University of California San Francisco
Helen Diller Family Comprehensive Cancer Center
Rebecca Smith-Bindman, MD

Rebecca Smith-Bindman, MD

Professor in Residence, Departments of Radiology, Epidemiology/Biostatistics, and Obstetrics, Gynecology, and Reproductive Medicine, UCSF

Cancer Center Program Memberships

Breast Oncology

Research Summary

Rebecca Smith-Bindman, MD, is a Professor in Residence of Radiology, Epidemiology and Biostatistics, Obstetrics, Gynecology and Reproductive Medicine. Dr. Smith–Bindman directs the Radiology Outcomes Research Laboratory. She provides her expertise in the diagnosis of fetal anomalies, the evaluation of patients with symptoms of vaginal bleeding, and helps to understand efficient ways to evaluate a range of symptoms to minimize unnecessary and excessive testing while maximizing accurate diagnoses. Dr. Smith-Bindman received her medical degree from the University of California, San Francisco in 1991, and completed her residency in Radiology at UCSF in 1996, followed by a fellowship in Epidemiology and Biostatistics at UCSF in 1998.

Dr. Smith-Bindman’s research continues to concentrate on understanding the impact of diagnostic testing on important patient outcomes and understanding the difference in access to different tests and variance in accuracy of these tests. Present research projects are assessing the risk of cancer associated with incidental findings identified on ultrasound and CT imaging, and assessing patterns of radiation from diagnostic imaging.

Dr. Smith-Bindman has 68 peer-reviewed articles. In many of her studies, she was responsible for the design, data collection, analysis, manuscript preparation, and dissemination of the results. A few of her significant articles have been covered by extensive media coverage such as the New York Times and the Wall Street Journal.


Princeton University, Princeton, NJ, B.S.E., 1985, Architecture/Engineering
Columbia University, New York, NY, 7/85-6/86, Pre-Medical Program
University of California, San Francisco, CA, M.D., 1991, Medicine

Professional Experience

  • 1986-1987
    Research Assistant, Radiology and General Internal Medicine, UCSF
  • 1991-1992
    Intern, Department of Pathology, UCSF
  • 1992-1996
    Resident, Department of Radiology, UCSF
  • 1996-1997
    Clinical Instructor, Ultrasound, Department of Radiology, UCSF
  • 1996-1998
    Fellow, Women's Health, Epidemiology, Biostatistics, and Medicine, UCSF
  • 1998-2000
    Asst. Adjunct Professor of Radiology, Epidemiology & Biostatistics, UCSF
  • 1998-2000
    Asst. Adjunct Professor of Epidemiology & Biostatistics, UCSF
  • 1999-2000
    Visiting Research Fellow, Dept. of Environmental and Preventive Medicine, Wolfson Institute, St. Bartholowmew's and The Royal London School of Medicine
  • 2000-current
    Assistant Professor in Residence, Radiology, Epidemiology and Biostatistics, UCSF
  • 2000-current
    Director, Radiology Outcomes Research Lab
  • 2003-current
    Associate Professor in Residence, Radiology, Epidemiology and Biostatistics, Obstetrics, Gynecology, and Reproductive Medicine, UCSF

Honors & Awards

  • 1985
    Cum laude, Princeton University
  • 1985
    Senior Thesis Prize, Princeton University
  • 1988
    Student Summer Research Fellowship, Institute for Health Policy, UCSF
  • 1999, 2000
    Radiologic Society of North America Nycomed Amersham Fellow

