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  • 1
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 30, No. 7 ( 2021-07-01), p. 1416-1423
    Abstract: We investigated the association between reproductive risk factors and breast cancer subtype in Black women. On the basis of the previous literature, we hypothesized that the relative prevalence of specific breast cancer subtypes might differ according to reproductive factors. Methods: We conducted a pooled analysis of 2,188 (591 premenopausal, 1,597 postmenopausal) Black women with a primary diagnosis of breast cancer from four studies in the southeastern United States. Breast cancers were classified by clinical subtype. Case-only polytomous logistic regression models were used to estimate ORs and 95% confidence intervals (CI) for HER2+ and triple-negative breast cancer (TNBC) status in relation to estrogen receptor–positive (ER+)/HER2− status (referent) for reproductive risk factors. Results: Relative to women who had ER+/HER2− tumors, women who were age 19–24 years at first birth (OR, 1.78; 95% CI, 1.22–2.59) were more likely to have TNBC. Parous women were less likely to be diagnosed with HER2+ breast cancer and more likely to be diagnosed with TNBC relative to ER+/HER2− breast cancer. Postmenopausal parous women who breastfed were less likely to have TNBC [OR, 0.65 (95% CI, 0.43–0.99)]. Conclusions: This large pooled study of Black women with breast cancer revealed etiologic heterogeneity among breast cancer subtypes. Impact: Black parous women who do not breastfeed are more likely to be diagnosed with TNBC, which has a worse prognosis, than with ER+/HER2− breast cancer.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 2
    In: Cancer Causes & Control, Springer Science and Business Media LLC, Vol. 33, No. 4 ( 2022-04), p. 515-524
    Type of Medium: Online Resource
    ISSN: 0957-5243 , 1573-7225
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1496544-6
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  • 3
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2020
    In:  Breast Cancer Research and Treatment Vol. 182, No. 2 ( 2020-07), p. 421-428
    In: Breast Cancer Research and Treatment, Springer Science and Business Media LLC, Vol. 182, No. 2 ( 2020-07), p. 421-428
    Type of Medium: Online Resource
    ISSN: 0167-6806 , 1573-7217
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2004077-5
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  • 4
    In: Journal of Proteome Research, American Chemical Society (ACS), Vol. 12, No. 12 ( 2013-12-06), p. 5383-5394
    Type of Medium: Online Resource
    ISSN: 1535-3893 , 1535-3907
    Language: English
    Publisher: American Chemical Society (ACS)
    Publication Date: 2013
    detail.hit.zdb_id: 2065254-9
    SSG: 12
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  • 5
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. 517-517
    Abstract: 517 Background: Breast cancer is the leading cause of cancer-associated death among Black women, and they are 41% more likely to die from breast cancer compared to White women. Few studies have evaluated if tumor biology differences contribute to this disparity in outcomes. Similar to triple negative breast cancer (TNBC), hormone receptor-positive (HR+) tumors classified as Basal-Type with BluePrint genomic analysis (HR+/Basal) are more aggressive, higher grade, are over-represented among young Black women and have worse clinical outcomes. TNBC is associated with low ACKR1 expression, which encodes the Duffy antigen and correlates with worse breast cancer outcomes. Given the over-representation and worse outcomes among Black women with HR+/Basal tumors, we compared differentially expressed genes (DEGs) by race and subtype. Methods: This study includes 2657 women with Stage I-III breast cancer who received BluePrint testing and are participants of the ongoing BEST study (5R01CA204819) at Vanderbilt University Medical Center or FLEX study (NCT03053193). Of 455 Black women, 315 had Luminal (HR+/Luminal) and 140 had Basal tumors (66 HR+/Basal and 74 HR-/Basal). White women within FLEX (n = 2202) were included as a reference group with HR+/Luminal (n = 1825), HR+/Basal (n = 158), or HR-/Basal (n = 219) tumors. Two-tailed proportional z-test was used to assess differences in subtype proportion by race. Limma R package was used to perform differential gene expression analysis (DGEA) of whole transcriptome data. Significant DEGs had an adjusted p-value 〈 0.05 and absolute log2 fold change 〉 1. Results: Black women had a significantly higher proportion of HR+/Basal (15%; p 〈 0.001) and HR-/Basal (16%; p 〈 0.001) tumors compared to White women (7% and 10%, respectively). In a multidimensional scaling analysis, HR+/Basal tumors cluster with TNBC rather than with HR+/Luminal tumors. While a DGEA comparing HR+/Basal with HR+/Luminal tumors resulted in over 700 DEGs within Black women, no DEGs were identified when comparing HR+/Basal tumors with TNBC. ACKR1 expression in HR+/Basal tumors was comparable to TNBC in Black women (p = 0.81) and White women (p = 0.46). In contrast, HR+/Basal tumors had significantly lower ACKR1 expression than HR+/Luminal tumors in Black (p 〈 0.01) and White women (p 〈 0.01). Conclusions: In this racially diverse cohort, transcriptomic analyses suggest that HR+/Basal tumors are biologically analogous to TNBC, independent of race. Molecular profiling identified racial disparities in the proportion of HR+/Basal tumors and underscores the need for diverse representation in clinical trials. With an over-representation of HR+/Basal tumors in Black women and evidence of worse outcomes, these data suggest that patients with HR+/Basal tumors should not be treated uniformly with HR+/Luminal tumors and highlight the importance of further genomic classification for patients with HR+ tumors. Clinical trial information: NCT03053193.