Vermont Administrative Core

乳腺癌筛查导致美国乳腺癌死亡率大幅下降 在过去的30年里，这些国家受到了威胁，但也不是没有意外的伤害和缺点。全面、 整个筛查过程的基于人群的纵向数据可以评估当前的筛查做法 并提出改进建议。佛蒙特州繁荣研究中心(VPRC)建议继续和 延长佛蒙特州乳腺癌监测系统(VBCS)的工作时间，该系统已有16年的历史 综合收集患者危险因素、乳房影像、病理、治疗、癌症转归的经验 和重要状态数据。我们的第一个目标是在社区中记录整个乳腺癌筛查过程 在佛蒙特州各地练习。收集的新数据将增加我们16年的纵向数据， 这为我们提出的研究计划提供了基础，即与统计局共享数据 协调中心，以及与PROSPR其他站点的协作。第二，我们将进行一项研究 通过开发可用于诊断的预后标志物来改进筛查过程的计划 导管原位癌(DCIS)的个性化治疗策略使用纵向数据 从VBCS中大约1400例DCIS病例，我们将寻求确定新的分子，形态， 放射学和肿瘤微环境标记物可以根据进展到 侵袭性疾病。我们的比较有效性分析将为新的DCIS提供一个框架 预后标记物可以根据其对筛查的益处和危害的潜在影响进行评估。 第三，我们将与其他PROSPR研究中心，PROSPR统计中心进行合作研究 协调中心、国家癌症研究所和更大的研究社区。我们的多学科 由经验丰富的基础、临床和人口科学家组成的团队将领导和参与跨网络 倡议，并确保传播我们的数据和研究结果。实现这些目标将 为评估和改进当前的乳腺癌筛查过程提供丰富的数据来源。 我们研究计划的成功将填补识别DCIS预后标志物的迫切需求， 可以实现个性化的管理策略。

Breast cancer screening has led to substantial reductions in breast cancer mortality in the United States over the past 30 years, but not without unintended harms and shortcomings. Comprehensive, population-based, longitudinal data on the entire screening process can evaluate current screening practices and recommend improvements. The Vermont Prosper Research Center (VPRC) proposes to continue and extend the work of the Vermont Breast Cancer Surveillance System (VBCSS), which has 16 years of experience in collecting Integrated patient risk factor, breast imaging, pathology, treatment, cancer outcome and vital status data. Our first aim is to document the entire breast cancer screening process In community practice across the state of Vermont. The new data collected will add to our 16 years of longitudinal data, which provide the foundation for our proposed research program, data sharing with the Statistical Coordination Center, and collaborations with other PROSPR sites. Second, we will pursue a research program that improves the screening process by developing prognostic markers that can be used to develop personalized management strategies for ductal carcinoma in situ (DCIS). Using longitudinal data on approximately 1400 DCIS cases from the VBCSS, we will seek to identify novel molecular, morphologic, radiologic, and tumor microenvironment markers that can stratify DCIS patients by risk of progression to invasive disease. Our comparative effectiveness analyses will provide a framework by which new DCIS prognostic markers can be evaluated for their potential impacts on the benefits and harms of screening. Third, we will conduct collaborative research with other PROSPR Research Centers, the PROSPR Statistical Coordination Center, the National Cancer Institute, and the larger research community. Our multidisciplinary team of experienced basic, clinical, and population scientists will lead and participate in trans-Network initiatives and ensure the dissemination of our data and study findings. Accomplishment of these aims will provide a rich source of data for use in evaluating and improving current breast cancer screening processes. Success in our research program will fill an urgent need for identification of DCIS prognostic markers that could enable personalized management strategies.