Selected Publications

  • Block JE, Smith R, Black D, Genant HK. Does Exercise Prevent Osteoporosis? JAMA 1987; 257:3115-3117.
  • Smith-Bindman R, Cummings SR, Steiger P, Genant HK. A comparison of morphometric definitions of vertebral fractures. J Bone Miner Res 1991;6:25-34.
  • Smith-Bindman R, Steiger P, Cummings SR, Genant HK. The Index of Radiographic Area (IRA): a new approach for estimating the severity of vertebral deformity. Bone and Mineral 1991;15:137-50.
  • Smith-Bindman R, Kerlikowske K, Feldstein V, Subak L, Scheidler J, Segal M, Brand R, Grady D. Endovaginal ultrasound to exclude endometrial cancer and other endometrial abnormalities: JAMA 1998;280:1510-1517.
  • Smith-Bindman R, Kerlikowske K. Is there a downside to elderly women undergoing screening mammography? J Natl Cancer Inst 1999:18;1322-3.
  • Vincoff N, Callen P, Smith-Bindman R, Goldstein R. Effect of transducer frequency on the appearance of the fetal bowel. J Ultrasound Med 1999;18:799-803.
  • Smith-Bindman R, Kerlikowske K. Is there a downside to elderly women undergoing screening mammography? J Natl Cancer Inst 1999:18;1322-3.
  • Smith-Bindman R, Gebretsadik T, Kerlikowske K, Newman J. Is screening mammography effective in elderly women? Am J Med 2000:108:112-118.
  • Smith-Bindman R, Hosmer W, Feldstein VA, Deeks JJ, Goldberg JD. Second-trimester ultrasound to detect fetuses with Down syndrome: a meta-analysis. JAMA 2001;285:1044-55.
  • Smith-Bindman R, Hosmer W, Coppanigro M, Cunningham G. The variability in the interpretation of prenatal diagnostic ultrasound. Ultrasound Obstet Gynecol 2001;17:(4):326-332.
  • Goldstein RB, Brer RL, Benson CB, et al (including Smith-Bindman) Evaluation of woman with postmenopausal bleeding: Society of Radiologists in Ultrasound Consensus Conference. J Ultrasound Med 2001 20:10;1025-1036.
  • Smith-Bindman R, Chu PW, Ecker J, Feldstein V, Filly R, Bacchetti P. US evaluation of fetal growth: prediction of neonatal outcomes. Radiology 2002; 223(1):153-161.
  • Shepherd JA, Kerlikowske K, Smith-Bindman R, Genant H, Cummings SR. Measurement of breast density with dual X-ray absorptiometry: feasibility. Radiology 2002 223(5): 554-557.
  • Prevrhal S, Shepherd JA, Smith-Bindman R, Kerlikowske K, Cummings SR. Accuracy of Mammographic Breast Density analysis: Results of Formal Operator Training. J Cancer, Epi. Bio. & Prev 2002 Nov;11(11); 1389-93.
  • Smith-Bindman R, Chu PW, Miglioretti DL, et al. Comparison of Screening Mammography in the United States and the United Kingdom. JAMA 2003 22;290(16):2129-37.
  • Smith-Bindman R, Chu PW, Bacchetti P, Waters JJ, Mutton D, Alberman E. Prenatal screening for Down syndrome in England and Wales and population-based birth outcomes. Am J Obstet Gynecol 2003 Oct;189(4):980-5.
  • Smith-Bindman R, Chu PW, Ecker J, Feldstein V, Bacchetti P, Filly R. Adverse birth outcomes in relation to prenatal sonographic measurements of fetal size. J Ultrasound Med 2003 Apr 22:347-356.
  • Kerlikowske K, Smith-Bindman R, Barclay J, Ling BM, Grady D. Evaluation of Abnormal Mammography Results and Palpable Breast Abnormalities. Ann Intern Med 2003 Aug 19;139(4):274-84.
  • Ziv E, Shepherd J, Smith-Bindman R, Kerlikowske K. Mammographic Breast Density and Family History of Breast Cancer. J Natl Cancer Inst 2003 Apr 2; 95(7) 556-558.
  • Kerlikowske K, Smith-Bindman R, Sickles EA. Short-interval follow-up mammography: are we doing the right thing? J Natl Cancer Inst. 2003 Aug 6;95(15):1175-6.
  • Smith-Bindman R, Weiss E, Feldstein V. How thick is too thick? What endometrial thickness should prompt biopsy in an asymptomatic postmenopausal woman? Ultrasound Obstet Gynecol, 2004 June; 24:558-565.
  • Smith-Bindman R. Diagnostic Imaging in the Differential Diagnosis of Vaginal Bleeding and Breast Mass. Adv Stud Med 2004 Oct;4(9):476-482.
  • Benn PA, Egan JF, Fang M, Smith-Bindman R. Changes in the utilization of prenatal diagnosis. Obstet Gynecol 2004 Jun; 103(6):1255-60.
  • Smith-Bindman R, Chu PW, Miglioretti D, Kerlikowske K. Comparison of screening mammography in the United States and the United Kingdom. JAMA 2004 Feb 18;291(7):824.
  • Smith-Bindman R, Chu PW, Miglioretti D, Quale C, et al. Physician Predictors of Mammographic Accuracy. J Natl Cancer Inst 2005; 97:358-67.
  • Kerlikowske K, Smith-Bindman R, Abraham LA, et al. Breast Cancer Yield for Screening Mammographic Examinations with Recommendation for Short-Interval Follow-up. Radiology 2005 Mar;234(3):684-692.
