ACRIN Breast Committee

ACRIN Breast CommitteeOctober 1, 2010

Constance Lehman, M.D., PhD, FACR

Professor and Vice Chair of Radiology

University of Washington

ACRIN Breast Committee

ACRIN Breast Committee

Clinical Breast Imaging Radiologists-–Constance Lehman, M.D. PhD–Hiroyuke Abe, MD–Wendie Berg, M.D. PhD–Christiane Kuhl, MD–Emily Conant, M.D–Laurie Fajardo, M.D–Ellen Mendelson, M.D–Jay Baker, M.D–Chris Comstock, M.D–Sina Meisamy, MD–Janie Lee, MD

• Other Radiologists with subspecialization in breast applications–Mike Jacobs, M.D–David Mankoff, M.D–Marilyn Roubidoux, M.D.

Breast Committee Members

ACRIN Breast Committee

•Other Disciplines–Nancy Ellerbroek, M.D Radiation Oncology–Tom Julian, M.D Surgical Oncology–Shahla Masood, M.D Pathology–Charlie Shapiro, M.D. Medical Oncology–Isabelle Bedrosian, M.D. Surgical Oncology

•Physicists–Ed Hendrick, PhD–Nola Hylton, PhD–Martin Yaffe, PhD–Robert Nishikawa, PhD

ACRIN Breast Committee

•Statisticians/Epidemiologists–Constantine Gatsonis, PhD–Ben Herman, MS–Zheng Zhang, PhD

•Others–Barbara LeStage, Patient Advocate–Nancy Sauers, Patient Advocate–Judy Johnson, Patient Advocate

–Roslynn Marzan, Research Associate–Bernadine Dunning–Maxine Crooks–Darryl L’Heureux–Ashley Fails

ACRIN Breast Committee

•Historical strength of breast committee–Assessment of diagnostic accuracy of relatively mature technology

• Digital mammography for screening average risk populations• Ultrasound for screening high risk populations• MRI for screening contralateral breast/diagnosing EOD • DCE MRI to assess response to therapy

•Future development–Develop and validate new imaging biomarkers to predict and assess response to therapy

• Advanced MR imaging (MR spectroscopy, MR DWI), Advanced PET applications, optical imaging

ACRIN Breast Committee

•SPECIFIC AIMS•Test new screening strategies based on individualized risk profiles.

•Assess the use of imaging for the measurement of extent of disease and for monitoring and mid-therapy adaptation of treatment protocols.

•Reduce the morbidity of breast cancer therapy through non-invasive imaging-guided mechanisms.

ACRIN Breast Committee

Aim 1: Targeted surveillance of at-risk populations

Protocol Number 4006 – Tomosynthesis: Comparison of Full Field Digital Mammography with Digital Breast Tomosynthesis (T-MIST) Image Acquisition and Projection Combinations in relation to

Screening Call-Back RatePI: Emily Conant, MD

ACRIN Breast Committee

Aim 2: Characterization of cancer in order to drive targeted therapy

Protocols applying functional imaging methods to determine the anatomic extent

of tumor in order to focus therapyACRIN 6694 ACOSOG collaboration pre op MRIACRIN DCIS trial—potential collaboration with

SWOG

ACRIN Breast Committee

Aim 3: Development of imaging-based predictive and prognostic

biomarkers of response to targeted treatment.

6657 extension (MR diffusion, spectroscopy) ISPY2 (6693)

EISC FLT study (6688)

ACRIN Breast Committee

• Concepts approved by ACRIN steering committee

–ACRIN Concept 6693: MR Imaging Biomarkers for Assessment of Breast Cancer Response to Neoadjuvant Treatment: A sub-study of the I-SPY 2 TRIAL (Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging And molecular Analysis)PI: Nola Hylton, PhD–ACRIN Concept 6694 – ACOSOG Z1101: Impact of Breast MRI on Selection and Outcome of Breast Cancer Patients Undergoing Breast Conserving TherapyPI: Isabelle Bedrosian, MD, Surgery PI: Chris Comstock, MD, Imaging

