Risk for and Detection of Breast Cancer in Marin and San Francisco County

PI Name: Kerlikowske K
Title: Risk for and Detection of Breast Cancer in Marin and San Francisco County
Institute: Marin Public Health Department and Centers for Disease Control and Prevention

The overall goal of this proposal is to compare risk factors, cancer detection rates and mammography accuracy in women who live in Marin County compared to San Francisco County. To accomplish this goal, the investigators will expand the population-based, computerized San Francisco Mammography Registry (SFMR) to include Marin County. Specifically, they will collect demographic, clinical and risk factor information, mammographic interpretations and cancer outcomes obtained through linkage with the regional population-based Surveillance, Epidemiology, and End Results (SEER) program for the purpose of comparing risk factors, evaluating the performance of mammography, and cancer outcomes among women living in Marin County compared with San Francisco County. They will examine the prevalence of individual risk factors as well as calculate a Gail score for individual women to determine the age-specific proportion of women at high risk of breast cancer. They will also determine the rate of cancer, sensitivity, specificity and positive predictive value of mammography, rate of biopsy, and type of cancer detected [DCIS vs. invasive, size, grade, stage and estrogen receptor status] among screened women living in Marin compared with San Francisco. Lastly, they will examine tumor characteristics among women undergoing mammography to determine whether mammography utilization is having a similar influence on tumor outcomes in Marin county and San Francisco county. The results of this study will provide population-based information about what risk factors may contribute to increased breast cancer risk in Marin County and the impact of screening mammography on breast cancer outcomes. This information may be useful in identifying and designing the best intervention to decrease breast cancer risk in Marin County.