Breast Cancer Screening. Making Sense of Complex and Evolving Evidence

Table of Contents

1. Foreword: Breast Cancer Screening: A focus on the evidence 2. Breast Cancer Screening: balancing evidence with culture, politics, money, and media 3. Estimates of Screening Benefit: The Randomized Trials of Breast Cancer Screening 4. Weighing the benefits and harms: Screening mammography in the balance 5. The Importance of Observational Evidence to Estimate and Monitor Mortality Reduction from Current Breast Cancer Screening 6. The role of microsimulation modeling in evaluating the outcomes and effect of screening 7. Challenges in understanding and quantifying over-diagnosis and over-treatment 8. Challenges and opportunities in the implementation of risk-based screening for breast cancer 9. Breast Cancer Screening in the Older Woman 10. Screening Women in their Forties 11. Screening for Breast Cancer in Women with Dense Breasts 12. Screening women with known or suspected cancer gene mutations 13. Imaging Surveillance of Women with a Personal History of Breast Cancer 14. Evolution of mammography screening: from film screen to digital breast tomosynthesis 15. Ethical and Societal Considerations in Breast Cancer Screening 16. Treatment of screen-detected breast cancer: can we avoid or minimize over-treatment? 17. Informed and shared decision-making in breast screening

Authors

Nehmat Houssami Professor of Public Health, and National Breast Cancer Foundation (NBCF Australia) Breast Cancer Research Leader Fellow, School of Public Health, Sydney Medical School, University of Sydney, NSW, Australia. Dr. Nehmat Houssami is a medical graduate with specialization in Public Health Medicine, and holds an MPH and a PhD (Clinical Epidemiology). She is also a breast physician and clinical researcher who has focused her career on breast cancer, specifically in the screening and diagnosis setting, for the past 22 years. Her expertise includes population screening, breast diagnostic and prognostic testing, cancer staging, and the effect of tests on patients' treatment and clinical outcomes. Dr. Houssami has expertise in systematic evidence reviews and evidence synthesis, and in evaluating new breast screening technologies in the clinical field. Her scholarly work integrates clinical with public health medicine and aims to support evidence-based practice in breast screening and healthcare. She currently leads the breast cancer research portfolio in the Screening & Test Evaluation Program (Sydney Medical School) and the majority of her research is based on leading international collaborations including prospective studies and IPD meta-analyses. Her research portfolio has achieved international recognition. Dr. Houssami is a clinical consultant at the Royal Hospital for Women, Sydney; she is also Co-Editor of The Breast (an Elsevier journal). Diana Miglioretti Dean's Professor in Biostatistics, Department of Public Health Sciences, UC Davis School of Medicine, University of California, Davis, CA, USA. Diana L. Miglioretti, PhD, is the Dean's Professor of Biostatistics at University of California Davis and a Senior Investigator at Group Health Research Institute. She received her Ph.D. from the Department of Biostatistics at Johns Hopkins University in 2000. Dr. Miglioretti's primary research is in the evaluation of breast cancer screening and breast cancer risk prediction modeling. Dr. Miglioretti has been the principal investigator of the Statistical Coordinating Center for the National Cancer Institute (NCI) funded Breast Cancer Surveillance Consortium (BCSC) since 2005. The BCSC is a collaboration of eight breast imaging registries in the United States. She is currently the contact principal investigator and Biostatistics and Data Management Core Director of the BCSC's multi-site Program Project titled "Risk-Based Breast Cancer Screening in Community Settings". She is faculty member for the Radiologic Society of North America's clinical trials methodology workshop.