At a recent National Cancer Institute (NCI) media briefing, Tomosynthesis Mammographic Imaging Screening Trial (TMIST) Study Chair Etta Pisano, MD, stated that, despite the ongoing COVID-19 pandemic, TMIST has enrolled more patients than any other NIH-sponsored clinical trial since non-urgent care resumed last July.
Pisano added that, unlike many other studies, “TMIST enrollment has doubled since the start of the pandemic. While more sites and women are wanted, TMIST participation has surpassed 56,000 women at 114 active sites in the United States and abroad. This is remarkable, given national and global circumstances.”
The NCI, part of the National Institutes of Health, continues to fund TMIST and work with the ECOG-ACRIN Cancer Research Group to modify TMIST to more quickly complete patient accrual and reach the primary study endpoint. TMIST is the first randomized, controlled trial that seeks to identify women in which digital breast tomosynthesis (DBT) may outperform 2D digital mammography in reducing advanced breast cancer development.
Pisano says that determination is vital and remains unreached, that 3D mammography still is not universal and that TMIST participation provides access to DBT for many women who may want, but otherwise could not get, 3D mammography.
“Only 44% of accredited mammography systems are DBT units, and 22% of U.S. imaging facilities do not have DBT systems,” said Pisano. “Many of these sites may be in underserved areas. Black women are far less likely to be screened with DBT than white or Asian women. TMIST may shed light on the impact of such disparities and one day help eliminate them.”
TMIST has recruited one of the most racially diverse populations of any NCI trial ever. Nearly 20% of U.S. women in TMIST are Black. The average Black cohort in U.S. clinical trials is 8%. Including those from the Argentina site, nearly 37% of all TMIST participants are Hispanic. Enrollment of U.S. Hispanic women stands at or above the national average.
TMIST also will create the world’s largest curated dataset of breast cancer screening clinical data, images and biospecimens to help researchers tailor future screenings to a woman’s individual risk. One TMIST goal is aiding the development of individualized screenings to reduce breast cancer impact on women not as well served by the current process, including minorities and those in underserved (including rural) areas.
“TMIST covers screening costs for uninsured women who qualify for cost-free care at that participating site,” said Pisano. “This may be the only way many can access screening. With the added ability to get a funding advance to hire a dedicated research assistant, TMIST sites can enhance their positive impact on their communities.”
Medical imaging providers may find more information on the American College of Radiology® website, including how and why to take part in one of the world’s largest randomized, controlled breast cancer screening trials.
If you have questions or would like more information about TMIST, email TMIST@acr.org.