Hollings participating in large national breast cancer study aimed at improving screenings and treatment

October 21, 2021
Dag Pavic with breast imaging device
The Tomosynthesis Mammographic Imaging Screening Trial (TMIST) will provide insights into which type of screening is best and how to improve future breast cancer patient care. Photo by Josh Birch

Getting routine breast exams is something Dag Pavic, M.D., a breast radiologist at MUSC Hollings Cancer Center, stresses all the time. That’s why he’s excited that Hollings is participating in a large National Cancer Institute-funded trial, aimed at improving breast cancer screenings and treatment options for women with, and without, health insurance.

“Breast screening is our best weapon in the fight against breast cancer,” Pavic said. “When breast cancer is caught early, the patient has numerous treatment options and usually a very good outcome.”

The trial, called the Tomosynthesis Mammographic Imaging Screening Trial (TMIST), will provide insights into which type of screening is best and how to improve future breast cancer patient care. Nationwide, researchers hope to enroll 165,000 women in the trial.

“This trial helps us offer more personalized medicine to each individual patient,” Pavic said. “We have to consider a patient’s risk of breast cancer and breast characteristics that may alter what may be the best type of screening for that person.”

Breast imaging 
Image of a breast. Photo provided

The trial is being supported by the NCI Community Oncology Research Program (NCORP). “Nearly 50 million screening mammograms occur each year in the United States, yet it has been decades since a large-scale randomized trial of mammography has been done,” said Worta McCaskill-Stevens, M.D., director of NCORP. “The evolution of mammography technology provides us with an opportunity to fill in the gaps in our knowledge about two available breast cancer screening tests.”

Hollings is currently enrolling women ages 45 to 74 in TMIST. As part of the randomized study, women will receive a mammogram using conventional two-dimensional mammography or the newer tomosynthesis three-dimensional mammography.

“Through this trial, we hope to learn whether or not there are differences between 2D and 3D mammography in detecting cancers and advanced cancers and whether one type of mammography results in more false positives and callbacks for further evaluation,” Pavic said.

Pavic, who serves as the primary investigator of the TMIST trial at Hollings, said researchers will also collect genetic samples from enrolled patients. “These samples allow us to understand and study cancer on a molecular level, which will ultimately lead to better therapies. Once you understand the molecular aspects of breast cancer, you can investigate, produce and use medicine that will target those components.”

Pavic said he hopes that the trial also answers two other questions: Is standard-of-care 3D mammography better than standard-of-care 2D mammography? And how frequently should patients be screened for breast cancer?

The trial is being offered at two MUSC locations — Hollings Cancer Center in downtown Charleston and MUSC Women’s Health at East Cooper Medical Pavilion. To date, 90 women have enrolled in the trial at MUSC locations, and Pavic said that, eventually, he hopes to have several hundred enroll before trial enrollment ends in 2024.

“Patients should be excited to participate in this trial because they can be part of something for the greater good,” he said. “We have an opportunity to gain a better understanding of breast cancer screenings and treatments. That will ultimately help to save lives in the years to come.”

Patients interested in enrolling in TMIST should contact study coordinator Kristin Thompson at thompskn@musc.edu or 843-792-6463.

About the Author

Josh Birch
MUSC Hollings Cancer Center

Keywords: Cancer