Investigating Breast Cancer

About 30 percent of people diagnosed with early-stage breast cancer will experience a recurrence and develop metastatic disease. Dr. Christina Curtis and her colleagues are working to uncover why recurrence (when breast cancer comes back) and metastasis (when it spreads to other areas of the body beyond the breast and lymph nodes) happens. A BCRF investigator since 2011, Dr. Christina Curtis is an endowed professor of medicine and genetics at Stanford University, where she leads the Cancer Computational and Systems Biology group and serves as the director of Breast Cancer Translational Research and co-director of the Molecular Tumor Board at the Stanford Cancer Institute. 

In the latest episode of BCRF’s official podcast, Investigating Breast Cancer, Dr. Hyman Muss explores the need for more research in the geriatric oncology field. Thanks to Dr. Muss and others, much has been learned about breast cancer in elderly people—but there’s still much more to uncover. A BCRF investigator since 2000, Dr. Muss is professor of medicine at the University of North Carolina School of Medicine and director of the Geriatric Oncology Program at the UNC Lineberger Comprehensive Cancer Center.

What is triple-negative breast cancer and how is it identified? How can triple-negative breast cancers escape the immune system? And how can determining whether circulating tumor DNA in blood samples be used to predict metastatic breast cancer or treatment resistance in patients with aggressive disease? BCRF investigator since 2007, Dr. Hope Rugo answers these questions and many more on the latest episode of Investigating Breast Cancer.

Many extraordinary new treatments, diagnostic tests, and procedures for breast cancer patients have been introduced in the past decade—and more are needed and sure to come. But researchers are still exploring ways to improve health disparities in cancer care delivery, quality of care, and quality of life for patients and thrivers. In this latest episode, we spoke to BCRF Investigator since 2008, Dr. Dawn Hershman, on ways to shrink these gaps in care.

Triple negative breast cancer (TNBC) makes up about 15 percent of all the breast cancers diagnosed. And, better therapeutic strategies are urgently needed to treat this breast cancer subtype. BCRF Investigator, Dr. Elisa Port is working to combat drug resistance in TNBC by developing a drug for the protein PRKCQ—a promising therapeutic target that may make TNBC more responsive to chemotherapy.

Can cancers resulting from lifestyle choices be preventable? What foods should you be eating to reduce your risk of breast cancer? And what non-lifestyle decisions should be considered when looking to reduce their risk? Dr. Graham Colditz, a BCRF investigator since 2004, has spent decades diving into these questions and more. Dr. Colditz is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a longstanding interest in the preventable causes of chronic disease, particularly among women. He is also interested in strategies to speed translation of research findings to prevention strategies that work.

BCRF’s annual Boston Hot Pink Luncheon and Symposium convenes the Foundation’s dedicated New England–based supporters to honor the area’s investigators and raise additional funds for lifesaving breast cancer research. This year’s virtual program included an outstanding expert panel of BCRF investigators, moderated by BCRF Scientific Director Dr. Judy Garber. The panelists discussed novel breast cancer therapies and what’s on the horizon in research. The symposium panelists included Dr. Melinda Irwin, Dr. Elizabeth Mittendorf, and Dr. Dennis Sgroi. We’re proud to make their discussion available in this special episode of Investigating Breast Cancer.

Effective medicine has always relied on clear and verifiable diagnoses. Of course, for patients, the wait and uncertainty of diagnostics can be especially trying. BCRF investigator since 2019, Dr. Connie Lehman, is among the scientists and practitioners trying to change that. And she’s doing it in myriad ways to drastically reduce wait times and detect cancers earlier. Dr. Lehman is a professor of radiology at Harvard Medical School, and chief of Breast Imaging and co-director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital.

Can breast cancer be found with a blood test? What role do genes and proteins play in developing cancer? What, exactly, are personalized diagnostics? We spoke with BCRF investigator Dr. Joshua LaBaer to answer these questions and more. Dr. LaBaer is one of the country’s foremost investigators in personalized medicine. He serves as executive director of the Biodesign Institute, director of the Biodesign Virginia G. Piper Center for Personalized Diagnostics, and the Dalton Endowed Chair of Cancer Research at Arizona State University. Dr. LaBaer's research involves discovering and validating biomarkers to detect cancer and other diseases early.

While academic and medical research has led to incredible breakthroughs in breast cancer care—including new treatments and screening methods—these advances have not reached every patient in every corner of the globe. With breast cancer now the most commonly diagnosed cancer in the world, it’s critical that lifesaving advances are deployed more equitably and universally—especially to women and men in lower-income and -resource countries. Dr. Fadelu discussed his work that lies at the intersection of breast cancer and global health services research Each year, BCRF underwrites several grants to breast cancer researchers in partnership with Conquer Cancer, the ASCO Foundation. Dr. Temidayo Fadelu recently received the Career Development Award for Diversity, Inclusion and Breast Cancer Disparities. His BCRF-supported project aims to improve adherence to endocrine therapies among patients in Rwanda and Haiti. 

