prevalence estimates of mammography.185 Important note about estimated cases and deaths. While these estimates provide a reasonably accurate portrayal of the current cancer burden in the absence of actual data, they should be interpreted with caution because they are model-based projections that may vary from year to year for reasons other than changes in cancer occurrence. In addition, they are not informative for tracking cancer trends. Instead, trends in cancer occurrence should be analyzed using age-adjusted incidence rates reported by population-based cancer registries and mortality rates reported by the NCHS.: NAACCR Incidence Data - CiNA Analytic File, 1995-2016, for NHIAv2 Origin and for Expanded Races, Custom File With County, ACS Facts and Figures projection Project (which includes data from CDC’s National Program of Cancer Registries (NPCR), CCCR’s Provincial and Territorial Registries, and the NCI’s Surveillance, Epidemiology and End Results (SEER) Registries), certified by the North American Association of Central Cancer Registries (NAACCR) as meeting high-quality incidence data standards for the specified time periods, submitted December 2018. 9. Dieci MV, Orvieto E, Dominici M, Conte P, Guarneri V. Rare breast cancer subtypes: histological, molecular, and clinical peculiarities. Oncologist. 2014;19(8):805-813. 10. Cheang MC, Martin M, Nielsen TO, et al. Defining breast cancer intrinsic subtypes by quantitative receptor expression. Oncologist. 2015;20(5):474-482. 11. Howlader N, Cronin KA, Kurian AW, Andridge R. Differences in Breast Cancer Survival by Molecular Subtypes in the United States. Cancer Epidemiol Biomarkers Prev. 2018;28:28. 12. Parise CA, Caggiano V. Risk of mortality of node-negative, ER/PR/ HER2 breast cancer subtypes in T1, T2, and T3 tumors. Breast Cancer Res Treat. 2017;165(3):743-750. 13. Prat A, Adamo B, Cheang MC, Anders CK, Carey LA, Perou CM. Molecular characterization of basal-like and non-basal-like triplenegative breast cancer. Oncologist. 2013;18(2):123-133. 14. Plevritis SK, Munoz D, Kurian AW, et al. Association of Screening and Treatment With Breast Cancer Mortality by Molecular Subtype in US Women, 2000-2012. JAMA. 2018;319(2):154-164. 15. Costa RLB, Gradishar WJ. Triple-Negative Breast Cancer: Current Practice and Future Directions. J Oncol Pract. 2017;13(5):301-303. 16. Sharma P. Biology and Management of Patients With TripleNegative Breast Cancer. Oncologist. 2016;21(9):1050-1062. 17. Wolff AC, Tung NM, Carey LA. Implications of Neoadjuvant Therapy in Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer. J Clin Oncol. 2019;3. 18. Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019:1-23. 19. Mariotto AB, Etzioni R, Hurlbert M, Penberthy L, Mayer M. Estimation of the Number of Women Living with Metastatic Breast Cancer in the United States. Cancer Epidemiol Biomarkers Prev. 2017;26(6):809-815. 20. Howlader N, Noone AM, Krapcho M This report is the culmination of more than 2 years of collective effort by both the IBCERCC and staff that supported the work of the Committee. The production of this report could not have been accomplished without the generous assistance of the many agencies and individuals who collaborated in contributing to the contents of this report. The Committee would like to thank Linda Birnbaum of NIEHS for committing the necessary resources, supporting the Committee’s activities, and for her wisdom and encouragement throughout its deliberations. The Committee would like to acknowledge Jennifer Collins of NIEHS for coordinating and managing the activities of this Committee throughout the development of this report. Ms. Collins provided support across the spectrum to the Committee from communicating with various Federal agencies to drafting and editing portions of this report. The Committee also would like to acknowledge the staff from both the NIEHS and the NCI who dedicated considerable time and expertise as they provided ongoing consultation during Committee deliberations and/or drafted and edited portions of this report. In particular, the following staff members put in long hours throughout many months to help with the report’s development: Gary Ellison, Chinonye Harvey, Christie Kaefer, Edward Kang, and Laura McGuinn. The Committee’s work also was supported by individuals and organizations that provided information, materials, and portfolio analyses that were considered and used by the Committee in generating this report. These individuals/organizations include: Marilyn Gaston (NCI), Russell Glasgow (NCI), Muin Khoury (CDC), Ilane Maximo (University of Texas at Austin), Liam O’Fallon (NIEHS), Heather Shaw (University of North Carolina, Chapel Hill), Elyse Wiszneauckas (NCI), and the NCI Office of Advocacy Relations. The Committee would like to acknowledge Susan Braun (The V Foundation) for her careful and critical review of this report to ensure scientific accuracy and responsiveness to the legislation mandating the report. x Breast Cancer and the Environment: Prioritizing Prevention The Committee would like to thank the following individuals who provided presentations to the Committee during meetings: Paolo Boffetta (Mount Sinai School of Medicine), Marc Hurlbert (Avon Foundation for