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Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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Index

A

Access to care, 10, 14, 208, 211-212, 219-220, 230
     see also Health insurance
     disabled persons, 19, 182, 205-206, 216-217
     race/ethnicity, 206, 207, 208
     socioeconomic status, 182, 206, 207, 208
Accuracy, see Positive predictive value; Sensitivity; Specificity
Advanced Breast Biopsy Instrumentation, 38
Advanced Medical Technology Association, 173(n.4)
Advanced Technology Program, 143-146
Advocacy groups, 11, 13, 113, 133, 143, 163, 172, 228, 233, 235
Age factors, 2, 103, 218, 224
     clinical practice guidelines, 210
     databases, 192
     effectiveness, 40-41, 44
     magnetic resonance imaging (MRI), 82
     mammography, patient acceptance/use, 206, 207, 230
     scintimammography, 86
     screening, general, 35, 40-44, 52, 103, 201, 202-203
     screening, women over 40 years of age, 14, 34, 35, 42, 52, 70, 175, 201, 202, 203, 204, 208-209, 210, 220, 223, 230, 236;
     see also Elderly persons
     ultrasound, 77
Agency for Healthcare Research and Quality, 172, 174-175, 189(n.11)
     clinical trials, 13, 235
     Preventive Services Task Force, 29(n.3), 173-174, 209
Alliance of Genetic Support Groups, 113
American Association for Cancer Research, 54(n.12)
American Board on Radiology, 213
American Cancer Society, 34, 175, 200-201, 202
American College of Radiology, 14, 34, 201, 202, 236
American College of Radiology Imaging Network, 13, 136, 230, 235, 236
American Medical Association, 172, 193, 202
Animal models, 124-125
     breast cancer-associated tumor suppressor gene (BRCA), 45
     drug development, FDA process, 155
     magnetic resonance imaging (MRI), 83
Antigens, see Carcinoembryonic antigens
Applied Research Program, 191
Army Breast Cancer Research and Materiel Command, 70
Army Medical Research and Materiel Command, 142-143
Aspiration, see Fine-needle aspiration biopsies; Nipple aspiration
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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Asymptomatic (occult) tumors, 19, 40, 43, 46, 48, 50, 77, 230
     defined, 244
Ataxia telangiectasia, 44-45, 237

B


Benign tumors
     biopsies, 2, 52, 53
     unnecessary, 29, 55, 84, 90, 132, 134
     breast self-examination, 29
     magnetic resonance imaging (MRI), 78-79
     mammographic findings, 2, 36, 55
     scintimammography, 61
     ultrasound, 78, 79
Bias, 157, 158, 162, 180
     see also Randomization
     defined, 26 (n.2), 237, 242
     lead-time, 26, 27, 186, 242
     length bias, 26, 27, 186, 201, 242
     selection bias, 28-29, 181, 182
Biofield Breast Examination, 64, 93-95
Bioinformatics, 5, 11, 131, 141, 233
     defined, 238
Biomarkers, 5-7, 11, 17, 29, 105-132, 222, 225-227
     see also Cellular processes; Fluids, breast; Genetic factors; Molecular biology; Proteins
     defined, 238, 244, 247
     funding for research, 20, 21, 23, 24, 132, 233
     metastasis, 29, 104, 117-118, 122, 123, 125
     positron emission tomography and, 88
     recurrent cancers, 125, 142
Biomedical Information Science and Technology Implementation Consortium, 141
Biopsies, 29, 52, 129, 211, 212, 225
     banks, 5, 11-12, 106-107, 130-131, 233-234, 246
     benign tumors, 2, 52, 53; see also “unnecessary” infra
     biology of breast cancer, general, 106
     Breast Imaging Reporting and Data System (BIRADS), 37
     breast self-examination and, 29
     computer-aided detection, 75
     core-needle biopsies, 37-38, 129, 195, 239
     defined, 238, 246
     digital mammography and, 72
     elastic scattering spectroscopy (ESS) and, 90
     false positive mammographs and, 2, 53
     FDA adoption criteria, 156
     fine-needle aspiration biopsies, 37, 84, 129, 195, 211, 240
     gene expression studies, 121
     magnetic resonance imaging (MRI) and, 81, 84
     magnetic resonance spectroscopy (MRS), 5, 56, 57, 60-61, 84-85, 243
     “optical,” 89, 91
     pain and reduced sexual sensitivity, 39
     procedures described, 37-38
     unnecessary, 29, 55, 84, 90, 132, 134
     vacuum-assisted, 38
Biostatistics, FDA approval process, 12, 154, 234
Biotechnology, 125, 126, 141
     private sector, 17, 149
Blue Cross/Blue Shield Association (BCBSA), 86, 176-177, 188
BRCA,
     see Breast cancer-associated tumor suppressor gene
Breast and Cervical Cancer Mortality Prevention Act, 211
Breast and Cervical Treatment Act, 14, 236
Breast cancer-associated tumor suppressor gene (BRCA), 6, 44, 45-46, 108, 110-114, 224, 227, 238
Breast Cancer Fund, 23
Breast Cancer Progress Review Group, 130
Breast Cancer Research Foundation, 23
Breast Cancer Research Program, 142-143, 144-145
Breast Cancer Surveillance Consortium, 13, 14, 191-192, 229-230, 235, 236
Breast-conserving therapy
     digital mammography, FDA approval, 160
     magnetic resonance imaging (MRI), 81
Breast fluids, see Fluids, breast
Breast Imaging Reporting and Data System, 36, 37

C


Calcium and calcification, 37, 38, 57, 59
     defined, 244
     magnetic resonance imaging (MRI), 81-82
     ultrasound, 77
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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California Breast Cancer Research Program, 23
Canada, 35, 52, 113-114, 187-188
Cancer Genome Anatomy Project (CGAP), 106-107, 131, 136
Capillary optic arrays, 71
Carcinoembryonic antigens, 123, 127-128, 181
cDNA, 2, 6, 108, 119, 120, 121, 122, 238
Cell cultures, 5, 109, 124-126
Cellular processes, general
     see also Biopsies; Fluids, breast; Genetic factors
     definitions, 239
     epithelial cells, 93, 121, 123, 125, 128, 240
     funding for research, 20, 24, 132, 138
     growth in young women, 44
     magnetic resonance imaging, 83
Center for Devices and Radiological Health, 149, 153
Center for Health Plans and Providers, 172
Center for Practice and Technology Assessment, 174
Centers for Disease Control and Prevention (CDC)
     screening program,
14, 220, 230, 236

