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Ongoing Collaborations: American Cancer Society (ACS) and the Breast Cancer Stamp Funds

In 2006, the National Cancer Institute and American Cancer Society (ACS)External Web Site Policy awarded funds for "AIM: Assessing and Improving Mammography" to the six NCI-funded BCSC sites and the BCSC-affiliated site at the New Mexico Mammography Project (please see more details on the funding plan below). The purpose of this project was to use the BCSC?s unique strengths as a research resource to examine on factors that influence accuracy in the interpretation of mammograms. Findings contributed to the development of guidance and tools for use in the initial and on-going training of interpreting physicians. These resources have also been used to provide ongoing feedback to interpreting physicians, thereby helping them maintain their skills.

ACS, NCI program staff, and BCSC investigators worked together to incorporate into the priorities from the 2005 Institute of Medicine (IOM)External Web Site Policy report Improving Breast Imaging Quality Standards. This collaboration also influenced the Policy briefing and workshop summary Assessing and Improving Imaging Interpretation in Breast Cancer ScreeningExternal Web Site Policy in 2015.

The specific aims of the project include:

  • Determine the effects of radiologists' mammographic interpretative volume on clinical interpretive performance, controlling for patient, physician, and facility factors that influence interpretive performance;
  • Create assessment test sets that consist of representative screening mammograms from community practice to assess radiologists' interpretative skills and determine if performance on assessment test sets is associated with performance in clinical practice; and
  • Develop and test two interventions designed to improve radiologists' mammographic interpretative skills.

Funding Structure

The ACS dedicated more than $1.5M for this descriptive research effort, and NCI contributed over $1M toward this initiative from the Breast Cancer Stamp Funds. NCI supported the first year of research through administrative supplements to the six active BCSC sites. ACS supported the remaining years of the project as well as the BCSC-affiliated site at the University of New MexicoExternal Web Site Policy for year one.


Buist DS, Anderson ML, Haneuse SJ, Sickles EA, Smith RA, Carney PA, Taplin SH, Rosenberg RD, Geller BM, Onega TL, Monsees BS, Bassett LW, Yankaskas BC, Elmore JG, Kerlikowske K, Miglioretti DL. Influence of annual interpretive volume on screening mammography performance in the United States. Radiology 2011 Apr;259(1):72-84. [View Abstract]

Buist DS, Anderson ML, Smith RA, Carney PA, Miglioretti DL, Monsees BS, Sickles EA, Taplin SH, Geller BM, Yankaskas BC, Onega TL. Effect of radiologists' diagnostic work-up volume on interpretive performance. Radiology 2014 Nov;273(2):351-64. [View Abstract]

Carney PA, Bogart TA, Geller BM, Haneuse S, Kerlikowske K, Buist DS, Smith R, Rosenberg R, Yankaskas BC, Onega T, Miglioretti DL. Association between time spent interpreting, level of confidence, and accuracy of screening mammography. AJR Am J Roentgenol 2012 Apr;198(4):970-8. doi: 10.2214/AJR.11.6988. [View Abstract]

Carney PA, Bogart A, Sickles EA, Smith R, Buist DS, Kerlikowske K, Onega T, Miglioretti DL, Rosenberg R, Yankaskas BC, Geller BM. Feasibility and acceptability of conducting a randomized clinical trial designed to improve interpretation of screening mammography. Acad Radiol 2013 Nov;20(11):1389-98. doi: 10.1016/j.acra.2013.08.017. [View Abstract]

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 May;267(2):359-67. [View Abstract]

Carney PA, Sickles EA, Monsees BS, Bassett LW, Brenner RJ, Feig SA, Smith RA, Rosenberg RD, Bogart TA, Browning S, Barry JW, Kelly MM, Tran KA, Miglioretti DL. Identifying minimally acceptable interpretive performance criteria for screening mammography. Radiology 2010 May;255(2):354-61. doi: 10.1148/radiol.10091636. [View Abstract]

