Diana L. Miglioretti, PhD
Research interests and experience
- Biostatistics: clustered and longitudinal data analysis; latent variable modeling; assessment of diagnostic and screening tests
- Cancer control: biostatistics; breast cancer screening and surveillance; mammographic breast density; risk prediction; colorectal cancer screening
- Radiology: Imaging trends; radiation exposure from medical imaging; evaluation of imaging tests
Senior Investigator and Biostatistician Diana Miglioretti is committed to helping improve early detection of breast cancer. She pursues a rigorous combination of applied and methodological research, overseeing analyses of the largest and most comprehensive collection of breast cancer screening data in the nation.
Dr. Miglioretti co-leads the Breast Cancer Surveillance Consortium (BCSC)—a network of mammography registries linked to tumor and pathology registries. Established in 1994, the BCSC kicked off a new $20 million Program Project grant from the National Cancer Institute (NCI) in 2011. Dr. Miglioretti serves as the program’s contact principal investigator (PI) and the Director of the Biostatistics and Data Management Core, which houses the Statistical Coordinating Center—the repository and central analysis site for all BCSC data.
The vast BCSC database includes information on more than 9.5 million mammograms, 2.3 million women, and 114,000 breast cancer cases. Dr. Miglioretti leads the SCC in maximizing the value of these data: establishing and evaluating data collection, helping individual sites and outside researchers with analyses, and developing new statistical techniques. Through these efforts, BCSC data play an essential role in formulating national breast cancer screening policy decisions and clinical guidelines. It’s a one-of-a-kind resource that lets researchers worldwide answer timely questions about benefits and risks of breast cancer screening.
For example, Dr. Miglioretti worked with GHRI Senior Investigator Diana Buist, PhD, MPH, and colleagues from the University of Sydney in Australia on the first-ever study to rigorously assess screening mammography outcomes for women who’d had breast cancer before. Examining 12 years of information from more than 110,000 mammograms, they found that yearly screening detected second breast cancers at an early stage—results they published February 23, 2011 in the Journal of the American Medical Association (see news release).Another example comes from Dr. Miglioretti’s collaboration with NCI’s Cancer Intervention and Surveillance Modeling Network (CISNET) and the Oregon Evidence-based Practice Center. Publishing in the May 1, 2012, Annals of Internal Medicine, the team found that women age 40 to 49 with a twofold increase in breast cancer risk who have screening mammograms every two years experience similar benefits and harms as average-risk women who start biennial screening at age 50 (see news release).
BCSC data are also being used to better understand variation in radiologists’ interpretive performance of mammography. In the Assessing and Improving Mammography (AIM) study, Dr. Miglioretti worked with BCSC collaborators to develop mammography test sets to assess individual radiologist's interpretive performance (see news release). She is currently working with international colleagues to expand the test set to compare radiologist performance across many counties as part of the International Cancer Screening Network.
Additionally, Dr. Miglioretti develops statistical methods to more rigorously analyze longitudinal mammography data and is tackling questions related to the rapidly increasing use of diagnostic imaging. As imaging rates trend upward, so does exposure to medical radiation—results she reported June 12, 2012, in the Journal of the American Medical Association with Rebecca Smith-Bindman, MD, of the University of California, San Francisco, and colleagues from the Cancer Research Network (see news release).
These many achievements earned Dr. Miglioretti an appointment as the Dean’s Professor of Biostatistics in the Department of Public Health Sciences, School of Medicine at the University of California, Davis—a position she undertook at the outset of 2013, while still maintaining her leadership role in the BCSC and other key GHRI projects. Dr. Miglioretti enthusiastically shares her expertise as an instructor at the Radiological Society of North America's (RSNA) annual workshop in clinical trials methodology, which aims to prepare radiologists to develop clinical research protocols and apply for funding. Among her many professional memberships are the American Association for Cancer Research, the International Biometrics Society Eastern and Western North America regions (ENAR and WNAR), and the American Statistical Association, for whom she served as a Council of Sections representative in Biometrics.
