Why: Not all screen-detected cancerous lesions progress to life-threatening disease. To avoid overtreatment, identification of non-progressive lesions is critical.

What: We combine experimental data from human tumors with mathematical modeling to elucidate the evolutionary dynamics of cancer initiation and to identify markers of invasive progression.

How: Multi-regional sequencing assays (genetic and epigenetic), mechanistic mathematical models

Collaborators: Hwang and Marks lab @ Duke, Shibata lab@ USC

Why: Women diagnosed with ductal carcinoma in situ (DCIS) have several management options. To enable informed decision making, quantitative risk predictions are needed.

What: We use model-based approaches to synthesize evidence from observational studies and randomized trials to predict a range of risks for treatment and active surveillance strategies.

How: Mathematical and statistical modeling, Bayesian evidence synthesis, decision analysis

Collaborators: Etzioni lab@ Fred Hutch

Why: Women diagnosed with ductal carcinoma in situ (DCIS) face complex decisions. In addition to guideline-concordant care options, ongoing trials are investigating the viability of active surveillance as an alternative strategy

What: We are developing an interactive web-based decision support tool that helps newly diagnosed DCIS patients navigate the multi-faceted trade-offs between different management options.

How: Risk modeling, knowledge synthesis, uncertainty visualization, patient communication, qualitative research