Research Activities


The long-term goal of the Hawaii Pacific Islands Mammography Registry (HIPIMR) is to develop accurate and validated models of breast cancer risk and detection in real time for women with the diverse breast cancer risk profiles as described above who have not been well represented in breast cancer cohorts and clinical trials so far.

Despite recent advances in early detection and treatment of breast cancer, this disease remains a major cause of morbidity and mortality among women across the world. Notable racial/ethnic differences in incidence and survival have been described repeatedly and support the existence of preventable risk factors.

For example, Native Hawaiian women have the highest breast cancer incidence in Hawai’i despite their favorably reproductive patterns. Japanese American women now experience the same breast cancer risk as Caucasian women although the incidence in Japan is still much lower.

Findings from the Multiethnic Cohort (MEC) in Hawai’i and Los Angeles have shown that body fat distribution and not just body mass index (BMI) is an important predictor of breast cancer risk.

The long-term goal of the HIPIMR is to develop accurate and validated models of breast cancer risk and detection in real time for women with the diverse breast cancer risk profiles as described above who have not been well represented in breast cancer cohorts and clinical trials so far. The HIPIMR constitutes a resource to develop and validate novel risk and detection approaches for the diverse ethnic groups with varying risk factor profiles of this region including Native Hawaiians, Japanese, Filipino, Micronesian, and other ethnic groups.

This registry is a dynamic cohort continuously acquiring 2D and 3D digital mammograms from clinics representing the region’s screening mammography population and 100% of the reported breast cancer findings from linkage to the Hawai’i Tumor Registry. It will allow us to follow participants for years through multiple screening exams, identify those at high risk of breast cancer, and offer them in high-risk clinics where they could take advantage of risk-reducing strategies and therapies.

Our central hypothesis is that current breast cancer risk and computer-aided diagnostic programs are not calibrated to the diverse populations of Asia and the Pacific, and thus may not accurately identify high-risk women in Hawai’i and the Pacific Islands.

The rationale that underlies the formation of the registry is the need to develop accurate breast cancer risk models  among women with Asian (primarily Japanese and Filipino) and Pacific Islander (primarily Native Hawaiian, Samoan, and Chamorro) ancestry.

The HIPIMR investigators are in a unique position to answer these questions with experts in breast imaging (Shepherd), managing high-risk women (Rhee), and breast cancer population studies (Maskarinec).

Below are some of the ongoing research projects within the HIPIMR. If you are interested in using registry data for your own research questions, please visit our Data Use Request page for more information.

Quantitative Tomosynthesis Imaging

Under the Lesion Composition and Quantitative Imaging Analysis on Breast Cancer Diagnosis grant and in partnership with GE Healthcare, the goals of this study are to explore the methods and performance of adapting SXA to tomosynthesis, explore the application of deep learning to mammography, and investigate how a tomogram can be deconstructed into 3 image volumes that are specific to the three molecular compartments of the breast: lipid, water, protein.

Accessible Breast Cancer Screening in the Pacific

Under the U54 Partnership, the purpose of this study is to determine the clinical efficacy of a handheld point-of-care medical device (iBreastExam) for breast cancer screening that could potentially augment diagnostic mammography in the Pacific Islands.