     uninsured women, screening of, 10, 230, 236
Central Intelligence Agency (CIA), 134, 135
Cervical cancer, see Pap smears
Chemotherapy
     cell cultures, 125
     scintimammography, 87
China, 29
Civil Health and Medical Program of the Uniformed Services, 172
Clinical breast examinations, 1, 8, 33, 50(n.11), 80-81, 180, 203
     see also Clinical practice guidelines;
     Imaging technologies, general;
     specific techniques
     Agency for Healthcare Research and Quality (AHRQ), 13, 235
     defined, 238
     interval cancers, 38, 44, 72, 184
Clinical Laboratory Improvement Amendments, 113, 169
Clinical outcome, 5, 8-9, 12, 13, 15, 19, 26, 27, 136, 165, 184, 234, 235
     see also Clinical trials; Life expectancy; Mortality; Sensitivity; Specificity
     defined, 238
     FDA approval process, 154, 165
Clinical practice guidelines, 11, 52, 178, 179, 180, 202-203, 209-210, 219, 222
     FDA guidelines, 151
     magnetic resonance imaging (MRI), 82
     Pro*Duct catheter, 161
     risk-based, 217-219
Clinical trials, 1, 3, 9, 12-13, 33, 57, 74, 75, 135-136, 178-181, 189(n.11), 222
     see also Clinical outcome
     ataxia telangiectasia, 45
     breast self-examination, 29
     Cancer Genome Anatomy Project, 107
     cost of, 9, 12, 146, 159, 235
     defined, 238-239
     digital mammography, 3, 70-71, 72, 136, 158, 159
     electrical potential measurements, 94
     electronic palpation, 97
     FDA criteria/approval process, 12, 13, 151, 153, 154, 155, 161, 164, 166, 171, 234, 235
     funding, 12, 13, 20, 21, 22, 23, 136, 138, 142, 177
     genetic testing, 112-113, 114
     life expectancy, 26, 27, 40
     magnetic resonance imaging (MRI), 5, 61, 82, 83, 84, 218, 225
     mortality measures, 14, 19, 26, 34, 43, 154, 222-223, 228, 235
     NCI sponsorship, 13, 14, 181, 190-192, 200, 229-230, 234, 235, 236
     nipple aspiration fluid, 127
     prevention trials, 54(n.12)
     Pro*Duct catheter, 161
     randomization, 1, 2, 15, 26, 33, 179, 180-181, 184, 190-191, 197, 200, 217, 222-223, 228-229
     defined, 245
     metastasis, 49
     screening mamammography, 34, 35, 42, 43, 49, 222-223
     scintimammography, 86
     standards, general, 19, 26, 151, 178, 181-184
     thermography, 92
     ultrasound, 5, 225
     various imaging technologies, 58-66 (passim), 135-136
     women over 70 years of age, 2, 14, 40-41, 52, 201
     World Health Organization guidelines, 19, 26
Cloning, 125, 239, 245
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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Comparative Genomic Hybridization, 6, 108
Computer-aided detection or diagnosis, 34, 17, 57, 58-59, 68, 74-76, 134, 224, 228
     see also Digital mammography; High-throughput technology
     bioinformatics, 5, 11, 131, 141, 233, 238
     defined, 239
     electrical impedance, 96
     FDA approval, 4, 75, 163, 224
     funding, 21, 56, 134
     Internet, 135(n.1)
     microwave imaging, 100
     NCI initiatives, 56, 134
     optical imaging, 90
     thermography, 92-93
     tomography (CT), 4, 57, 73, 86, 150, 195, 224, 239, 244-245
     virtual reality, 97, 102, 247
     workstations and displays, 21, 56, 68-69
Computer applications, other, 12, 17
     see also Databases; Internet
     bioinformatics, 5, 11, 131, 141, 233, 238
     cost-effectiveness analysis models, 187, 224-225
     high-throughput technology, 5, 11, 105, 110, 118, 119, 122, 124, 130, 131, 141, 227, 233, 241
     pattern recognition, 56
     RNA changes, 108, 121
     telemammography, 71, 246
     texture analysis, 56
     virtual reality, 97, 102, 247
     workstations and displays, 21, 56, 68-69
Confidentiality, see Privacy and confidentiality
Consent, see Informed consent
Contrast agents, 59, 60, 61, 78, 81-82, 83, 91, 103, 161
     defined, 239, 241-242
Cooperative Trials in Diagnostic Imaging, 21
Core-needle biopsies, 37-38, 129, 195, 239
Cost and cost-effectiveness factors, 133-134, 167, 185-188, 189, 190, 191, 196, 199, 218, 220, 230, 235
     see also Funding; Health insurance
Advanced Technology Program, 144, 145
Agency for Healthcare Research and Quality, 174
     clinical trials, 9, 12, 146, 159, 235
     computer-aided detection, 74
     computer models of, 187, 224-225
     core-needle biopsies, 187
     defined, 239
     digital mammography, 59, 69, 159, 160, 186-187, 225
     elderly women, 40-41
     FDA approval, 10, 159, 160, 164
     fine-needle aspiration, 187
     genetic testing, 114
     Hall effect imaging, 101
     Health Care Financing Administration, 172, 194, 230
     historical perspectives, 167
     magnetic resonance imaging (MRI), 44, 82, 86, 101, 187
     Medicare/Medicaid reimbursement and, 13-14, 170, 172
     mammography, 10, 14, 36, 40-41, 103, 186, 193-194, 211-213, 219, 227, 231, 235-236
     new technologies, general, 10, 17, 19, 146, 149, 185-188, 227, 231
          venture capital, 146-148, 149, 164
     optical imaging, 90
     positron emission tomography, 88
     quality-adjusted life years (QALYs), 185, 186
     scintimammography, 86
     screening, general, 10, 12, 13-14, 28-29, 182
     specimen banks, 11, 130, 132, 233-234
     ultrasound, 44, 82, 86, 101, 187
Counseling, 113, 206
Court cases, see Malpractice
Cysts, 37
     ultrasound, 76-77, 78, 79

