Appendix

Saving Women’s Lives: Strategies for Improving Breast Cancer Detection and Diagnosis

A Breast Cancer Research Foundation and Institute of Medicine Symposium

June 14, 2004

National Academy of Sciences

2100 C Street, N.W.

Washington, D.C.

8:30–9:00

Continental Breakfast in the Great Hall

9:00–9:15

Plenary Session—The Lecture Room

Introduction of Symposium

Evelyn H.Lauder, Founder and Chairman, The Breast Cancer Research Foundation

Ed Penhoet, Ph.D., Chair, Committee on Saving Women’s Lives: Strategies for Improving Breast Cancer Detection and Diagnosis and Director Science and Higher Education Programs, Gordon and Betty Moore Foundation

9:15–9:45

“The Pros and Cons of Screening Mammography: What Women Need to Know”

An Overview of the Report’s Findings on Mammography

Laura Esserman, M.D., Director, Carol Franc Buck Breast Care Center and Professor of Surgery and Radiology, University of California, San Francisco



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Saving Woman’s Lives: Strategies for Improving Breast Cancer Detection and Diagnosis Appendix Saving Women’s Lives: Strategies for Improving Breast Cancer Detection and Diagnosis A Breast Cancer Research Foundation and Institute of Medicine Symposium June 14, 2004 National Academy of Sciences 2100 C Street, N.W. Washington, D.C. 8:30–9:00 Continental Breakfast in the Great Hall 9:00–9:15 Plenary Session—The Lecture Room Introduction of Symposium Evelyn H.Lauder, Founder and Chairman, The Breast Cancer Research Foundation Ed Penhoet, Ph.D., Chair, Committee on Saving Women’s Lives: Strategies for Improving Breast Cancer Detection and Diagnosis and Director Science and Higher Education Programs, Gordon and Betty Moore Foundation 9:15–9:45 “The Pros and Cons of Screening Mammography: What Women Need to Know” An Overview of the Report’s Findings on Mammography Laura Esserman, M.D., Director, Carol Franc Buck Breast Care Center and Professor of Surgery and Radiology, University of California, San Francisco

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Saving Woman’s Lives: Strategies for Improving Breast Cancer Detection and Diagnosis 9:45–10:15 “Challenges to Expanding Mammography Capacity” Better Quality for Women in Screening Sites Reed Dunnick, M.D., Professor and Chair, Department of Radiology, University of Michigan 10:15–10:45 “Better Models for U.S. Mammography Services: Implications for Accuracy and Encouragement of Screening” Better Quality for Women Through Better Organized Mammography Robert Smith, Ph.D., Director of Cancer Screening, American Cancer Society 10:45–11:05 Q & A 11:05–11:35 “Risk Stratification for Breast Cancer Detection” Better Quality Mammography Through Better Focusing of Services Suzanne Fletcher, M.D., Professor of Ambulatory Care and Prevention, Harvard Medical School 11:35–12:05 “The Promise of Biomarkers in Early Detection of Breast Cancer” Better Quality for Women Through New Ways of Detecting Breast Cancer Samir Hanash, M.D., President and Chair, Human Proteome Initiative Committee and Professor, Department of Pediatrics, University of Michigan 12:05–12:35 “Bringing New Technologies into Service” Better Quality for Women Through New or Improved Technologies Sean Tunis, M.D., M.Sc., Chief Medical Officer, and Director, Office of Clinical Standards and Quality, Centers for Medicare and Medicaid Services 12:35–1:00 Q&A 1:00–1:45 Lunch in the Great Hall for speakers and attendees

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Saving Woman’s Lives: Strategies for Improving Breast Cancer Detection and Diagnosis 1:45–3:30 Simultaneous group discussions with invited speakers Moderators & Rapporteurs: Etta Pisano, M.D., Professor of Radiology and Biomedical Engineering, Chief of Breast Imaging and Director, Biomedical Research Imaging Center, University of North Carolina at Chapel Hill Richard Bohmer, M.B.Ch.B., M.P.H., Assistant Professor, Harvard Business School. Panelists: Up to 20 minute talks each, followed by group Q & A and discussion for the balance of the time. 1:45–3:30 Delivering Better Breast Cancer Screening Services—Members Room To discuss the report’s findings and recommendations: about enhancing mammography quality, capacity, and interpretation; concerning regulation; regarding barriers to better mammography like liability, reimbursement, and access; and about advances in mammography in every day practice. Panelists: Stephen Taplin, M.D., Senior Scientist, Applied Research Program, NCI Rebecca Smith-Bindman, M.D., Associate Professor, Obstetrics, Gynecology and Reproductive Medicine, Radiology and Epidemiology/Biostatistics, UCSF Charles Finder, M.D., Associate Director, Division of Mammography Quality and Radiation Programs, FDA James Borgstede, M.D., Chairman, Board of Chancellors, American College of Radiology 1:45–3:30 Developing and Delivering New Detection Technologies—Board Room To discuss the report’s recommendations: that appropriate federal and other agencies consider ways to assemble expertise and funding toward a more comprehensive approach to the assessment, adoption, and comparison of multiple new technologies; and that sponsors should support research on technology adoption and monitoring of use in practice to identify both potential failures as well as opportunities for improvement. Panelists: Dan Sullivan, M.D., Associate Director, Cancer Imaging Program, NCI

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Saving Woman’s Lives: Strategies for Improving Breast Cancer Detection and Diagnosis   Kirby Vosburgh, Ph.D., Associate Director, Center for Integration of Medicine and Innovative Technologies, Partners Health Care Carole Flamm, M.D. Technology Evaluation Center, Blue Cross Blue Shield Association and Eric Baugh, M.D., Senior Vice President, Medical Affairs, Care First, Blue Cross Blue Shield Diana Petitti, M.D., M.P.H., Director, Research and Evaluation, Kaiser Permanente 3:30–4:00 Plenary Session—The Lecture Room Summary of sessions and wrap-up with rapporteurs, Etta Pisano and Richard Bohmer 4:00 Comments on the presentations and discussions from the per spective of survivors Carolina Hinestrosa, M.A., M.P.H., Executive Vice President for Programs and Planning, National Breast Cancer Coalition 4:30 Adjourn Acknowledgments The Institute of Medicine acknowledges the generous support of this symposium by The Apex Foundation, The Breast Cancer Research Foundation and The Broad Reach Foundation. The Apex Foundation support was given in memory of Mabel Frost McCaw and Joan Morgan, and in honor of Sallie Nicholls, Beth Weibling, Jane Carlson Williams, Bonnie Main and Amy McGraw. Also acknowledged is the assistance of the American Cancer Society, Centers for Disease Control and Prevention, and National Cancer Institute in the planning and implementation of this symposium. Register for the Symposium at http://www.iom.edu/event.asp?id=19062