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
Tice JA, Bissell MCS, Miglioretti DL, Gard CC, Rauscher GH, Dabbous FM, Kerlikowske K. Validation of the breast cancer surveillance consortium model of breast cancer risk. Breast Cancer Res Treat. 2019;175(2):519-23. Epub 2019/02/24. PubMed
Miglioretti DL, Lee JM, Kerlikowske K. Re: "Linkage of the ACR National Mammography Database to the network of state cancer registries: proof of concept evaluation by the ACR National Mammography Database Committee". J Am Coll Radiol. 2019;16(2):135-136. doi: 10.1016/j.jacr.2018.09.056. PubMed
Arasu VA, Miglioretti DL, Sprague BL, Alsheik NH, Buist DSM, Henderson LM, Herschorn SD, Lee JM, Onega T, Rauscher GH, Wernli KJ, Lehman CD, Kerlikowske K. Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk. J Clin Oncol. 2019 Apr 20;37(12):954-963. doi: 10.1200/JCO.18.00378. Epub 2019 Jan 9. PubMed
Sprague BL, Kerlikowske K, Bowles EJA, Rauscher GH, Lee CI, Tosteson ANA, Miglioretti DL. Trends in clinical breast density assessment from the Breast Cancer Surveillance Consortium. J Natl Cancer Inst. 2019 Jan 8. pii: 5280767. doi: 10.1093/jnci/djy210. [Epub ahead of print]. PubMed
Smith-Bindman R, Wang Y, Chu P, Chung R, Einstein AJ, Balcombe J, Cocker M, Das M, Delman BN, Flynn M, Gould R, Lee RK, Yellen-Nelson T, Schindera S, Seibert A, Starkey J, Suntharalingam S, Wetter A, Wildberger JE, Miglioretti DL. International variation in radiation dose for computed tomography examinations: prospective cohort study. BMJ. 2019;364:k4931. doi: 10.1136/bmj.k4931. PubMed
Tiro JA, Betts AC, Kimbel K, Buist DSM, Mao C, Gao H, Shulman L, Malone C, Beatty T, Lin J, Thayer C, Miglioretti DL, Winer RL. Understanding patients' perspectives and information needs following a positive home human papillomavirus self-sampling kit result. J Womens Health (Larchmt). 2018 Nov 27. doi: 10.1089/jwh.2018.7070. [Epub ahead of print]. PubMed
Smith-Bindman R, Poder L, Johnson E, Miglioretti DL. Risk of malignant ovarian cancer based on ultrasonography findings in a large unselected population. JAMA Intern Med. 2018 Nov 12. pii: 2714301. doi: 10.1001/jamainternmed.2018.5113. [Epub ahead of print]. PubMed
Lee CI, Zhu W, Onega TL, Germino J, O’Meara ES, Lehman CD, Henderson LM, Haas JS, Kerlikowske K, Sprague BL, Rauscher GH, Tosteson ANA, Alford-Teaster J, Wernli KJ, Miglioretti DL. The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume. AJR Am J Roentgenol. 2018 Nov;211(5):957-963. Epub 2018 Sep 20.
Wang Y, Tancredi D, Miglioretti DL. Joint indirect standardization when only marginal distributions are observed in the index population. J Am Stat Assoc., 2018 Oct 09 [Epub ahead of print].
Lee JM, Abraham L, Lam DL, Buist DSM, Kerlikowske K, Miglioretti DL, Houssami N, Lehman CD, Henderson LM, Hubbard RA. Cumulative risk distribution for interval invasive second breast cancers after negative surveillance mammography. J Clin Oncol. 2018 Jul 10;36(20):2070-2077. Epub 2018 May 2. PubMed
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.
Family history sparks interest for KPWHRI senior investigator, UC Davis professor, and co-leader of the BCSC.
Read it in News and Events.
Digital breast tomosynthesis reduced patient recalls with no change in cancer detection, study shows.
HealthDay, Jul 24, 2019