D


Databases, 12, 13
     see also Bioinformatics; Internet; Specimen banks
     bioinformatics, 5, 11, 131, 141, 233, 238
     Cancer Genome Anatomy Project, 106-107
     clinical trials, 138
     NCI efforts, 141, 191-192
     standards, 107, 192
DCIS, see Ductal carcinoma in situ
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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Defense Advanced Research Projects Agency, 139
Defense Appropriations Act, 143
Demographic factors
     see also Age factors; Educational attainment; Race/ethnicity; Socioeconomic status
     access to health care, 206, 207, 208
     computer-aided detection, 75
     databases, 192
     geographic, 181
     immigrants, 208
Department of Commerce, see National Institute of Standards and Technology
Department of Defense, 17, 139, 142-143, 144-145, 228
     Army Breast Cancer Research and Materiel Command, 70
     Army Medical Research and Materiel Command, 142-143
     Civil Health and Medical Program of the Uniformed Services, 172
     digital mammography, 70, 72
     Federal Multi-Agency Consortium to Improve Women's Health, 135
Department of Energy, 135
Department of Health and Human Services, 14, 17, 113, 169, 208
     see also Agency for Healthcare Research and Quality; Centers for Disease Control and Prevention; Food and Drug Administration; Health Care Financing Administration; National Cancer Institute; National Institutes of Health
Department of Veterans Affairs, 172
Dense tissue, see Tissue density
Development and Testing of Digital Mammography Displays and Workstations, 21
Diaphanography, see Transillumination
Digital mammography (FFDM), 3, 17, 57, 58-59, 67-71, 224, 225, 228, 230
     clinical trials, 3, 70-71, 72, 136, 158, 159
     computer-aided, 17, 74, 75
     defined, 239, 240
     electronic palpation, 97
     FDA approval, 4, 59, 70, 75, 134, 156-161, 164, 165, 224
     funding for research, 23, 134
     NCI initiatives, 134
     telemammography, 71, 246
     thermography, 92-93
     tissue density, 68-69, 136
Director's Challenge: Toward a Molecular Classification of Tumors, 21
Disabled persons, 19, 182, 205-206, 216-217
Discomfort, see Pain and discomfort
Discrimination, genetic, 11, 112, 129-130, 227, 233
Displays, see Workstations and displays
DNA, 105, 107, 108, 110, 111, 117, 118-119, 240, 245
     see also Genomics
     arrays, 6, 110, 118, 119-120, 121, 124, 127, 131, 146, 244
     cDNA, 2, 6, 108, 119, 120, 121, 122, 238
     defined, 239, 244
     methylation, 6, 119, 243
     polymerase chain reaction, 6, 108, 118, 119, 122, 131, 245
Doppler effect, 4, 57, 59, 78
Ductal carcinoma in situ (DCIS), 46-48, 51-52, 121, 125, 183, 226, 240
Dynamic area telethermometry, 93

E


Early Clinical Advanced Technology Program, 21
Early Detection Research Network, 20
Economic factors, 8, 147, 167, 219, 228
     see also Cost and cost-effectiveness factors; Funding; Socioeconomic status
Education, see Patient education and outreach; Professional education
Educational attainment, 206, 207, 208
Effectiveness, 1, 5, 17, 19, 26, 52, 131, 178, 184
     see also Cost and cost-effectiveness factors; Sensitivity; Specificity
     age factors, 40-41, 44
     Agency for Healthcare Research and Quality, 175
     computer-aided detection, 163
     defined, 178, 240
     diagnostic delays, 40
     early detection, 48, 50
     FDA approval process, 12, 13, 34, 65, 113, 151-155 (passim), 157, 160, 163, 168, 170, 171
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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     Health Care Financing Administration (HFCA), 170, 171, 173
     magnetic resonance imaging (MRI), 83, 84-85
     magnetomammography, 101
     microwave imaging, 100
     National Cancer Institute (NCI), 13, 190-192, 235
     NIH Office of Medical Applications of Research, 175
     older women, 40-41
     private insurers, 177
     scintimammography, 87
     specimen banks, 130
Efficacy, 26, 154, 178, 182, 218
     see also Sensitivity; Specificity chemotherapy, 87
     clinical trials, 155
     counseling regarding, 113
     defined, 178, 240
     FDA approval process, 13, 17-18, 155, 157, 159, 189
     National Cancer Institute, 13, 235
     older women, 40
     scintimammography, 102
Elastic scattering spectroscopy, 89-90
Elastography, 4, 57, 78-79, 240
Elderly persons, 220, 223, 230, 231, 236
     see also Medicare
     clinical data on mammography, 2, 14, 40-41, 52, 201
     clinical practice guidelines, 210
     Medicare, 13-14, 169-174, 190, 193-195, 199, 210, 215, 232, 235-236, 243
     patient education and outreach, 202, 203, 204, 205-206, 208-209
     risk assessment, 113, 231
     state screening mandates, 175
Electrical impedance tomography system, 64-65, 95-96
     defined, 240
     FDA approval, 4, 57, 65, 224
     TransScan electrical impedance imaging, 64, 96, 161-162
Electrical potential measurements, 57, 62-63, 93-95, 240
Electronic palpation, 33, 57, 64-65, 96-98
     defined, 240
     FDA approval, 4, 57, 63, 94, 97, 98
Emotional factors, see Psychological/emotional factors
Ensuring Quality Cancer Care, 206
Epidemiology, 106, 107
     see also Incidence and prevalence;
     Mortality
     Cancer Genome Anatomy Project, 107
     defined, 240
     FDA criteria, 12, 234
Epigenetic factors, 6, 117, 118-119, 131, 240
Epithelial cells, 93, 121, 123, 125, 128, 240
Estrogen, 43, 122, 128, 218
Etiology, 5, 11, 106, 131, 191, 225, 233
     see also Biomarkers; Cellular processes, general; Genetic factors; Molecular biology
European Economic Area, 94-95
Evidence-based practice centers (EPCs), 174, 175, 177