How can genetic testing data encourage prevention and agency without amplifying personal fear? What can research reveal about genetic markers of risk and predisposition? Or, put differently, how can understanding one’s inherited risk improve approaches to precision prevention? Dr. Ephrat Levy-Lahad is on the forefront of this research, focusing on breast cancer–associated genetic mutations among various populations, including Arab and Ashkenazi Jewish women. She is a professor of internal medicine and medical genetics at Hebrew University and director of the Medical Genetics Institute at Shaare Zedek Medical Center in Jerusalem.

While breast cancer is not typically caused by inherited factors, as many as 10-15 percent of people diagnosed with breast cancer carry a known genetic mutation. The most well-known mutations are in the BRCA1 and BRCA2 genes. But these only account for 5-10 percent of inherited breast cancers, so what about the many other gene mutations that increase a person’s risk of breast cancer? Also, what does this mean not only for genetic testing—but also how we should consider results? More significantly, what effect might this have on the personalization of risk? We talk with BCRF investigator and cancer geneticist Dr. Katherine Nathanson to answer these questions.

There are many challenges in managing breast cancer. Top among them is the fact that initial breast conserving surgeries often miss vestiges of a patient’s tumor. In fact, up to 40 percent of women require another procedure following lumpectomy. Not only can additional surgery, of course, increase a patient’s anxiety and be physically taxing, but it can cause delays in critical subsequent treatments like chemotherapy and radiation. So, why is that rate so high? Why is properly identifying the tumor so difficult? Most importantly: What can be done to reduce repeat surgeries? Dr. Mehra Golshan is working to uncover answers to these questions. A BCRF investigator since 2014, Dr. Golshan is the deputy chief medical officer for surgical services and director of the Breast Cancer Program for the Yale Cancer Center, Smilow Cancer Hospital, and Smilow Cancer Hospital Care Centers.

How do you measure quality of life? As researchers across fields discover new drug therapies or disease prevention—in breast cancer as well as other fields—science finds innumerable ways to measure physical results. But what about the social, behavioral, and psychological aspects of cancer care? And how should medical providers discuss such realties with patients? This is just one area of extraordinary impact that Professor Dame Lesley Fallowfield has made in medicine. Dame Lesley is professor of psycho-oncology at Brighton & Sussex Medical School at the University of Sussex where she is director of the Sussex Health Outcomes Research & Education in Cancer group.   She has been a BCRF Investigator since 2016—the same year she was made a Dame Commander of the Order of the British Empire by Queen Elizabeth II for services to psycho-oncology.

For so many breast cancer patients, radiation therapy can bring extraordinary benefits—top among them improved survival rates and reduced recurrence. But there are also challenges and questions: Why do some people experience a recurrence after treatment? How can we reduce side effects? How can we ensure the right patients receive radiation therapy—and that the treatment works as well as possible? These are among the many medical mysteries to which Dr. Lori Pierce, BCRF investigator since 2003, has dedicated her career to answering.

Women with breast cancer who are overweight or obese experience inferior outcomes compared to those with normal weight despite receiving optimal therapies. Dr. Vered Stearns discusses researching ways to reduce breast cancer recurrence through effective weight-loss interventions and why we need to bring more discoveries from the lab to the clinic. Dr. Stearns is a member of the BCRF Scientific Advisory Board and has been a BCRF Investigator since 2003.

Each October, BCRF-funded investigators are honored at the Foundation’s Symposium & Awards Luncheon in New York City. This year, the program was held virtually, without the lunch—but with all of the important conversations and ideas. The annual event announces the Foundation’s grant investment for the coming year and recognizes BCRF investigators for their trailblazing scientific inquiry. This year’s program included an extraordinary symposium, moderated by BCRF Scientific Director Dr. Judy Garber, that included Dr. Angela DeMichele, Dr. William G. Kaelin Jr. and Dr. Lori J. Pierce. We’re proud to make their discussion available in a special episode of Investigating Breast Cancer.

Women of African descent are more likely to be diagnosed with aggressive breast cancers than white women and are more likely to die from their disease regardless of its type or stage. For those living in remote or low-resource areas, limited access to screening and genetic testing make improving outcomes even more challenging. In this episode of our podcast, Dr. Funmi Olopade, talks about her work in Africa and Chicago, the critical importance of precision medicine, and why she’s “impatient” about eliminating barriers to breast cancer care around the world. Dr. Olopade, a BCRF investigator since 2001, serves as the founding director of the Cancer Risk and Prevention Clinic and associate dean for global health, both at the University of Chicago.

The immune system plays a critical role in tumor growth by attacking cancer cells with white blood cells. Cancer cells that survive this immune attack can become invasive and metastatic (a process called immune escape). In this episode of Investigating Breast Cancer, Dr. Kornelia Polyak shares the impact of understanding breast cancer at a molecular level. Dr. Polyak, a BCRF investigator since 2008, is an internationally recognized leader in the breast cancer research field. 

While genetic testing and counseling for breast cancer has been available in the U.S. for many years, accessing these services in Mexico and the rest of Latin America is more challenging due to limited resources. Leading genetics researcher and oncologist, Dr. Jeffrey Weitzel, has devoted his career to decreasing these barriers. Dr. Weitzel, a BCRF investigator since 2013, is director of the Clinical Cancer Genetics Program and professor of oncology and population sciences at the Beckman Research Institute at City of Hope.