Vermont Administrative Core

乳腺癌筛查已导致美国乳腺癌死亡率大幅下降。 在过去30年里，美国政府一直在努力，但并非没有意想不到的伤害和缺点。全面， 基于人群的、关于整个筛查过程的纵向数据可以评估当前的筛查实践 并提出改进建议。佛蒙特州生产研究中心（VPRC）建议继续和 延长佛蒙特州乳腺癌监测系统（VBCSS）的工作，该系统有16年的 收集综合患者风险因素、乳腺成像、病理学、治疗、癌症结局的经验 和生命状态数据我们的第一个目标是记录整个乳腺癌筛查过程在社区 在佛蒙特州各地执业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， 协调中心，并与其他PROSPR网站的合作。第二，我们会继续研究 通过开发可用于发展的预后标志物来改善筛查过程的计划 导管原位癌（DCIS）的个性化管理策略。使用纵向数据 从VBCSS中大约1400例DCIS病例中，我们将寻求鉴定新的分子，形态， 放射学和肿瘤微环境标志物，可以根据进展至 侵袭性疾病我们的比较有效性分析将提供一个框架， 可以评估预后标志物对筛查的益处和危害的潜在影响。 第三，我们将与其他PROSPR研究中心、PROSPR统计中心和PROSPR统计中心开展合作研究。 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 并确保我们的数据和研究结果的传播。实现这些目标将 提供了丰富的数据来源，用于评估和改善目前的乳腺癌筛查过程。 我们研究项目的成功将满足对DCIS预后标志物鉴定的迫切需求， 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.