F


Family factors, 105, 107, 110, 112, 113, 114, 192, 218, 224, 240
     psychosocial factors, 112
False negatives, 2, 40, 50, 53, 71, 75, 112, 156, 163, 183-184, 223, 240
False positives, 2, 38-39, 53, 70-71, 74, 156, 183-184, 240
Federal Food, Drug, and Cosmetic Act, 151(n.18), 167-168
Federal government, 11
     see also Funding; Legislation; Regulatory issues; specific departments and agencies
     coordination of research, 24, 135, 143, 165, 191
Federal Multi-Agency Consortium to Improve Women's Health, 135
Film-screen mammography (FSM), 57, 69, 71, 72, 74, 104, 186, 225, 231, 240
     defined, 246
     FDA approval, 4, 57, 152-153, 157, 159, 160-161, 165, 198
Fine-needle aspiration biopsies, 37, 84, 129, 187, 195, 211, 240
Fluids, breast, 5, 37, 77, 105, 107, 126-128, 132, 161
     cysts, 37, 76-77, 78, 79
     fine-needle aspiration biopsies, 37, 84, 129, 195, 211, 240
     lavage, 7, 127, 156, 161
     nipple aspiration, 7, 126-127, 244
Fluorescent in situ hybridization, 6, 108, 117-118, 120, 240
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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Food and Drug Administration (FDA), 4, 8, 134, 149-166, 189(n.11)
     approval criteria/process, 6-7, 12, 17, 113, 134, 149, 151-156, 164, 165-166, 167-168, 170-172, 196-197, 198, 227, 228, 234-235
          biostatistics, 12, 154, 234
          case studies of approval, 156-163
          clinical outcomes, 154, 165
          clinical trials, 12, 13, 151, 153, 154, 155, 161, 164, 166, 171, 234, 235
          effectiveness, 12, 13, 34, 65, 113, 151-155 (passim), 157, 160, 163, 168, 170, 171
          efficacy, 13, 17-18, 155, 157, 159, 189
          epidemiology, 12, 234
          historical perspectives, 156-163, 164-165, 167-168
          investigational device exemptions (IDEs), 151, 166, 170, 171
          premarket approval, 94, 96, 97, 151, 152, 157, 159, 160, 163, 164, 171
          sensitivity/specificity, 154, 161, 162, 165, 234
     approval stage, various technologies, 6-7, 58-65, 156-163, 224; see also specific technologies infra
     Center for Devices and Radiological Health, 149, 153
     clinical practice guidelines, 151
     cost-effectiveness analysis, 188
     digital mammography, 4, 59, 70, 75, 134, 156-161, 164, 165, 224
     electronic impedance, 4, 57, 65, 224
     Federal Multi-Agency Consortium to Improve Women's Health, 135
     funding for research coordination, 24
     investigational device exemptions (IDEs), 151, 166, 170, 171
     magnetic resonance imaging (MRI), 4, 5, 79, 159, 224
     magnetic resonance spectroscopy, 4, 57
     Medicare coverage/reimbursement, 170
     premarket approval, 94, 96, 97, 151, 152, 157, 159, 160, 163, 164, 171
     premarket notification, 151, 153
     mammography facility inspections, 34, 36
     optical spectroscopy, 4, 57, 89, 91
     pad to assist self-examination, 33
     scintimammography, 4, 57, 61, 85, 87, 224
     thermoacoustic computed tomography, 4, 57, 224
     thermography, 4, 63, 92, 93, 150
     ultrasound, 4, 224
Food and Drug Administration Modernization Act, 152
Foreign countries, see International perspectives;
specific countries
Friends...You Can Count On, 24
Full-field digital mammography, see Digital mammography
Functional magnetic resonance imaging, 83
Funding, 133, 137-146, 163-164, 211, 228
     see also Cost and cost-effectiveness factors
     biomarkers, general, 20, 21, 23, 24, 132, 233
     cellular biology research, general, 20, 24, 132, 138
     clinical trials, 12, 13, 20, 21, 22, 23, 136, 138, 142, 177
     computer-aided detection, 21, 56, 134
     Department of Defense, 142-143, 144-145
     digital mammography, 23, 134
     genetic testing/treatment, 23, 116, 142, 146, 233
     imaging, general, 21-22, 136, 141, 146, 148-149, 165, 230
     professional education, 14, 236
     research, general, 17, 20-24, 135, 233
     specimen banks, 11-12, 130, 131, 233-234
     technology development process, general, 8, 11
     venture capital, 146-147, 149, 164
     World Health Organization, 177

G


Gadolinium agents, 83
Gamma camera, 61, 87, 101, 102, 241
Gel electrophoresis, 7, 124, 241
General Accounting Office
Genetic factors, 6, 11, 17, 105-124, 142, 192, 227
     see also Biomarkers; DNA; Family factors; Mutation; Race/ethnicity; RNA
     bioinformatics, 131
     breast cancer-associated tumor suppressor gene (BRCA), 6, 44, 45-46, 108, 110-114, 224, 227, 238
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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     clinical trials of genetic testing, 112-113, 114
     cloning, 125, 239, 245
     definitions, 237, 238, 241
     discrimination, 11, 112, 129-130, 227, 233
     epigenetic factors, 6, 117, 118-119, 131, 240
     fluorescent in situ hybridization, 6, 108, 117-118, 120, 240
     funding for research, 23, 116, 142, 146, 233
     health insurers, 113-114
          discrimination, 11, 112, 129-130, 227, 233
     HER-2 gene amplification, 51
     magnetic resonance imaging, 83
     oligonucleotides, 110, 142, 244
     p53 tumor suppressor genes, 114, 128, 227
     polymorphisms, 6, 108, 118, 128, 245
     transcription, 108, 110, 119, 121, 122, 246, 247
     tumor suppressor gene, 114, 117, 119, 247
Genomics, 118, 119, 181, 239, 241
     Comparative Genomic Hybridization, 6
     fluorescent in situ hybridization, 118
     National Human Genome Research Institute
Geographic factors, 181
Government role, see Federal government; Legislation; Regulatory issues; State government; specific departments and agencies

H


Hall effect imaging, 57, 64-65, 100-101
Handicapped persons, see Disabled persons
Health Care Financing Administration (HCFA), 12, 13-14, 169-174, 189(n.11), 196, 197, 234, 235
     see also Medicaid; Medicare
     cost-effectiveness analysis, 188
     effectiveness of procedures, 170, 171, 173
     funding for research, 24
     National Center for Health Care Technology and, 169
Health insurance, 10, 14, 136, 153, 176-177, 204-205, 210
     see also Medicaid; Medicare
     Blue Cross/Blue Shield Association (BCBSA), 86, 176-177, 188
     Centers for Disease Control and Prevention (CDC), screening of uninsured, 10, 230, 236
     coverage, 8, 10, 12, 13, 17, 18, 53, 135, 165, 166, 168, 169-177 (passim), 188, 189, 190, 192-193, 196, 199, 234
     genetic testing, 113-114
     discrimination, 11, 112, 129-130, 227, 233
     reimbursement decisions, 5, 10, 13, 53, 135, 168, 169-173 (passim), 177, 192-196, 199, 211-212, 215(n.5), 219, 222, 227, 231, 232, 235-236
     state mandates, 175, 232
     technology development/assessment process, 8, 12, 13, 17, 18, 153, 165, 166, 176-177, 227, 234, 235
Health Insurance Plan of Greater New York, 33, 153
Health Insurance Portability Act, 112
Health Resources and Services Administration, 14, 236
Healthy People 2010, 14, 208, 236
HER-2 gene amplification, 51
Heterozygosity
     ataxia telangiectasia, 45
     defined, 241
     loss of, 117, 118, 243
High-throughput technology, 5, 11, 105, 110, 118, 119, 122, 124, 130, 131, 141, 227, 233
     defined, 241
Historic perspectives, 15-17, 18, 51, 167-168, 197, 223-224, 228
     cost of health care, 167
     Department of Defense funding, 142-143, 144-145
     digital mammography, 156-161
     FDA approval process, 156-163, 164-165, 167-168
     imaging products, shipments, 150
     magnetic resonance imaging (MRI), 79-80
     mammography, introduction/diffusion of, 10, 15-17, 200-204, 217, 219
     NCI funding, 137, 138-139, 140
     nipple aspiration, 126
     proteome, 124
Hodgkin's lymphoma, 44, 121
HRGI, see National Human Genome Research Institute
Human mammary epithelial cells, see Epithelial cells
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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I