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 6
    In: BMC Cancer, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Implementing genetic testing for inherited cancer predisposition into routine clinical care offers a tremendous opportunity for cancer prevention and early detection. However, genetic testing itself does not improve outcomes; rather, outcomes depend on implemented follow-up care. The IMPACT study is a hybrid type I randomized effectiveness-implementation trial to simultaneously evaluate the effectiveness of two interventions for individuals with inherited cancer predisposition focused on: 1) increasing family communication (FC) of genetic test results; and 2) improving engagement with guideline-based cancer risk management (CRM). Methods This prospective study will recruit a racially, geographically, and socioeconomically diverse population of individuals with a documented pathogenic/likely pathogenic (P/LP) variant in an inherited cancer gene. Eligible participants will be asked to complete an initial trial survey and randomly assigned to one of three arms: A) GeneSHARE, a website designed to increase FC of genetic test results; B) My Gene Counsel’s Living Lab Report, a digital tool designed to improve understanding of genetic test results and next steps, including CRM guidelines; or C) a control arm in which participants continue receiving standard care. Follow-up surveys will be conducted at 1, 3, and 12 months following randomization. These surveys include single-item measures, scales, and indices related to: 1) FC and CRM behaviors and behavioral factors following the COM-B theoretical framework (i.e., capability, opportunity, and motivation); 2) implementation outcomes (i.e., acceptability, appropriateness, exposure, and reach); and 3) other contextual factors (i.e., sociodemographic and clinical factors, and uncertainty, distress, and positive aspects of genetic test results). The primary outcomes are an increase in FC of genetic test results (Arm A) and improved engagement with guideline-based CRM without overtreatment or undertreatment (Arm B) by the 12-month follow-up survey. Discussion Our interventions are designed to shift the paradigm by which individuals with P/LP variants in inherited cancer genes are provided with information to enhance FC of genetic test results and engagement with guideline-based CRM. The information gathered through evaluating the effectiveness and implementation of these real-world approaches is needed to modify and scale up adaptive, stepped interventions that have the potential to maximize FC and CRM. Trial registration This study is registered at Clinicaltrials.gov (NCT04763915, date registered: February 21, 2021). Protocol version September 17th, 2021 Amendment Number 04.
    Type of Medium: Online Resource
    ISSN: 1471-2407
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041352-X
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  • 7
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2020
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 29, No. 6_Supplement_2 ( 2020-06-01), p. C075-C075
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 29, No. 6_Supplement_2 ( 2020-06-01), p. C075-C075
    Abstract: Although non-Hispanic White and non-Hispanic Black women have similar breast cancer incidence rates, Black women are more likely to be diagnosed with aggressive or late-stage disease and have higher mortality rates compared to White women. Clinical studies have demonstrated that tumors lacking estrogen receptor (ER), progesterone receptor (PR) and/or human epidermal growth factor receptor 2 (HER2) (referred to as “triple negative breast cancers” or TNBC), are associated with an aggressive pathology and poor prognosis and distinct risk factor profiles, compared to those with receptor positivity. Through the current study, we examined the effect of obesity in the development of breast cancer subtypes; specifically, ER- tumors and TNBC. To examine the association between body mass index (BMI) and breast cancer subtype, we utilized a pooled dataset of Black women with breast cancer from four studies: Black Women Etiology and Survival of Triple-negative Breast Cancers Study, Southern Community Cohort Study, Nashville Breast Health Study and the Tri-State Breast Study. For all four studies, information on tumor ER, PR and HER2 status was abstracted from state