Breast Cancer Surveillance (BCS) at Group Health has been funded by the National Cancer Institute (NCI) since 1996. The focus of first five-year cycle of the BCS, led by Stephen Taplin, MD, MPH, was to
- Establish a comprehensive breast care data system that linked mammography exposure to cancer outcomes.
- Use the data system to examine mammography use and performance.
- Evaluate cancer outcomes in populations.
- Identify differences in tumor biomarkers between mammography detected and interval cancers.
- Evaluate the costs of diagnostic processes.
- Test and improve radiologists’ mammography interpretive skills.
In the second five-year cycle of the grant (2000–2005), we undertook the following 11 projects:
- Calculate the additional effect of breast density on estimation of the five-year risk of breast cancer.
- Determine the accuracy of mammography by phase of menstrual cycle among premenopausal women.
- Clarify the utility of the "probably benign" mammographic assessment.
- Examine the effect of computer-assisted reading upon interpretive performance.
- Determine the tumor characteristics associated with lymph node metastasis among screened women with breast cancers.
- Evaluate the effect of stopping hormone replacement therapy on breast density.
- Enumerate the probabilities and costs of evaluating screened women on hormone replacement therapy.
- Investigate the factors that explain the poorer sensitivity of mammography among younger women.
- Understand factors associated with risk of late-stage breast cancer among screened women with breast cancer.
- Analyze the effect of screening interval on stage at diagnosis.
- Develop automated alternatives for eliciting patient information for breast cancer screening and surveillance.
Dr. Taplin left Group Health in 2003 to work as a senior scientist at the NCI. Diana S.M. Buist, PhD, MPH, took over leadership of the project and has continued as principal investigator through the third cycle of the grant (2006–2010). The current grant cycle does not include specific projects, but provides funding for maintaining the infrastructure of the Breast Cancer Screening Program data.