Imaging technologies, general, 1-5, 55-104, 135-136, 146, 221-222, 223-224, 227-230, 231-232
     see also Computer-aided detection or diagnosis; Contrast agents; Hall effect imaging; Magnetic resonance imaging; Magnetic resonance spectroscopy; Mammography; Microwave imaging; Optical imaging; Scintimammography; Thermography; Tomography
     disabled persons, 19, 182, 205-206, 216-217
     expenditures on, 149
     funding, general, 21-22, 136, 141, 146, 148-149, 165, 230
     infrared thermography, 62-63, 91-93
     magnetomammography, 57, 64-65, 101-102
     Medicare coverage, 173
     National Electrical Manufacturers' Association, 135, 150
     virtual reality, 97, 102, 247
Immigrants, 208
Immunohistochemistry, 7, 45, 52, 109, 183
     Breast Imaging Reporting and Data System (BIRADS), 37
     defined, 242
     functional magnetic resonance imaging, 83
     proteins, 122, 123
Incidence and prevalence, 1-2, 15, 18, 184, 226, 231
     see also Mortality
     defined, 242, 245
     genetic testing, 112
     male breast cancer, 218(n.6)
Income, see Socioeconomic status
India, 33
Industry Forum & Workshop on Biomedical Imaging in Oncology, 24
Information dissemination,
     see Databases; Internet; Professional education
Information Storage, Curation, Analysis, and Retrieval program, 141
Informed consent, 11, 13, 113, 129-130
Infrared thermography, 62-63, 91-93
Institutional review boards, 151(n.19)
Insulin-like growth factor type 1, 128-129
Insurance
     see also Health insurance; Managed care; Medicaid; Medicare
     malpractice, 215
Intellectual property, 12, 113, 114, 130-131, 134, 245
Interdisciplinary approaches, see Multidisciplinary approaches
International perspectives
     see also specific countries
     breast self-examination, 29
     clinical breast examination, 33
     electrical potential measurements, 94-95
     electronic palpation, 98
     genetic testing, 113-114
     magnetic resonance imaging (MRI), 82
     mammography screening, 35, 42, 52
     mortality, 52, 223
Internet
     digital mammography, FDA approval, 160(n.26)
     imaging technology, 135(n.1)
     NCI forum, 135(n.2)
     NCI funding, 137(n.6)
     telemammography, 71, 246
     venture capital, 146-148
Interval cancers, 38, 44, 72, 184
Invasive breast cancer, 54, 242
     see also Metastasis
     core-needle biopsies, 38
     ductal carcinoma in situ (DCIS), 46, 48, 51-52, 242
     incidence, 1, 15, 52
     lobular carcinoma in situ (LCIS), 48, 81, 242
     magnetic resonance imaging (MRI), 81
     preinvasive lesions, 13
     treatment, 51-52
Investigational device exemptions (IDEs), 151, 166, 170, 171
Iran, 98
Ireland, 113-114

J


Japan, 113-114

K


Kaiser Permanente, 177
Keratins, 123, 128
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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L

Labeling, 152, 161, 165
Lavage, 7, 127, 156, 161, 238
Legal issues, see Discrimination, genetic; Food and Drug Administration; Informed consent; Intellectual property; Malpractice; Privacy and confidentiality;
Legislation
     see also Regulatory issues
     Breast and Cervical Cancer Mortality Prevention Act, 211
     Breast and Cervical Treatment Act, 14, 236
     Clinical Laboratory Improvement Amendments, 113, 169
     confidentiality/genetic discrimination, 11, 227, 233
     Defense Appropriations Act, 143
     Federal Food, Drug, and Cosmetic Act, 151(n.18), 167-168
     Food and Drug Administration Modernization Act, 152
     Health Insurance Portability Act, 112
     Mammography Quality Standards Act, 14, 34-35, 193-194, 222, 236
     Medical Device Amendment, 92, 151, 153, 156-157, 158
     National Health Planning and Resources Development Act, 169
     Social Security Act, 170
     uninsured women, screening of, 10, 230, 236
Lewin Group, 173
Life expectancy, clinical trials,
     standards, 26, 27
     elderly women, 40
Lobular carcinoma in situ (LCIS), 46-48, 81, 242
Loss of heterozygosity, see Heterozygosity
Lumpectomies, 82, 83
Lymphoma, 44, 121

