Comparative Modeling of Precision Breast Cancer Control Across the Translational Continuum Administrative Supplement

ABSTRACT The CISNET Breast Working Group (BWG) conducts innovative modeling research focused on new precision oncology paradigms that are expected to re-define breast cancer control best practices. In the parent award, we selected significant topics where modeling is suited to fill evidence gaps and facilitate clinical and policy translation. The activities of this award have encompassed multiple lines of activity including analyses for the US Preventive Services Task Force, publishing a cross-CISNET monograph, dedicating Rapid Response funds to address priority areas for new investigation, and fostering the career of early-stage investigators. The models share common inputs and provide a standard set of outcomes for benefits (e.g., distant recurrences and deaths avoided, mortality reductions, life years and quality-adjusted life years), harms (e.g., false positives and benign biopsies, advanced stage diagnoses, overdiagnosis and treatment impact on quality of life), and costs. Unique components of our approach include modeling of absolute risk of disease accounting for multiple risk factors, evaluating emerging screening modalities, addressing important comorbidities—specifically type 2 diabetes—that affect both disease risk and survival, and providing guidance regarding new precision systemic treatments and their impact on outcomes among survivors. The specific aims of this extension are to: 1) complete manuscripts in progress; 2) fully implement common inputs that consider important recent trends in screening and treatment; 3) update documentation of program code and manuscript specifications; and 4) retain essential programming staff to complete coding, finalize documentation, and facilitate future use of breast cancer modeling resources. This scope of work would not be feasible without the availability of five distinctive BWG models: Dana Farber (D), Georgetown-Einstein (GE), MD Anderson (M), Stanford (S), and Wisconsin (W). This extension period will ensure that the BWG models are supported to incorporate the latest input data and record key decisions as a foundation for future use. Retention of key programming staff will guarantee that modeling resources will be updated, documented, and accessible for utilization in new studies. Continuously funded for the past 25 years, the modeling teams have published >230 research papers informing public health and trained >20 junior investigators. An experienced Coordinating Center provides the infrastructure to support the project goals including resource sharing and model accessibility. The exceptional environment provides unprecedented synergy and leveraging of resources to address new research questions and support career development that would not otherwise be possible. Overall, infrastructure support for the Breast Working Group will advance modeling research and guide breast cancer control decision making.