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Grant Details

Grant Number: 5R01CA105274-10 Interpret this number
Primary Investigator: Kushi, Lawrence
Organization: Kaiser Foundation Research Institute
Project Title: Prospective Study of Breast Cancer Survivorship
Fiscal Year: 2013
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Abstract

DESCRIPTION (provided by applicant): This is a competing continuation application to continue a prospective cohort study of breast cancer prognosis, the Pathways Study. The Pathways Study is an ongoing study that is currently enrolling and following women who are newly-diagnosed with breast cancer, and takes its name from the idea that each woman diagnosed with breast cancer follows her own path. This cohort study was begun in part because little is known regarding whether lifestyle factors such as diet, physical activity, or use of complementary and alternative therapies may influence breast cancer prognosis. This is despite the substantial interest in this area among women with breast cancer, their families, and their health care providers. An additional focus was on the role of molecular markers, including genetic factors and epigenetic modification of tumor DNAs, on breast cancer prognosis. These continue to be a major focus of this research program. With the recognition that disparities in prognosis by race may be influenced in part by these factors, this application requests continuation of enrollment of women diagnosed with breast cancer into this cohort, with an emphasis on enrollment of minority participants. By the end of the fourth year of this proposed continuation, enrollment is projected to include about 550 African American women, and over 750 Asian and 700 Hispanic women, out of a cohort of over 4,300 women. Overall, about 40% of the cohort will consist of women from non-white populations. It is anticipated that over 900 deaths and 360 recurrences will occur in the Pathways Study cohort through four additional years of follow-up. In addition to following this cohort, objectives of this application are to: 1) Investigate associations of diet, physical activity, and use of complementary and alternative therapies with breast cancer recurrence and survival; 2) Examine the impact of social and built environment on prognosis, lifestyle factors, and their relationship; 3) Continue studies of methylation profiles of tumor DNAs; and 4) conduct nested case-control studies in two areas that may provide insight into racial differences in prognosis, namely the role of inflammatory and immune factors, and of vitamin D levels. The Pathways Study involves a multi-disciplinary, multi-institutional team of investigators, with a biorepository and molecular studies at Roswell Park Cancer Institute, DNA methylation studies at UCSF, and, newly proposed in this application, linkage to contextual-level databases at the Northern California Cancer Center, and continued involvement of community investigators at Zero Breast Cancer, and clinicians at KPNC. With data from interviews and questionnaires, blood samples from 89% of study participants, saliva as a source of DNA from 95%, availability of tumor blocks and clinical data from KPNC resources and databases, and the addition of contextual-level data, the Pathways Study will be a major resource for the epidemiologic investigation of breast cancer prognosis.