cancer registry records and supplemented by available pathology reports and medical records. We calculated BMI as kg/m2, based on self-reported weight and height, and classified it as normal (18.5- & lt;25), overweight (25- & lt;30), obese I (30- & lt;35), obese II (35- & lt;40) and obese III (40+). Case-only logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between obesity and breast cancer subtype, using ER+ as the reference group for ER- and TNBC. Since the association between obesity and breast cancer has been shown to differ between pre- and postmenopausal women, all analyses were stratified by menopausal status at breast cancer diagnosis. Approximately 70% of the 2,801 women included in the study were postmenopausal at breast cancer diagnosis. Overall, 69% of the tumors were ER+, with similar proportions among pre- and post-menopausal women. In total, 25% were TNBC, of which a third were among pre-menopausal patients. In multivariable analyses, using premenopausal women with ER+ breast cancer as the reference group, those with ER- breast cancer (OR 2.16, 95% CI 1.20-3.88) or TNBC (OR 2.13, 95% CI 1.06-4.28) were more likely to be in the obese II category. Among postmenopausal women, there was no clear association between obesity and breast cancer subtype, although the obese class I category was non-significantly associated with lower risk of TNBC compared to ER+ subtype (OR 0.79, 95% CI 0.53-1.17). Our study represents one of the largest studies to assess the differential impact of obesity on breast cancer subtypes among Black women. Our findings suggest that higher BMI is associated with increased risk of TNBC for premenopausal women and demonstrates that premenopausal obese Black women are more likely to be diagnosed with ER- and TNBC compared with ER+ tumors. Citation Format: Jaleesa Moore, Maureen Sanderson, Tuya Pal, Mary Kay Fadden, Steffie-Ann Dujon, Sonya Reid, Anne Tezak, Loren Lipworth. Association of obesity with breast cancer subtypes among non-Hispanic Black women [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C075.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
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    detail.hit.zdb_id: 1153420-5
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  • 8
    Online Resource
    Online Resource
    Elsevier BV ; 2022
    In:  Genetics in Medicine Vol. 24, No. 3 ( 2022-03), p. S195-
    In: Genetics in Medicine, Elsevier BV, Vol. 24, No. 3 ( 2022-03), p. S195-
    Type of Medium: Online Resource
    ISSN: 1098-3600
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2063504-7
    SSG: 12
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  • 9
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 15_suppl ( 2017-05-20), p. e13090-e13090
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e13090-e13090
    Abstract: e13090 Background: Young black women bear a disproportionate burden of breast cancer (BC), yet there is limited characterization of these cancers based on BRCA1 and BRCA2 ( BRCA) status and tumor genomics. In this pilot study, we characterized: tumor and clinical characteristics based on BRCA carrier status and overlap of basal-like (BL) and triple negative (TN) BC. Methods: A population-based sample of 481 black women diagnosed with invasive BC 〈 age 50 were recruited through the Florida Cancer Registry (FCR). BRCA status was determined based on germline testing. TN status was determined based on pathology reports and FCR data. Among a subset of 90 participants, gene expression profiling (GEP) was conducted on tumor samples through PAM50 analyses to classify intrinsic subtypes and risk of recurrence (ROR) scores. Results: Mean age at BC diagnosis was 41.9 (range: 25-50) and mean ROR score was 49.6 (range: 8.7-80.7). Participants included 7 BRCA1 carriers, 5 BRCA2 carriers, 67 non-carriers (NC), and 11 with no confirmed testing. Of 46 BL tumors, 33 were TN (71.7%) constituting 94.3% of TN tumors (the remaining 5.7% were Luminal A). All BRCA1 carriers had BL tumors, of which 5 were TN. Sensitivity, positive predictive value, and negative predictive value in identifying BRCA1 carrier was higher based on BL compared to TN status (Table 1). BRCA2-associated tumors included 3 Luminal A, 1 Luminal B, and 1 BL. Mean ROR score was highest among BRCA1 carriers (57.7), followed by NC (50.5) and BRCA2 carriers (41.5). Conclusions: Study findings suggest BL status predicted BRCA1 positivity better than TN status. BRCA2- (compared to BRCA1-) associated tumors were more heterogeneous with over half being Luminal A, which may explain the lower ROR among BRCA2 carriers. Additional follow-up and expansion of this cohort with collection of clinical outcomes will be useful in assessing the predictive utility of ROR scores among young black women with BC. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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  • 10
    In: PEC Innovation, Elsevier BV, Vol. 2 ( 2023-12), p. 100133-
    Type of Medium: Online Resource
    ISSN: 2772-6282
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 3108512-X
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