ACRIN Breast Committee

•3 Active Trials– ACRIN 6683 CAD 1 is complete and was presented at 2009 RSNA. CAD 2 is was presented at this meeting and will be presented at the 2010 RSNA.– ACRIN 6657 ISPY Extension: Contrast Enhanced Breast MRI and MRS for evaluation of Patients undergoing neoadjuvant treatment for Locally Advanced Breast Cancer.PI: Nola Hylton, PhDTarget accrual 140- accrual to date 114– ACRIN 6688 Phase II study of 3’-Deoxy-3’ 18F Flourothymidine (FLT) in Invasive Breast Cancer PI- Lale Kostakoglu, MD David Mankoff, MD PITarget accrual 54- accrual to date 12

ACRIN Breast Committee

Manuscripts

6652

Comparison of Softcopy and Hardcopy Reading for Full-Field Digital Mammography. Radiology, 252(1):41-49. April 2009. Nishikawa R; Acharyya S; Gastonsis C; Pisano E; Cole E; Marques H; D’Orsi C, Farria D; et al.

6652

Cancer Cases from ACRIN Digital Mammographic Imaging Screening Trial: Radiologist Analysis with use of a Logistic Regression Model. Radiology, 252(2):348-357. August 2009. Pisano E; Acharyya S; Cole E; Marques H; Yaffe M; Blevins M; Conant E; Hendrick R; et al.

6652

Comparison of Acquisition Parameters and Breast Does in Digital Mammography and Screen-Film Mammography in the ACRIN DMIST Trial. American Journal of Roentgenology, 194:362-369. February 2010. Hendrick E, Pisano E; Averbukh A; Moran C; Berns A; Yaffe M; Herman B; Acharyya S; Gatsonis C.

6667Frequency of Malignancy in Probably Benign Lesions Seen on Contrast-Enhanced Breast MRI. Radiology, 255:731-737. June 2010. Weinstein S, Hanna L, Gatsonis C, Schnall M, Rosen M, Lehman C.

6666Reasons Women at Elevated Risk of Breast Cancer Refuse Breast MR Imaging Screening. Radiology, 254(1): 79-87. January 2010. Berg W; Blume J; Adams A; Jong R; Barr R; Lehrer D; et al.

Papers Published 7/1/09-6/30/10

ACRIN Breast Committee

Abstracts

6652Title: Comparative Effectiveness and Cost-Effectiveness of Digital Mammography and MRI for Breast Cancer Screening in

BRCA1 Gene Mutation Carriers Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)Presenter: Janie Lee, MD

6657Title: MRI Tumor Volume Predicts Response to Neoadjuvant Chemotherapy: Findings from the ACRIN Rrial 6657 (poster)Conference: 2009 American Society of Clinical Oncology (ASCO)Presenter: Nola Hylton, PhD

6657

Title: Assessing Residual Disease in Breast Cancer Patients Post Neoadjuvant Chemotherapy Prior to Surgery: Findings of the American College of Radiology Imaging Network (ACRIN) Trial 6657  

Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)Presenter: Constance Lehman, MD, PhD

6666Title: Screening Breast Ultrasound as a Supplement to Mammography: Yield of Annual Screening in ACRIN 6666 Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)Presenter: Wendie Berg, MD, PhD, FACR

6666Title: False Positives Induced by Annual Screening US Added to Mammography: ACRIN 6666  Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)Presenter: Wendie Berg, MD, PhD, FACR

6666Title: Supplemental Yield and Performance Characteristics of Screening MRI after Combined Ultrasound and Mammography:

ACRIN 6666 Conference: 2009 Radiological Society of North America Annual Meeting (RSNA)Presenter: Wendie Berg, MD, PhD, FACR

6683Title: CAD System Marking of Digital Mammograms of DMIST CancersConference: 2009 Radiological Society of North America Annual Meeting (RSNA)Presenter: Elodia Cole

Abstracts Published 2009