M


Magnetic resonance imaging (MRI), 17, 56, 57, 60-61, 79-84, 91, 134, 150, 195, 224-225
     see also Contrast agents
     biopsies and, 38
     clinical trials, 5, 61, 82, 83, 84, 218, 225
     defined, 243
     elastography, 78-79, 82
     FDA approval, 4, 5, 79, 159, 224
     functional, 93
     Internet, 135(n.1)
     recurrent cancers, 60, 82
     sensitivity, 81, 82, 91
     specificity, 78-79, 81, 91
     standards, 82, 219
Magnetic resonance spectroscopy (MRS), 56, 57, 60-61, 84-85
     defined, 243
     FDA approval, 4, 57
     NCI initiatives, 61, 82
Magnetomammography, 57, 64-65, 101-102
Males, see Men
Malpractice, 40, 193, 215-217, 220
Mammography, 29, 33-53, 56, 102-103, 136, 143, 150, 158, 181, 192, 193, 195, 202-223, 225, 229-232
     see also Contrast agents; Digital mammography; Film-screen mammography; Patient education and outreach
     adoption and dissemination, 9
     age factors, 2, 14
     benign tumors, 2, 36, 55
     computer-aided detection and, 163
     cost of, 10, 14, 36, 40-41, 103, 186, 193-194, 211-213, 219, 227, 231, 235-236
     defined, 239, 243, 246
     disabled persons, 19, 182, 205-206, 216-217
     electrical impedance and, 96
     electronic palpation and, 97
     expenditures on, 149
     false negatives, 2, 40, 50, 53, 71, 75, 156, 163, 183-184, 223, 240
     false positives, 2, 38-39, 53, 70-71, 74, 156, 183-184, 240
     film-screen mammography
     full-field digital mammography
     historical perspectives, 10, 15-17, 200-204, 217, 219
     Internet, 135(n.1)
     lesion classification, 2
     magnetic resonance imaging (MRI) and, 61, 80-81, 82
     magnetomammography, 57, 64-65, 101-102
     Medicare coverage, 170
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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     military technology applied to, 91, 143
     mortality rates and, 38, 43. 49-51, 52, 55, 103
     nipple aspiration fluid and, 127
     Pro*Duct catheter and, 161
     racial/ethnic factors in use of, 206, 207, 208
     sensitivity, general, 9, 12, 25, 53, 55, 136, 219
     socioeconomic status, 206, 207, 208
     specificity, general, 9, 12, 25, 38-39, 53, 136
     standards, general, 14, 34-37 (passim), 102-103, 193-194, 206, 218-219, 222, 236
     state health insurance mandates, 175, 232
     telemammography, 71, 246
     thermoacoustic computed tomography and, 98, 99
     tissue density, 2, 37, 43, 55, 68-69, 136, 223
     TransScan electrical impedance imaging and, 64, 96, 161-162
Mammography Quality Standards Act (MQSA), 14, 34-35, 193-194, 222, 236
Mammotome, see Vacuum-assisted biopsies
Managed care, 8, 176-177
Mastectomy, 5, 44, 112, 245
The Mathematics and Physics of Emerging Biomedical Imaging, 56
Medicaid, 10, 13-14, 167, 169, 211, 230, 235-236
     defined, 243
Medical Coverage Advisory Committees (MCACs), 172, 173
Medical Device Amendment, 92, 151, 153, 156-157, 158
Medical Technology Leadership Forum, 189
Medicare, 13-14, 169-174, 190, 193-195, 199, 210, 215(n.5), 232, 235-236
     defined, 243
Men
     breast cancer incidence, 218(n.6)
     prostate cancer, 175, 180-181, 232
Menstrual cycle, 43, 128-129, 218
     definitions, 243
     electrical impedance, 162
     menopause, 43, 127, 129, 218, 243
Meta-analysis, 34, 82, 174, 177-178, 179, 209
     defined, 243
Metastasis, 19, 29, 34, 38, 40, 41, 46, 49, 50-54 (passim), 61, 104, 117-118, 122, 123, 125, 137, 142, 209, 225, 226
     defined, 243
     magnetic resonance imaging (MRI), 82
Methylation, 6, 119, 243
MIBI see Scintimammography; Technetium-99m sestamibi
Microwave imaging, 23, 56, 57, 64-65, 99-100
Mitochondrial DNA, 127
Molecular biology, 11, 105-106, 137, 226-227, 244
     see also Biomarkers; Genetic factors; Immunohistochemistry; Proteins
     carcinoembryonic antigens, 123, 127-128, 181
     funding for research, 20, 21, 137, 142
Mortality, 1-2, 5, 9, 13, 18, 51, 103, 131, 151, 204, 210, 223, 229
     see also Life expectancy
     breast self-examination and, 29(n.4)
     clinical trials, 14, 19, 26, 34, 43, 154, 222-223, 228, 235
     defined, 244
     disease-specific, 181, 184, 190, 235
     genetic testing, 112, 226
     international perspectives, 52, 223
     mammography and, 38, 43. 49-51, 52, 55, 103
     metastasis, 49
mRNA, 119, 121-122, 243
M1000 ImageChecker, 163
Multidisciplinary approaches, 134, 137, 138-139, 177
     coordination of federal research, 24, 135, 143, 165, 191
     Unconventional Innovations Program, 29, 139, 141, 142
Mutation, 6, 105, 107-124, 127, 227, 241
     ataxia telangiectasia, 45
     breast cancer-associated tumor suppressor gene (BRCA), 6, 44, 45-46, 108, 110-114, 224, 227, 238
     defined, 244, 246
     inherited, 44
     p53 tumor suppressor genes, 114, 128, 227
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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N

National Action Plan on Breast Cancer, 112
National Aeronautics and Space Administration, 17, 24, 135
National Breast and Cervical Cancer Early Detection Program, 10
National Breast Cancer Coalition, 113
National Cancer Institute (NCI), 12, 136-137, 197
     Breast Cancer Surveillance Consortium, 13, 14, 191-192, 229-230, 235, 236
     Cancer Genome Anatomy Project (CGAP), 106-107, 131, 136
     clinical trials, 13, 14, 181, 190-192, 200, 229-230, 234, 235, 236
     computer-aided detection, 56, 134
     confidentiality, 130
     databases, 141, 191-192
     effectiveness/efficacy surveillance, 13, 190-192, 235
     Federal Multi-Agency Consortium to Improve Women's Health, 135, 136
     funding for research, various programs, 20, 21, 24, 130, 131, 132, 135, 136-142, 228
     magnetic resonance imaging, 61, 82
     novel imaging technologies, 134, 165
     screening mammography, general, 34, 202
     specimen banks, 130, 131
National Center for Health Care Technology, 169
National Electrical Manufacturers' Association, 135, 150
National Health Care Financing Administration, 135
National Health Planning and Resources Development Act, 169
National Human Genome Research Institute, 112
National Institute of Standards and Technology, 143-146
National Institutes of Health (NIH), 172, 175, 189(n.11), 201
     see also National Cancer Institute
     funding for research, various programs, 20, 21, 133, 141, 143
     genetic testing, 114
National Mammography Database, 36(n.10)
National Science Foundation, 135
National Surgical Adjuvant Breast and Bowel Project, 48
Nipple aspiration, 7, 126-127
     defined, 244
Northern analysis, 6, 108
Nuclear medicine, general, 134, 150
     Internet, 135(n.1)

O


Observational studies, 34, 179-180, 244
Occult tumors, see Asymptomatic (occult) tumors
Office of Bioengineering, Bioimaging, and Bioinformatics, 141
Office of Medical Applications of Research, 175
Office of Technology and Industrial Relations, 137, 138-139
Office of Technology Assessment, 169
Office on Women's Health (OWH), 134, 135
Oligonucleotides, 110, 142, 244
Optical imaging, 56, 57, 62-63, 88-91
     defined, 244
     biopsies, 89, 91
     electronic palpation, 97
     FDA approval, 4, 57, 89, 91
Optical spectroscopy, 57, 62-63, 89
Optical tomography, 62-63, 90
OTIR, 20
Outreach, see Patient education and outreach
Overtreatment/overdiagnosis, 2, 5, 28, 29, 46-48, 55, 132, 204
     biopsies, unnecessary, 29, 55, 84, 90, 132, 134
     breast self-examination, 29
     defined, 244

