In this report The Breast Cancer Research Foundation (BCRF) and the Institute of Medicine (IOM) present a one-day symposium that was held at the IOM to further disseminate the conclusions and recommendations of the joint IOM and National Research Council report, Saving Women’s Lives: Strategies for Improving Breast Cancer Detection and Diagnosis. The symposium was introduced by Mrs. Evelyn Lauder, Founder and Chairman of the BCRF; and Dr. Edward Penhoet, Chairman of the IOM committee for the report. At a plenary session in the morning six invited experts from academia, the American Cancer Society, and the Centers for Medicare and Medicaid Services gave presentations on what women need to know about mammography, challenges to expanding mammography capacity, better models for mammography services, risk stratification for breast cancer detection, the promise of biomarkers, and bringing new technologies into service. In the afternoon, panelists from the National Cancer Institute, the Food and Drug Administration, Kaiser Permanente, Blue Cross Blue Shield, the American College of Radiology (ACR), Partners Health Care, and University of California, San Francisco, gave presentations and participated in discussions with attendees in two groups, one on delivering better breast cancer screening services and one on developing and delivering new detection technologies. A wrap-up session at the end summarized the issues raised, including: how to organize mammography better and recruit women to screening; lessons learned from screening in the United Kingdom; and disparities in breast cancer screening and care, Mammography Quality Standards Act enforcement, ACR perspectives on screening, the roles of National Institutes of Health in cancer detection technology development, engineers working with clinicians to develop breast cancer detection, technology evaluation and coverage policy, and assessing technologies in managed care systems. At the end, a representative of breast cancer survivors gave her perspectives on the day.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON NEW APPROACHES TO EARLY DETECTION AND DIAGNOSIS OF BREAST CANCER
• NATIONAL CANCER POLICY BOARD
• 1. Introduction
  Roger Herdman and Larry Norton.
• 2. Plenary Session
  • Introduction to the Symposium and of the Founder and Chairman of The Breast Cancer Research Foundation
  • Introductory Remarks
  • The Pros and Cons of Screening Mammography: What Women Need to Know—An Overview of the Report's Findings on Mammography
  • Challenges to Expanding Mammography: Better Quality for Women in Screening Sites
  • Better Models for U.S. Mammography Services: Implications for Accuracy and Encouragement of Screening. Better Quality Through Better Organized Mammography
  • Risk Stratification for Breast Cancer Detection: Better Quality Mammography for Women Through Better Focusing of Services
  • The Promise of Biomarkers in Early Detection of Breast Cancer: Better Quality Mammography Through Better Focusing of Services
  • Bringing New Technologies into Service: Better Quality for Women Through New or Improved Technologies
• 3. Simultaneous Group Discussions with Invited Speakers
  • First Group Discussion: Delivering Better Breast Cancer Screening Services
  • Second Group Discussion Developing and Delivering New DetectionTechnologies
• 4. Wrap-Up Session
  • Final Remarks
• References
• APPENDIX SYMPOSIUM AGENDA

Support for this project was provided by the Apex Foundation, The Breast Cancer Research Foundation, the Broad Reach Foundation, the Carl J. Herzog Foundation, Mr. Corbin Gwaltney, Mr. John Castle, the Josiah Macy Jr. Foundation, the Kansas Health Foundation, and the National Cancer Institute. This study was supported, in part, by Contract No. N01-OD-4-2139, TO #110 between the National Academy of Sciences and the National Cancer Institute.

Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.