PROJECT SUMMARY ? Program Integration and Management This Program Project renewal, ?Risk-based Breast Cancer Screening and Surveillance in Community Practice,? aims to identify the most effective risk-based breast cancer screening and surveillance strategies that also minimize harms. The program is a complex undertaking involving three research projects, two cores, six breast imaging registries that collect data from 115 participating imaging facilities, a statistical coordinating center, and multiple committees ? all which must work closely together to ensure success. The Program Integration and Management (PIM) team will be the operational backbone of the program, assisting the projects and cores in achieving their objectives and facilitating a collaborative environment to ensure that the program functions efficiently and productively. The Breast Cancer Surveillance Consortium (BCSC) has developed an effective model for program management and integration, demonstrated by the success and productivity of the current P01 upon which this renewal builds. The PIM team will continue to use this organizational model to centralize coordination, communication, and integration among the projects and cores. Activities will include providing overall scientific leadership, fiscal oversight, and administrative support by leading the program Steering Committee, planning program meetings, and overseeing project and core budgets and deliverables. The PIM team will standardize and facilitate inter-project collaboration by maintaining and monitoring established policies and procedures that ensure equitable opportunities and support for all investigators. The team will assess program progress through an annual evaluation and develop and implement improvement plans to overcome any challenges. They will also develop effective communication strategies for disseminating research findings and create mechanisms to encourage and facilitate data sharing with external investigators. The PIM specific aims are: Aim 1: Maintain centralized coordination and management of the program's logistical and financial requirements; Aim 2: Provide integrative support to projects and cores by promoting collaborations to create synergy within the program; and Aim 3: Evaluate and improve program performance through an annual evaluation. Together, with integration and support from the PIM team, the projects and cores will efficiently achieve multiple, related research goals united by a common theme by sharing methods, data, and results. The BCSC has 20+ years of experience in collaborative, multi-site research, including 5 successful years under the current P01. In the past 5 years the BCSC's collaborative model has resulted in over 100 peer-reviewed publications and 19 ancillary grants using P01 data and other resources?many led by junior faculty. The PIM team will support a successful and integrated research program with all parts working together to facilitate the exchange of knowledge, methods, and data to advance the research agenda. With efficient systems, communication, and processes, the research projects and cores will collaborate effectively to produce results greater than the sum of the individual parts.