P


Pacific Center for Ethics and Applied Biology, 19
Pain and discomfort, 10, 12, 231
     see also Psychological/emotional factors
     biopsies, 39
     optical imaging, 90
Palpation, 27, 53, 64, 78, 97-98, 157, 223
     see also Self-examination
     electronic, 4, 33, 57, 63, 64-65, 94, 96-98, 240
     scintimammography and, 86
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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Pap smears, 1, 15, 84, 125, 175, 194, 196, 204, 206
Patents, see Intellectual property
Patient education and outreach, 9-10, 199-213, 219-220
     counseling, 113, 206
     elderly persons, 202, 203, 204, 205-206, 208-209
     genetic testing, 112-113
     informed consent, 11, 13, 113, 129-130
Pattern recognition, 56, 102, 134
Peptides, 125
p53 tumor suppressor genes, 114, 128, 227
Pharmaceuticals, 229
     chemotherapy, 87, 125
     contrast agents, 59, 60, 61, 78, 81-82, 83, 91, 103, 161, 239, 241-242
     estrogen replacement, 43, 122, 128
     expenditures on, 148-149
     radiopharmaceuticals, 21, 85-86, 88; see also “contrast agents” supra
     scintimammography, multidrug resistance, 87
Phase-contrast X-ray imaging, 71, 73
Phased Innovation Award, 20, 21
Phased Technology Application Award, 21
Physicians, 209, 210, 230
     age of patients, 208-209
     FDA approved techniques, 165
     histological diagnosis, 49
     malpractice, 40, 193, 215-217, 220
     Medicare reimbursement, 193
     technology adoption, 165, 167, 188-189
     World Health Organization clinical trial guidelines, 19, 26
PMA, see Premarketing approval
Polymerase chain reaction (PCR), 6, 108, 118, 119, 122, 131
     defined, 245
Polymorphisms, 6, 108, 118, 128
     defined, 245
Positive predictive value, 25, 40, 55, 75, 245
     false negatives, 2, 40, 50, 53, 71, 75, 112, 156, 163, 183-184, 223, 240
     false positives, 2, 38-39, 53, 70-71, 74, 156, 183-184, 240
Positron emission tomography, 4, 56, 57, 62-63, 88, 135(n.1)
     defined, 245
Poverty, see Socioeconomic status
Pregnancy, scintimammography, 86
Premarketing approval (PMA), 94, 96, 97, 151, 152, 157, 159, 160, 163, 164, 171
Premarket notification, 151, 153
Prevalence, see Incidence and prevalence
Preventive Services Task Force, 29(n.3), 173-174, 209
Privacy and confidentiality, 11, 112, 129-130, 227, 233
Private sector, 8, 17, 116, 133-134, 146-149, 163-164, 172, 176-177, 189, 228
     see also Health insurance; Intellectual property; Regulatory issues
     Advanced Technology Program, 143-146
     biotechnology, 17, 149
     foundation programs, funding, 23-24
     specimen banks, 130-131
     venture capital, 146-148, 149, 164
Pro*Duct catheter, 161
Professional education, 9-10, 190, 199, 211, 213-215, 220, 236
     see also Specimen banks
     funding, 14, 236
Prognosis, 104
     see also Life expectancy
     databases, 191, 192
     defined, 245
     DNA arrays, 121
     fluorescent in situ hybridization, 118
     magnetic resonance imaging (MRI), 82-83
     thermography, 91
Prostate cancer, 175, 180-181, 232
Proteins, 5, 7, 11, 109, 114, 117, 119, 122-124, 226, 233, 245
     serum, 105, 122, 127, 128-129, 132
Proton magnetic resonance spectroscopy,
     see Magnetic resonance spectroscopy
Psychological/emotional factors
     see also Pain and discomfort
     biopsies, general, 156
     BRCA mutations, 112
     false positives, 39, 183
PTEN, see Tumor suppressor gene
Public education,
     see Patient education and outreach
Public Health Service
     see also Agency for Healthcare Research and Quality
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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     Office of Women's Health (OWH), 134, 135
     Preventive Services Task Force, 29(n.3), 173-174, 209

Q


Quality-adjusted life years (QALYs), 185, 186
Quality control
     see also Regulatory issues; Standards
     Agency for Healthcare Research and Quality, 174
     evidence, 180
     mammogram interpretation, 2, 5
     NCI programs, 191
Quality of life, other, 185-186
     see also Pain and discomfort; Psychological/emotional factors

R


Race/ethnicity
     databases, 192
     mammography use, 206, 207, 208
Radiation doses, 55, 156, 201
     reduction in, 17, 224
     scintimammography, 86
Radiation sensitivity, 9, 12, 15, 44-46
Radiation therapy, 51-52, 150
Radioactive antibodies, 62-63
Randomization
     clinical trials, 1, 2, 15, 26, 33, 179, 180-181, 184, 190-191, 197, 200, 217, 222-223, 228-229
     screening mammography, 34, 35, 42, 43, 49, 222-223
     defined, 245
     observational studies, 180
Recurrent breast cancer
     biomarkers, 125, 142
     ductal carcinoma in situ, 51-52
     magnetic resonance imaging (MRI), 60, 82
Regulatory issues, 8-9, 10, 53, 133, 135, 151, 164, 222, 225, 227
     see also Food and Drug Administration; Legislation; Standards
     electrical potential measurements, Europe, 94-95
     labeling, 152, 161, 165
Reverse transcription, 108, 119, 246
Riboflavin carrier protein, 128
Risk assessment, 28, 49, 54, 107, 217-219, 226, 227, 232
     see also Age factors; Family factors; Race/ethnicity
     biomarkers, 132
     clinical practice guidelines, 217-219
     cost-effectiveness, 28-29
     definitions, 28, 237, 245, 246
     elderly persons, 113, 231
     FDA approval and, 151
     germ-line mutations, 107-116
     radiation sensitivity, 44-46
     scintimammography, 86
     thermography, 91
Risk reduction, 5
RNA, 108, 119, 121-122, 244
     mRNA, 119, 121-122, 243
Russia, 29