  • Smith-Bindman R, Ballard-Barbash R, Miglioretti D, Patnick J, Kerlikowske K. Comparing the Performance of Mammography Screening in the United States and the United Kingdom. J Med Screen 2005 12(1): 50-54.
  • Sickles EA, Miglioretti D, Ballard-Barbash R, Geller B, Leung J, Rosenberg R, Smith-Bindman R, Yankaskas B. Performance Benchmarks For Diagnostic Mammography. Radiology 2005 Jun;235(3):775-90.
  • Kerlikowske K, Creasman J, Leung JW, Smith-Bindman R, Ernster VL. Differences in screening outcomes among White, Chinese, and Filipino women. Arch Intern Med. 2005 Sept. 12; 165(16):1862-8
  • Smith-Bindman R, Miglioretti D, Lurie N, Abraham L, et al. Does Utilization of Screening Mammography Explain Racial and Ethnic Differences in Breast Cancer? Ann Intern Med, 2006 Apr18;144(8):541-53.
  • Smith-Bindman R, Quale C, Chu PW, et al. Can Medicare Billing Claims Data Be Used to Assess Mammography Utilization Among Women Age 65 and Older. Medical Care 2006 May;44(5):463-70
  • Kado DM, Christianson L, Palermo L, Smith-Bindman R, Cummings SR, Greendale GA. Comparing a supine radiologic versus standing clinical measurement of kyphosis in older women: The Fracture Intervention Triall. Spine 2006 31:4;4463-467
  • Haggstrom DA, Quale C, Smith-Bindman R. Differences in the Quality of Breast Cancer Care Among Vulnerable Populations. Cancer. 2005 Dec 1;104(11):2347-58
  • Kagay C, Quale C, Smith-Bindman R. Mammography Use Among the American Elderly, Am J Prev Med 2006 Aug;31(2):142-9. Schell MJ, Yankaskas BC, Ballard-Barbash R, Qaqish BF, Barlow WE, Rosenberg RD, Smith-Bindman R. Evidence-based target recall rates for screening mammography. Radiology 2007;243(3):681-9.
  • Smith-Bindman R, Chu P, Goldberg JD. Second trimester prenatal ultrasound for the detection of pregnancies at increased risk of Down Syndrome. Prenat Diagn 2007;27(6):535-44.
  • Kerlikowske K, Ichikawa L, Miglioretti DL, Buist DS, Vacek PM, Smith-Bindman R, Yankaskas B, Carney PA, Ballard-Barbash R; National Institutes of Health Breast Cancer Surveillance Consortium. Longitudinal measurement of clinical mammographic breast density to improve estimation of breast cancer risk. J Natl Cancer Inst 2007;99(5):386-95.
  • Miglioretti DL, Smith-Bindman R, Abraham L, et al Radiologist Predictors of the Interpretive Performance of Diagnostic Mammography. J Natl Cancer Inst 2007 10;99(24)1854-63
  • Goldman L, Haneuse S, Miglioretti D, Kerlikoswke K, Buist D, Yankaskas B, Smith-Bindman R, An assessment of the quality of mammography care at facilities treating medically vulnerable populations. Medical Care 2008 Jul;46(7):701-8. Pub Med Reference No. 96607
  • Curtis E, Quale C, Haggstrom D, Smith-Bindman R. Racial and Ethnic Differences in Breast Cancer Survival: How Much Is Explained By Screening, Tumor Severity, Biology, Treatment, and Co-morbidities. Cancer 2008 112(1):171. Pub Med Reference No. 96620
  • Smith-Bindman R, Miglioretti DL, Rosenberg R, Reid RJ, Taplin SH, Geller BM, Kerlikowske K; National Institutes of Health Breast Cancer Surveillance Consortium. Physician workload in mammography. Am J Roentgenol. 2008 Feb;190(2):526-32.
  • Dinkelspiel E, Chu P, Smith-Bindman R, Access to Diagnostic Mammography in the San Francisco Bay Area. Journal of Womens Health 2008 Jun ;17 (5):893-9
  • Scheuler K, Chu B, Smith-Bindman R. Factors Associated with Mammography Utilization: A Quantitative Meta-Analytic Review. Journal of Womens Health 2008 17 (9); 1477-98
  • Goldman L, Haneuse S, Miglioretti D, Kerlikoswke K, Buist D, Yankaskas B, Smith-Bindman R, Mammography facilities treating minority and socio-economically disadvantaged populations provide quality care. Medical Care 2008 Jul;46(7):701-8
  • Tice JA, Cummings SR, Smith-Bindman R, Ichikawa L, Barlow WE, Kerlikowshe K. Using clinical factors and mammograhic breast density to estimate breast cancer risk: development and validation of a new predictive model. Ann Intern Med 2008 Mar 4;148(5):337-47. Pub Med Reference No. 96623
  • Smith-Bindman R, Miglioretti D, Larson E. Rising use of diagnostic medical imaging in a large integrated healthcare systemHealth Affairs 2008 27 (6):1491-502
  • Venkatesan A, Chu P, Kerlikowske K, Smith-Bindman R The positive predictive value of specific mammographic findings by reader and patient variables. Radiology 2009. Pub Med Reference No. 95071