breast cancer survivors at high risk of an interval second breast cancer. During the next funding period, we propose three complementary Projects supported by three Cores. Project 1 aims to develop advanced breast cancer risk models that incorporate imaging features, artificial intelligence (AI) algorithms, and clinical factors; and compare the benefits and harms of targeted screening frequency and supplemental MRI based on advanced cancer risk. Project 2 takes a multilevel approach to identify woman-, area-, and facility-level factors that drive breast cancer screening performance and outcomes, and to explore whether targeted AI use and other interventions can improve population outcomes. Project 3 focuses on improving surveillance imaging in breast cancer survivors through predicting risk of a surveillance failure (i.e., interval 2nd breast cancer), improving surveillance performance through AI, and examining multilevel drivers of surveillance failures and targets for future interventions. The Administrative Core will provide overall scientific leadership and administration for an integrated Program. The Biostatistics and Data Management Core will provide centralized coordination of high-quality data collection, management, analysis, and sharing. The Comparative Effectiveness Core will provide specialized multidisciplinary expertise in decision sciences, risk communication, and qualitative research along with three established Cancer Intervention and Surveillance Modeling Network (CISNET) modeling groups to support the clinical and policy translation of Program findings. The Program leverages the Breast Cancer Surveillance Consortium, an established research network with robust, community-based, prospective data collection from geographically varied settings. Program findings will play a critical role in public health efforts to promote risk-based screening and surveillance with a goal of improving health care quality and population health.





None. See parent grant details.