S


Scintimammography, 56, 57, 60-61, 85-87, 101-102
     defined, 246
     FDA approval, 4, 57, 61, 85, 87, 224
     sensitivity, 86, 101-102
     specificity, 85, 86
Self-examination (BSE), 33-34
     defined, 238
     education and outreach, 200
     intervals, 1, 29, 202, 203, 204
     pad to assist, FDA approved, 33
Sensitivity, 182, 183-184, 197, 229, 231, 242
     biomarkers, 109
     cost of technology and, 168
     digital mammography, 70, 136, 230
     electrical impedance measurements, 162
     electrical potential measurements, 94
     false negatives, 2, 40, 50, 53, 71, 75, 112, 156, 163, 183-184, 223, 240
     false positives, 2, 38-39, 53, 70-71, 74, 156, 183-184, 240
     FDA approval process, 154, 161, 162, 165, 234
     magnetic resonance imaging (MRI), 81, 82, 91
     magnetomammography, 101-102
     mammography, general, 9, 12, 25, 53, 55, 103, 136, 219
     optical imaging, 88, 91
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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     positron emission tomography, 88
     Pro*Duct catheter, 161
     scintimammography, 86, 101-102
     ultrasound, 82
Sexual sensitivity, biopsies, 39
Single-photon emission computed tomography, 86, 244-245
Small Business Innovative Research, 137
Small Business Technology Transfer Research, 137
SNP Consortium Ltd., 116
Social Security Act, 170
Society of Breast Imaging, 14, 212, 213
Socioeconomic status, 182, 206, 207, 208
     Medicaid, 10, 13-14, 167, 169, 211, 230, 235
Specificity, 9, 12, 25, 38-39, 53, 103, 136, 219, 229, 230
     biomarkers, 109
     computer-aided detection, 74
     defined, 246
     electrical impedance measurements, 162
     electrical potential measurements, 94
     false positives, 2, 38-39, 53, 70-71, 74, 156, 183-184, 240
     FDA approval process, 154, 161, 162, 165, 234
     magnetic resonance imaging (MRI), 78-79, 81, 91
     mammography, general, 9, 12, 25, 38-39, 53, 136
     optical imaging, 88, 91
     positron emission tomography, 88
     Pro*Duct catheter, 161
     scintimammography, 85, 86
     ultrasound, 77, 78-79
Specimen banks, 5, 11-12, 13, 106-107, 130-131
     defined, 246
     funding, 11, 130, 131, 132, 233-234
Spectroscopy, 7, 142, 182, 183-184, 197, 231
     see also Elastic scattering spectroscopy; Electrical impedance tomography system; Magnetic resonance spectroscopy; Optical spectroscopy
Standards, 33, 178-184, 190, 197
     see also Clinical practice guidelines; Cost and cost-effectiveness factors; Effectiveness; Efficacy; Food and Drug Administration; Regulatory issues; Sensitivity; Specificity
     biomarkers, 107, 130
     clinical trials, general, 19, 26, 151, 178, 181-184
     data, 107, 192
     electronic palpation, 97
     genetic information, use of, 112, 227, 233
     ideal screening tool, 232-233
     magnetic resonance imaging (MRI), 82, 219
     mammography, general, 14, 34-37(passim), 102-103, 193-194, 206, 218-219, 222, 236
     Medicare coverage, 172-173
     National Institute of Standards and Technology, 143-146
     periodic health examinations, 182
     pharmaceuticals, 229
     specimen banks, 130
     state health insurance mandates, 175
     tissue density classification, 218-219
     World Health Organization clinical trial guidelines, 19, 26
State Children's Insurance Program, 169
State government
     health insurance coverage, 175, 232
     Medicaid, 10
Steroids, 125
Superconducting quantum interference device (SQUID), magnetomammography, 57, 64-65, 101-102
Surgery
     see also Biopsies
     breast-conserving therapy, 81, 161
     breast self-examination and, 29
     ductal carcinoma in situ (DCIS), 51-52
     elastic scattering spectroscopy (ESS) and, 90
     lumpectomies, 82, 83
     mastectomy, 5, 44, 112, 245
     Medicare coverage, 173
Susan G. Komen Breast Cancer Foundation, 23

T


Technetium-99m sestamibi (MIBI), 61, 87, 102
     see also Scintimammography
Telemammography, 71, 246
Texture analysis, 56
Suggested Citation:"Index." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington, DC: The National Academies Press. doi: 10.17226/10030.
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Thermoacoustic computed tomography, 57, 64-65, 98-99
     FDA approval, 4, 57, 224
Thermography, 57, 91-93
     defined, 247
     FDA approval, 4, 63, 92, 93, 150
     infrared thermography, 62-63, 91-93
Thermotherapy, 83, 247
Three-dimensional interactive visualization, 66-67, 102
     Internet, 135(n.1)
Tissue density, 2, 37, 43, 55, 136, 223
     classification standards, 218-219
     digital mammography, 68-69, 136
     microwave imaging, 100
     nipple aspiration fluid, 127
     scintimammography, 86
     ultrasound, 77
Tissue specimen banks, see Specimen banks
Tomography
     computer-aided, 4, 57, 73, 86, 150, 195, 224, 239, 244-245
     defined, 247
     electrical impedance tomography system, 95-96
     funding for research, 23
     optical tomography, 62-63, 90
     positron emission tomography, 4, 56, 57, 62-63, 88, 135(n.1), 245
     single-photon emission computed tomography, 86, 244-245
     thermoacoustic computed tomography, 4, 57, 64-65, 98-99. 224
     tuned aperture computed tomography, 73
Transcription, 108, 110, 119, 121, 122, 246, 247
Transillumination, 88-89
TransScan electrical impedance imaging, 64, 96, 161-162
Trials of Imaging Agents, 21
Tumor markers, see Biomarkers
Tumor Marker Utility Grading System, 124
Tumor suppressor gene, 114, 117, 119, 247
Tuned aperture computed tomography (TACT), 73

U


Ultrasound, 5, 17, 38, 39, 56, 57, 58-59, 76-79, 134, 150, 195, 211, 225
     cost of, 44, 82, 86, 101, 187
     defined, 247
     elastography, 4, 57, 78-79, 240
     expenditures on, 149
     FDA approval, 4, 224
     Hall effect imaging, 57, 64-65, 100-101
     Internet, 135(n.1)
     magnetic resonance imaging (MRI) and, 82
     sensitivity, 82
     specificity, 77, 78-79
     thermoacoustic computed tomography, 4, 57, 64-65, 98-99, 224
Unconventional Innovations Program, 29, 139, 141, 142
United Kingdom, 188
     magnetic resonance imaging (MRI), 82

V


Vacuum-assisted biopsies, 38
Venture capital, 146-148, 149, 164
Virtual reality, 97, 102, 247

W


Whitaker Foundation, 23
Workshop on Sensors for Bio-Molecular Signatures, 24
Workstations and displays, 21, 56, 68-69
World Health Organization, 177
     clinical trial guidelines, 19, 26
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Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer Get This Book
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Each year more than 180,000 new cases of breast cancer are diagnosed in women in the U.S. If cancer is detected when small and local, treatment options are less dangerous, intrusive, and costly-and more likely to lead to a cure.

Yet those simple facts belie the complexity of developing and disseminating acceptable techniques for breast cancer diagnosis. Even the most exciting new technologies remain clouded with uncertainty. Mammography and Beyond provides a comprehensive and up-to-date perspective on the state of breast cancer screening and diagnosis and recommends steps for developing the most reliable breast cancer detection methods possible.

This book reviews the dramatic expansion of breast cancer awareness and screening, examining the capabilities and limitations of current and emerging technologies for breast cancer detection and their effectiveness at actually reducing deaths. The committee discusses issues including national policy toward breast cancer detection, roles of public and private agencies, problems in determining the success of a technique, availability of detection methods to specific populations of women, women's experience during the detection process, cost-benefit analyses, and more.

Examining current practices and specifying research and other needs, Mammography and Beyond will be an indispensable resource to policy makers, public health officials, medical practitioners, researchers, women's health advocates, and concerned women and their families.

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