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
Marcus PM, Pashayan N, Church TR, Doria-Rose VP, Gould MK, Hubbard RA, Marrone M, Miglioretti DL, Pharoah PD, Pinsky PF, Rendle KA, Robbins HA, Roberts MC, Rolland B, Schiffman M, Tiro JA, Zauber AG, Winn DM, Khoury MJ. Population-based precision cancer screening: a symposium on evidence, epidemiology, and next steps. Cancer Epidemiol Biomarkers Prev. 2016 Aug 9. pii: cebp.0555.2016. [Epub ahead of print]. PubMed
Smith-Bindman R, Wang Y, Yellen-Nelson TR, Moghadassi M, Wilson N, Gould R, Seibert A, Boone JM, Krishnam M, Lamba R, Hall DJ, Miglioretti DL. Predictors of CT radiation dose and their effect on patient care: a comprehensive analysis using automated data. Radiology. 2017 Jan;282(1):182-193. doi: 10.1148/radiol.2016151391. Epub 2016 Jul 20. PubMed
Elmore JG, Cook AJ, Bogart A, Carney PA, Geller BM, Taplin SH, Buist DS, Onega T, Lee CI, Miglioretti DL. Radiologists' interpretive skills in screening vs. diagnostic mammography: are they related? Clin Imaging. 2016 Jul 1;40(6):1096-1103. doi: 10.1016/j.clinimag.2016.06.014. [Epub ahead of print]. PubMed
Houssami N, Miglioretti DL. Digital breast tomosynthesis: a brave new world of mammography screening. JAMA Oncol. 2016 Feb 18. doi: 10.1001/jamaoncol.2015.5569. [Epub ahead of print]. PubMed
Hubbard RA, Ripping TM, Chubak J, Broeders MJ, Miglioretti DL. Statistical methods for estimating the cumulative risk of screening mammography outcomes. Cancer Epidemiol Biomarkers Prev. 2016 Mar;25(3):513-20. doi: 10.1158/1055-9965.EPI-15-0824. Epub 2015 Dec 31. PubMed
Smith-Bindman R, Kwan ML, Miglioretti DL. Letter to the editor: who gets to decide? Radiology. 2016 Feb;278(2):635-7. doi: 10.1148/radiol.2015151682.
Miglioretti DL, Lang J, van den Broek JJ, Lee CI, van Ravesteyn N, RitleyD, Kerlikowske K, Fenton JJ, Melnikow J, de Koning HJ, Hubbard RA Radiation-induced breast cancer incidence and mortality from digital mammography screening: a modeling study. Ann Intern Med. 2016 Jan 12. doi: 10.7326/M15-1241. [Epub ahead of print].
Mandelblatt JS, Stout NK, Schechter CB, van den Broek JJ, Miglioretti DL, Krapcho M, Trentham-Dietz A, Munoz D, Lee SJ, Berry DA, van Ravesteyn NT, Alagoz O, Kerlikowske K, Tosteson AN, Near AM, Hoeffken A, Chang Y, Heijnsdijk EA, Chisholm G, Huang X, Huang H, Ergun MA, Gangnon R, Sprague BL, Plevritis S, Feuer E, de Koning HJ, Cronin KA. Collaborative modeling of the benefits and harms associated with different U.S. breast cancer screening strategies. Ann Intern Med. 2016 Jan 12. doi: 10.7326/M15-1536. [Epub ahead of print]. PubMed
Melnikow J, Xing G, Cox G, Leigh P, Mills L, Miglioretti DL, Moghadassi M, Smith-Bindman R. Cost analysis of the STONE randomized trial: can health care costs be reduced one test at a time? Med Care. 2016 Jan 12. [Epub ahead of print].
Nelson HD, O'Meara ES, Kerlikowske K, Balch S, Miglioretti DL. Factors affecting the rates and consequences of false positive and false negative digital mammography screening exams: an analysis of registry data. Ann Intern Med. 2016 Feb 16;164(4):226-35. doi: 10.7326/M15-0971. Epub 2016 Jan 12.
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