Breast
Health
HHS
Affirms Value of Mammography for Detecting Breast Cancer
Breast cancer is the second leading cancer killer of
American women. Approximately 182,800 women in the United States were diagnosed with
invasive breast cancer, and approximately 40,800 women died from breast cancer in 2000
(American Cancer Society). With the increased use of mammography screening, breast cancers
have increasingly been detected earlier in their development, which is when they are more
treatable. In order to address this public health problem, the Office on Women’s
Health in the Department of Health and Human Services (OWH) is engaged in numerous
activities. Below are some of the major programs developed by OWH to combat the issues
relating to breast health:
Breast
Cancer Clusters Workshop
The Breast Cancer Clusters Workshop, convened in December, 1998, was a national workshop
to address the research and policy issues related to the investigation of high-rate areas
(clusters) of breast cancer. The workshop was planned by a group of national and regional
experts and activists in the field of breast cancer cluster investigation. The goal of the
workshop was to define, examine and address approaches to investigating and responding to
high-rate areas of breast cancer. The workshops provided an opportunity for leaders of
both the scientific and activist breast cancer communities, representing a wide range of
viewpoints, to share information on current approaches to investigating high-rate areas of
breast cancer. The results of the workshop are currently being submitted for publication
in a peer-reviewed journal.
The co-chairs of the Breast Cancer Cluster Workshop were Dr. Suzanne Haynes, Senior Science Advisor in
OWH and Sandra Steingraber, Ph.D., environmental consumer advocate.
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Multi-Agency
Consortium on Imaging to Improve Women’s Health
In March 1996, DHHS OWH established the Federal Multi-Agency Consortium for Imaging
& Other Technologies to Improve Women's Health. This Consortium provides leadership in
coordination of crosscutting, multi-disciplinary collaborations of multiple government
agencies, industrial, academic and professional organizations for advancement of medical
technologies for early diagnosis and treatment of critical diseases in women and their
transfer from laboratories to consumers. The Membership of the Consortium includes the
Food and Drug Administration, National Cancer Institute, Health Care Financing
Administration, Central Intelligence Agency, Department of Defense, Department of Energy,
and National Aeronautics and Space Administration. Research Triangle Institute is working
with OWH to support this technology transfer effort. The activities of this Consortium
have been critical for sharing expertise, resources and technologies by multiple
government agencies for advancement of imaging and other technologies for women's health.
Working with the intelligence defense, space, energy and
other communities, the DHHS OWH has spearheaded an initiative called "From Missiles
to Mammograms: New Frontiers in Breast Cancer Imaging and Early Detection". The goal
is to share expertise, resources, risks, and technologies to improve the early detection
of breast cancer and its integration with staging, biologic characterization, treatment
planning and monitoring.
This program established models for government leadership in
transfer of promising technologies from laboratory settings to patients by fostering their
development, evaluation and implementation. For example, between July 1994 and May 1995,
DHHS OWH initiated a Joint working group with NCI, FDA, CIA & leading academic experts
to evaluate the potential of intelligence technologies to advance early detection and
treatment of breast cancer. The preliminary results generated by the working group
demonstrated that sophisticated computer algorithms originally developed for the
intelligence applications could significantly improve the accuracy of computer-aided
analysis of digital mammographic and MRI images. In June 1996, DHHS OWH issued a contract
solicitation "Transfer of Intelligence Technologies to Improve Women's Health"
to support multi-center clinical evaluation of this technology in 8 leading institutions
across this country. This contract supports:
- -the achievement of statistical goals for patient case accrual
(about 350 for M & about 900 for digital mammography);
- -the generation of critically needed national digital image
libraries for research and education;
- -the optimization of correlation of imaging data with
pathologic findings
- -the development and testing of telemammographic capabilities
for on-line, real time collaborative consultation among the study participants.
Currently, OWH in collaboration with other federal agencies,
including NASA, is exploring future partnerships with the Indian Health Service to utilize
telemammography services including digital mammography on Native American Reservations.
Additionally, OWH serves as a representative on the Federal
Work Group on Telehealth which fosters the development of collaborative projects and
outreach.
The OWH contact person is Dr. Saralyn Mark.
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National
Action Plan on Breast Cancer
The National Action Plan on Breast Cancer (NAPBC) was initiated in 1993 in response
to a call for action from private advocacy groups. The National Breast Cancer Coalition
presented a 2.6 million-signature petition to past-President Bill Clinton asking for a
coordinated national strategy to combat breast cancer. At the President’s direction,
former DHHS Secretary Donna Shalala convened the Secretary’s Conference to Establish
a National Action Plan on Breast Cancer, that brought together more than 300 individuals
to craft a series of recommendations for action in education, research, public policy and
service delivery through public/private partnerships. The NAPBC is the working product of
that conference. Its mission is to stimulate rapid progress in eradicating breast cancer
by advancing knowledge, research, policy, and service.
Since its inception, the Plan has served as a catalyst for
national efforts, coordinating activities of government and non-government organizations,
agencies and individuals. By encouraging new ideas and mobilizing partnerships, the Plan
has worked diligently to "jump-start" innovative, long-term efforts that will
result in rapid progress in the fight against breast cancer. The NAPBC web site provided a
gateway to selected public and private breast cancer web sites.
The work of the NAPBC was guided by a Steering Committee and
six Working Groups. The Steering Committee met quarterly, and Plan implementation was
coordinated by the Office on Women’s Health.
NAPBC Working Groups were formed around priorities identified
by the Steering Committee at the Plan’s inception and included Biological Resources,
Clinical Trials Accessibility, Etiology, Hereditary Susceptibility, Information Action
Council, and Consumer Involvement.
Over the last two years, two of the six working groups have
sunset (Biological Resources and Hereditary Susceptibility). In addition, the Steering
Committee convened A Day of Dialogue’ forum in February 2000 to assess the
accomplishments in the eradication of breast cancer since the Plan’s inception and
determine a future role of the Plan. Following a July 24 meeting, the Steering Committee
voted to sunset the Plan, forwarding a report of its accomplishments to the past-President
Clinton and former DHHS Secretary Shalala. This report was sent forth October 20, 2000.
The NAPBC was co-chaired by Wanda K. Jones, Dr.P.H., Deputy
Assistant Secretary for Health and Director of the DHHS OWH, and Frances M. Visco, Esq.,
President, National Breast Cancer Coalition.
To learn more about the National Action Plan on Breast
Cancer, you can view the HHS NAPBC press release or visit
the NAPBC web site archived.
For more information about NAPBC, please contact Anna Kinderman.
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