Epidemiology Research Team (ERT)
Director: Louise Henderson, PhD
The Department of Radiology’s Epidemiology Research Team (ERT) currently consists of two divisions: the Carolina Mammography Registry (CMR) and the North Carolina Lung Screening Registry (NC LSR).
The Carolina Mammography Registry (CMR) is a population based registry that was established in 1994. The registry collects and uses breast imaging and associated cancer follow-up data to examine the delivery and quality of breast cancer screening in North Carolina. By partnering with radiology facilities throughout the state, the CMR is able to collect and analyze data on patients who receive breast imaging services. This information is then used to answer pertinent research questions concerning breast imaging performance, breast cancer risk, diagnosis, and outcomes.
CMR Current Research Studies:
1. Risk-Based Breast Cancer Screening and Surveillance in Community Practice
This study addresses 3 projects to explore risk-based approaches to breast cancer screening. Project 1 involves a new risk assessment paradigm to predict screening detection, failures and false alarms. Project 2 includes breast cancer screening strategies in the era of new technologies and project 3 explores risk-based imaging strategies to improve breast cancer surveillance outcomes. The goal of this study is to provide relevant and timely information to guide women, providers, policymakers and healthcare delivery systems in identifying the most effective breast cancer screening and surveillance strategies. This study is being conducted by the Breast Cancer Surveillance Consortium and associated Mammography Registries.
2. Comparative Effectiveness of Breast Cancer Screening and Diagnostic Evaluation by Extent of Breast Density
The purpose of this study is to quantify the benefits and harms of supplemental imaging for breast cancer screening and preoperative work-up by extent of breast density. This work will provide valuable information to women and providers to guide decisions about the best strategies for screening and preoperative evaluation in women with dense and non-dense breast tissue. This study is being conducted by the Breast Cancer Surveillance Consortium and associated Mammography Registries.
3. Advanced Breast Imaging: Trends and Outcomes Associated with Recent Breast Density Reporting Legislation
This study is evaluating the impact of state-specific breast density legislation on population-level use of alternative breast imaging and downstream clinical and economic outcomes. The goal of this study is to determine whether state-level laws requiring breast density notification and encouraging use of supplemental screening tests will improve the detection of cancer, down-stage these cancers when they are found, and ultimately, increase the number of deaths averted from breast cancer.
4. Comorbidity and Screening Outcomes Among Older Women Undergoing Mammography
This study evaluates the benefits and harms of screening mammography among women aged 66 and older. The goal of this study is to move the breast imaging field forward by evaluating the benefits and harms of screening mammography in older women across the levels of advancing age, comorbid illness and functional status.
5. Evaluating the Effect of Breast Density Legislation on Supplemental Screening
The objective of this study is to determine if the North Carolina breast density law impacts screening behavior in a diverse population and to elucidate how breast imaging facilities across the state are interpreting and implementing the law. With this information we aim to better understand how supplemental screening among women with dense breasts is being utilized given the widespread attention to breast density legislation across the country.
6. Quantitative Imaging Data in a Community-Based Mammography Registry
The objective of this study is to establish an image bank within the Carolina Mammography Registry (CMR) to enable the integration of percent mammographic density into studies of breast cancer screening, risk, and survival among women in North Carolina. We will use a case-cohort design, in which the first case group will consist of women recalled for additional imaging after a screening mammogram. In this way, we will evaluate the association between quantitative density and screening recall, while laying the foundation for future studies of how density and other quantitative breast composition measures may affect breast tumor detection and tumor characteristics.