Houssami N, Abraham LA, Kerlikowske K, Buist DS, Irwig L, Lee J, Miglioretti DL. Risk factors for second screen-detected or interval breast cancers in women with a personal history of breast cancer participating in mammography screening. Cancer Epidemiol Biomarkers Prev. 2013 Mar 19 [Epub ahead of print]. PubMed
Kerlikowske K, Zhu WW, Hubbard R, Gellar B, Dittus K, Braithwaite D, O’Meara E, Wernli KJ, Miglioretti D, for the Breast Cancer Surveillance Consortium. Outcomes of screening mammography by frequency, breast density and postmenopausal hormone therapy. JAMA Intern Med. 2013;():1-10. doi:10.1001/jamainternmed.2013.307.
Kerlikowske K, Zhu W, Hubbard RA, Geller B, Dittus K, Braithwaite D, Wernli KJ, Miglioretti DL, O'Meara ES. Outcomes of screening mammography by frequency, breast density, and postmenopausal hormone therapy. JAMA Intern Med. 2013 Mar 18:1-10. doi: 10.1001/jamainternmed.2013.307 [Epub ahead of print]. PubMed
Hubbard RA, Miglioretti DL. A semiparametric censoring bias model for estimating the cumulative risk of a false-positive screening test under dependent censoring. Biometrics. 2013 Feb 5. doi: 10.1111/j.1541-0420.2012.01831.x. [Epub ahead of print]. PubMed
Braithwaite D, Zhu W, Hubbard RA, O'Meara ES, Miglioretti DL, Geller B, Dittus K, Moore D, Wernli KJ, Mandelblatt J, Kerlikowske K, for the Breast Cancer Surveillance Consortium. Screening outcomes in older U.S. women undergoing multiple mammograms in community practice: does interval, age or comorbidity score affect tumor characteristics or false positive rates? J Natl Cancer Inst. 2013 Feb 5. [Epub ahead of print]. PubMed
Carney PA, Parikh J, Sickles EA, Feig SA, Monsees B, Bassett LW, Smith RA, Rosenberg R, Ichikawa L, Wallace J, Tran K, Miglioretti DL. Diagnostic mammography: identifying minimally acceptable interpretive performance criteria. Radiology. 2013 Jan 7. [Epub ahead of print]. PubMed
Harvey JA, Gard CC, Miglioretti DL, Yankaskas BC, Kerlikowske K, Buist DS, Geller BA, Onega TL. Reported mammographic density: film-screen versus digital acquisition. Radiology. 2012 Dec 18 [Epub ahead of print]. PubMed
Smith RA, Kerlikowske K, Miglioretti DL, Kalager M. Clinical decisions. Mammography screening for breast cancer. N Engl J Med. 2012 Nov 22;367(21):e31. doi: 10.1056/NEJMclde1212888. PubMed
Onega T, Smith M, Miglioretti DL, Carney PA, Geller BA, Kerlikowske K, Buist DS, Rosenberg RD, Smith RA, Sickles EA, Haneuse S, Anderson ML, Yankaskas B. Radiologist agreement for mammographic recall by case difficulty and finding type. J Am Coll Radiol. 2012;9(11):788-94. doi: 10.1016/j.jacr.2012.05.020. PubMed
Yasmeen S, Hubbard R, Romano PS, Zhu W, Geller BM, Onega T, Yankaskas B, Miglioretti DL, Kerlikowske K. Risk of advanced-stage breast cancer among older women with comorbidities. Cancer Epidemiol Biomarkers Prev. 2012 Sep;21(9):1510-9. Epub 2012 Jun 28. PubMed
Rutter CM, Miglioretti DL, Savarino JE. Bayesian calibration of microsimulation models, Journal of the American Statistical Association, 2009; 104(488):1338–1350.
To view more publications, please see Dr. Miglioretti’s CV.