100 Sites Wanted for Breast Cancer Imaging Trial


Radiology is poised to embark on the largest imaging trial in nearly 25 years, according to the press release from the ACR. This is big and important news for both radiology and the breast cancer community.

The ECOG-ACRIN Cancer Research group has received funding from the National Cancer Institute to compare the incidence of advanced cancer in women screened with digital mammography versus breast tomosynthesis.

The target number of enrollees for the Tomosynthesis Mammography Imaging Screening Trial (TMIST) is 165,000 women, exceeding the size of the DMIST trial by more than a factor of three. It will be led by lead investigator Etta D. Pisano, MD, and lead statistician Constantin A. Gastonis, PhD, who bring their considerable experience with DMIST.

TMIST will be carried out by the ACR Center for Research and Innovation through ACRIN and ECOG, co-chaired by Mitchell D. Schnall, MD, PhD.

The timeframe for enrollment is ambitious—the investigators hope to reach the accrual goal within three years and enrollees will be screened for four years. Hence, there is a sense of urgency and two informational sessions have been scheduled at the RSNA.

For radiologists and radiology departments, TMIST represents a great opportunity to participate in an historic (no matter what the outcome), prospective trial that could provide much-needed answers to questions about who will benefit from use of the technologies. Moreover, participants will help to achieve the trial’s aim of providing “a modern basis for the continued use of mammography for breast cancer screening.”

We have seen women, primary care physicians and specialists bombarded with studies that seem more intent on pointing out the well-known limitations of mammography than discriminating between relevant and less-than-relevant data.

Perhaps this study can do one other thing: Maybe it will once and for all establish a “statute of limitations” on aged-out breast imaging studies conducted on obsolete technology from the last century, and the use thereof in meta-analysis ad infinitum, which present a disservice to women everywhere as compliance with annual screening declines.

All hands on deck!