investigation and attracting new investigators into the field. It recommended a three-pronged programmatic investment strategy to support scientific initiatives in the following areas:

• scientist training and recruitment: $27 million,

• infrastructure enhancement: $21 million, and

• investigator-initiated research: $151.5 million.

The report (IOM, 1993) also recommended that the BCRP institute a two-tiered system of peer review for research proposals submitted to the program. The first tier would be responsible for assessing the scientific excellence of the research proposals and the second tier would award funding based on their programmatic relevance. The report emphasized the importance of "channeling the research funds in directions that stimulate innovative ideas, involve interdisciplinary research, enhance the use of existing research resources, and reward scientific excellence among all disciplines" (IOM, 1993).

Congress appropriated another $30 million for the BCRP in FY 1994 (Public Law 103-139), $150 million in FY 1995 (Public Law 103-335), and $75 million in FY 1996 (Public Law 104-61), for a total of $465 million. While some of these funds have been congressionally directed toward specific areas (e.g., breast cancer centers, digital mammography technology and automated mammography screening, increased access to care, and improved treatment for military members and their dependents), the vast majority of funds were designated to support peer-reviewed scientific research focusing on the causes, prevention, detection, treatment, and outcome of breast cancer.

In late 1995, the USAMRMC asked the IOM to review the implementation and progress of the BCRP. Specifically, the IOM was asked to: (1) review the portfolio of breast cancer research funded by the Army's BCRP as well as breast cancer research supported by other public and private funding agencies; (2) provide an analysis of the BCRP as it has been implemented in response to the 1993 IOM report recommendations, assessing the process employed in program management and program achievement; and (3) provide recommendations delineating important research areas for which current support and programs are not yet in place or in which additional emphasis is needed.