Senior investigator and professor of biostatistics Diana Miglioretti, PhD, is committed to improving health care by building the evidence base for personalized cancer screening. To achieve this goal, Dr. Miglioretti pursues a rigorous combination of applied and methodological research. Her work focuses on the benefits and risks of cancer screening and appropriate use of screening and diagnostic tools including medical imaging.
Dr. Miglioretti co-leads the Breast Cancer Surveillance Consortium (BCSC)—a network of breast imaging registries that has the largest and most comprehensive collection of breast cancer screening data in the nation. Established in 1994, the BCSC is currently supported by a $17 million program project grant from the National Cancer Institute. The vast BCSC database includes information on about 12 million film, digital, and 3D mammograms for more than 2.4 million women. The BCSC also has extensive data on newer methods such as digital breast tomosynthesis (also called 3D mammography) and breast MRI (magnetic resonance imaging).
Dr. Miglioretti’s expertise in maximizing the value of the BCSC data includes establishing and evaluating data collection, helping individual sites and outside researchers with analyses, and developing new statistical techniques. In part through her efforts, results from BCSC studies have helped guide national breast cancer screening policy decisions and clinical guidelines. A few examples of Dr. Miglioretti’s BCSC studies are:
Other examples of Dr. Miglioretti’s research include:
In addition to her KPWHRI faculty position, Dr. Miglioretti is the Dean’s Professor of Biostatistics in the Department of Public Health Sciences, School of Medicine, University of California, Davis. She enthusiastically shares her expertise as an instructor at the Radiological Society of North America's (RSNA) annual workshop in clinical trials methodology, which prepares radiologists to develop clinical research protocols and apply for funding.
Among Dr. Miglioretti’s professional memberships are the American Association for Cancer Research, the International Biometrics Society Eastern and Western North America regions, and the American Statistical Association, for which she was elected a fellow.
Clustered and longitudinal data analysis; latent variable modeling; assessment of diagnostic and screening tests
Biostatistics; breast cancer screening and surveillance; mammographic breast density; risk prediction
Imaging trends; radiation exposure from medical imaging; evaluation of imaging tests
Yeh JM, Lowry KP, Schechter CB, Diller LR, Alagoz O, Armstrong GT, Hampton JM, Leisenring W, Liu Q, Mandelblatt JS, Miglioretti DL, Moskowitz CS, Oeffinger KC, Trentham-Dietz A, Stout NK. Clinical benefits, harms, and cost-effectiveness of breast cancer screening for survivors of childhood cancer treated with chest radiation: a comparative modeling study. Ann Intern Med. 2020. Epub 2020/07/07. PubMed
Sprague BL, Miglioretti DL, Lee CI, Perry H, Tosteson AAN, Kerlikowske K. New mammography screening performance metrics based on the entire screening episode. Cancer. 2020 May 6. doi: 10.1002/cncr.32939. [Epub ahead of print]. PubMed
Smith-Bindman R, Chu P, Wang Y, Chung R, Lopez-Solano N, Einstein AJ, Solberg L, Cervantes LF, Yellen-Nelson T, Boswell W, Delman BN, Duong PA, Goode AR, Kasraie N, Lee RK, Neill R, Pahwa A, Pike P, Roehm J, Schindera S, Starkey J, Suntharalingam S, Jeukens CRLPN, Miglioretti DL. Comparison of the effectiveness of single-component and multicomponent interventions for reducing radiation doses in patients undergoing computed tomography: a randomized clinical trial. JAMA Intern Med. 2020 Mar 30. pii: 2763413. doi: 10.1001/jamainternmed.2020.0064. [Epub ahead of print]. PubMed
Sprague BL, Coley RY, Kerlikowske K, Rauscher GH, Henderson LM, Onega T, Lee CI, Herschorn SD, Tosteson ANA, Miglioretti DL. Assessment of radiologist performance in breast cancer screening using digital breast tomosynthesis vs digital mammography. JAMA Netw Open. 2020;3(3):e201759. doi: 10.1001/jamanetworkopen.2020.1759. PubMed
Malone C, Tiro JA, Buist DS, Beatty T, Lin J, Kimbel K, Gao H, Thayer C, Miglioretti DL, Winer RL. Reactions of women underscreened for cervical cancer who received unsolicited human papillomavirus self-sampling kits. J Med Screen. 2019 Nov 20:969141319885994. doi: 10.1177/0969141319885994. [Epub ahead of print]. PubMed
Winer RL, Lin J, Tiro JA, Miglioretti DL, Beatty T, Gao H, Kimbel K, Thayer C, Buist DSM. Effect of mailed human papillomavirus test kits vs usual care reminders on cervical cancer screening uptake, precancer detection, and treatment: a randomized clinical trial. JAMA Netw Open. 2019;2(11):e1914729. Epub 2019/11/07. doi: 10.1001/jamanetworkopen.2019.14729. PubMed
Brandt KR, Scott CG, Miglioretti DL, Jensen MR, Mahmoudzadeh AP, Hruska C, Ma L, Wu FF, Cummings SR, Norman AD, Engmann NJ, Shepherd JA, Winham SJ, Kerlikowske K, Vachon CM. Automated volumetric breast density measures: differential change between breasts in women with and without breast cancer. Breast Cancer Res. 2019;21(1):118. doi: 10.1186/s13058-019-1198-9. PubMed
Marshall EL, Rajderkar D, Brown JL, Stepusin EJ, Borrego D, Duncan J, Sammet CL, Munneke JR, Kwan ML, Miglioretti DL, Smith-Bindman R, Bolch WE. A scalable database of organ doses for common diagnostic fluoroscopy procedures of children: procedures of historical practice for use in radiation epidemiology studies. Radiat Res. 2019 Oct 14. doi: 10.1667/RR15445.1. [Epub ahead of print]. PubMed
Demb J, Chu P, Yu S, Whitebird R, Solberg L, Miglioretti DL, Smith-Bindman R. Analysis of computed tomography radiation doses used for lung cancer screening scans. JAMA Intern Med. 2019 Sep 23. doi: 10.1001/jamainternmed.2019.3893. [Epub ahead of print]. PubMed
Reed SC, Bell JF, Miglioretti DL, Nekhlyudov L, Fairman N, Joseph JG. Fear of cancer recurrence and associations with mental health status and individual characteristics among cancer survivors:findings from a nationally representative sample. J Psychosoc Oncol. 2019 Sep 11:1-18. doi: 10.1080/07347332.2019.1649338. [Epub ahead of print]. PubMed
But for most women, digital breast tomosynthesis improves cancer detection and reduces recalls.
Dr. Diana Buist and team reflect on HOME trial showing 50 percent screening boost in underscreened women.
Interdisciplinary group shows that home-based HPV tests can boost cervical cancer screening for women at high risk.
A Kaiser Permanente-led BCSC study is among the largest ever to evaluate adding MRI surveillance for breast cancer survivors.
HealthDay, Nov 8, 2019