Carney PA, Sickles EA, Monsees BS, Bassett LW, Miglioretti DL. Letter to the editor author response to: Limitations of minimally acceptable interpretive performance criteria for screening mammography. Radiology. 2011;258(3):960-1. "Reply to letter to the editor": Doyle, Onysko, Pogany, Jamor, Caines, Shumak, Wadden. [View Article]External Web Site Policy

Geller BM, Bogart A, Carney PA, Elmore JG, Monsees BS, Miglioretti DL. Is confidence of mammographic assessment a good predictor of accuracy? AJR Am J Roentgenol 2012 Jul;199(1):W134-41. doi: 10.2214/AJR.11.7701. [View Abstract]

Geller BM, Bogart A, Carney PA, Sickles EA, Smith R, Monsees B, Bassett LW, Buist DM, Kerlikowske K, Onega T, Yankaskas BC, Haneuse S, Hill D, Wallis MG, Miglioretti D. Educational interventions to improve screening mammography interpretation: a randomized controlled trial. AJR Am J Roentgenol 2014 Jun;202(6):W586-96. doi: 10.2214/AJR.13.11147. [View Abstract]

Haneuse S, Buist DS, Miglioretti DL, Anderson ML, Carney PA, Onega T, Geller BM, Kerlikowske K, Rosenberg RD, Yankaskas BC, Elmore JG, Taplin SH, Smith RA, Sickles EA. Mammographic interpretive volume and diagnostic mammogram interpretation performance in community practice. Radiology 2012 Jan;262(1):69-79. [View Abstract]

Miglioretti DL, Haneuse SJ, Anderson ML. Statistical approaches for modeling radiologists' interpretive performance. Acad Radiol 2009 Feb;16(2):227-38. Review. [View Abstract]

Miglioretti DL, Ichikawa L, Smith RA, Bassett LW, Feig SA, Monsees B, Parikh JR, Rosenberg RD, Sickles EA, Carney PA. Criteria for identifying radiologists with acceptable screening mammography interpretive performance on basis of multiple performance measures. AJR Am J Roentgenol 2015 Apr;204(4):W486-91. doi: 10.2214/AJR.13.12313. [View Abstract]

Onega T, Anderson ML, Miglioretti DL, Buist DS, Geller B, Bogart A, Smith RA, Sickles EA, Monsees B, Bassett L, Carney PA, Kerlikowske K, Yankaskas BC. Establishing a gold standard for test sets: variation in interpretive agreement of expert mammographers. Acad Radiol 2013 Jun;20(6):731-9. doi: 10.1016/j.acra.2013.01.012. [View Abstract]

Onega T, Goldman LE, Walker RL, Miglioretti DL, Buist DS, Taplin S, Geller BM, Hill DA, Smith-Bindman R. Facility Mammography Volume in Relation to Breast Cancer Screening Outcomes. J Med Screen 2016 Mar;23(1):31-7. [View Abstract]

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 Nov;9(11):788-94. doi: 10.1016/j.jacr.2012.05.020. [View Abstract]

Torres-Mejia G, Smith RA, Carranza-Flores Mde L, Bogart A, Martínez-Matsushita L, Miglioretti DL, Kerlikowske K, Ortega-Olvera C, Montemayor-Varela E, Angeles-Llerenas A, Bautista-Arredondo S, Sánchez-González G, Martínez-Montañez OG, Uscanga-Sánchez SR, Lazcano-Ponce E, Hernández-Ávila M. Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists. BMC Cancer 2015 May 16;15:410. doi: 10.1186/s12885-015-1399-2. [View Abstract]

Wolf M, Krause J, Carney PA, Bogart A, Kurvers RH. Collective intelligence meets medical decision-making: the collective outperforms the best radiologist. PLoS One 2015 Aug 12;10(8):e0134269. eCollection 2015. [View Abstract]