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Publications

Changes in vitamin and mineral supplement use after breast cancer diagnosis in the Pathways Study: a prospective cohort study.
Authors: Greenlee H, Kwan ML, Ergas IJ, Strizich G, Roh JM, Wilson AT, Lee M, Sherman KJ, Ambrosone CB, Hershman DL, Neugut AI, Kushi LH
Source: BMC Cancer, 2014 May 29;14, p. 382.
EPub date: 2014 May 29.
PMID: 24884705
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Race and breast cancer survival by intrinsic subtype based on PAM50 gene expression.
Authors: Kroenke CH, Sweeney C, Kwan ML, Quesenberry CP, Weltzien EK, Habel LA, Castillo A, Bernard PS, Factor RE, Kushi LH, Caan BJ
Source: Breast Cancer Res Treat, 2014 Apr;144(3), p. 689-99.
EPub date: 2014 Mar 7.
PMID: 24604094
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Intrinsic subtypes from the PAM50 gene expression assay in a population-based breast cancer survivor cohort: prognostication of short- and long-term outcomes.
Authors: Caan BJ, Sweeney C, Habel LA, Kwan ML, Kroenke CH, Weltzien EK, Quesenberry CP Jr, Castillo A, Factor RE, Kushi LH, Bernard PS
Source: Cancer Epidemiol Biomarkers Prev, 2014 May;23(5), p. 725-34.
EPub date: 2014 Feb 12.
PMID: 24521998
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Intrinsic subtypes from PAM50 gene expression assay in a population-based breast cancer cohort: differences by age, race, and tumor characteristics.
Authors: Sweeney C, Bernard PS, Factor RE, Kwan ML, Habel LA, Quesenberry CP Jr, Shakespear K, Weltzien EK, Stijleman IJ, Davis CA, Ebbert MT, Castillo A, Kushi LH, Caan BJ
Source: Cancer Epidemiol Biomarkers Prev, 2014 May;23(5), p. 714-24.
EPub date: 2014 Feb 12.
PMID: 24521995
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Patient-physician interaction and quality of life in recently diagnosed breast cancer patients.
Authors: Kwan ML, Tam EK, Ergas IJ, Rehkopf DH, Roh JM, Lee MM, Somkin CP, Stewart AL, Kushi LH
Source: Breast Cancer Res Treat, 2013 Jun;139(2), p. 581-95.
EPub date: 2013 May 29.
PMID: 23715629
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Social networks, social support mechanisms, and quality of life after breast cancer diagnosis.
Authors: Kroenke CH, Kwan ML, Neugut AI, Ergas IJ, Wright JD, Caan BJ, Hershman D, Kushi LH
Source: Breast Cancer Res Treat, 2013 Jun;139(2), p. 515-27.
EPub date: 2013 May 9.
PMID: 23657404
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Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: the BQUAL study.
Authors: Vin-Raviv N, Hillyer GC, Hershman DL, Galea S, Leoce N, Bovbjerg DH, Kushi LH, Kroenke C, Lamerato L, Ambrosone CB, Valdimorsdottir H, Jandorf L, Mandelblatt JS, Tsai WY, Neugut AI
Source: J Natl Cancer Inst, 2013 Apr 17;105(8), p. 563-72.
EPub date: 2013 Feb 21.
PMID: 23434900
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Interpersonal influences and attitudes about adjuvant therapy treatment decisions among non-metastatic breast cancer patients: an examination of differences by age and race/ethnicity in the BQUAL study.
Authors: Shelton RC, Clarke Hillyer G, Hershman DL, Leoce N, Bovbjerg DH, Mandelblatt JS, Kushi LH, Lamerato L, Nathanson SD, Ambrosone CB, Neugut AI
Source: Breast Cancer Res Treat, 2013 Feb;137(3), p. 817-28.
EPub date: 2012 Dec 22.
PMID: 23263696
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Patterns and predictors of breast cancer chemotherapy use in Kaiser Permanente Northern California, 2004-2007.
Authors: Kurian AW, Lichtensztajn DY, Keegan TH, Leung RW, Shema SJ, Hershman DL, Kushi LH, Habel LA, Kolevska T, Caan BJ, Gomez SL
Source: Breast Cancer Res Treat, 2013 Jan;137(1), p. 247-60.
EPub date: 2012 Nov 9.
PMID: 23139057
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A survey of breast cancer physicians regarding patient involvement in breast cancer treatment decisions.
Authors: Hillyer GC, Hershman DL, Kushi LH, Lamerato L, Ambrosone CB, Bovbjerg DH, Mandelblatt JS, Rana S, Neugut AI
Source: Breast, 2013 Aug;22(4), p. 548-54.
EPub date: 2012 Oct 27.
PMID: 23107518
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Noninitiation of adjuvant chemotherapy in women with localized breast cancer: the breast cancer quality of care study.
Authors: Neugut AI, Hillyer GC, Kushi LH, Lamerato L, Leoce N, Nathanson SD, Ambrosone CB, Bovbjerg DH, Mandelblatt JS, Magai C, Tsai WY, Jacobson JS, Hershman DL
Source: J Clin Oncol, 2012 Nov 1;30(31), p. 3800-9.
EPub date: 2012 Sep 24.
PMID: 23008305
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Employment status and quality of life in recently diagnosed breast cancer survivors.
Authors: Timperi AW, Ergas IJ, Rehkopf DH, Roh JM, Kwan ML, Kushi LH
Source: Psychooncology, 2013 Jun;22(6), p. 1411-20.
EPub date: 2012 Aug 22.
PMID: 22912069
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Non-initiation of adjuvant hormonal therapy in women with hormone receptor-positive breast cancer: The Breast Cancer Quality of Care Study (BQUAL).
Authors: Neugut AI, Hillyer GC, Kushi LH, Lamerato L, Leoce N, Nathanson SD, Ambrosone CB, Bovbjerg DH, Mandelblatt JS, Magai C, Tsai WY, Jacobson JS, Hershman DL
Source: Breast Cancer Res Treat, 2012 Jul;134(1), p. 419-28.
EPub date: 2012 Apr 22.
PMID: 22527111
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The Breast Cancer Quality of Care Study (BQUAL): a multi-center study to determine causes for noncompliance with breast cancer adjuvant therapy.
Authors: Neugut AI, Hillyer GC, Kushi LH, Lamerato L, Nathanson SD, Ambrosone CB, Bovbjerg DH, Mandelblatt JS, Magai C, Tsai WY, Jacobson JS, Hershman DL
Source: Breast J, 2012 May-Jun;18(3), p. 203-13.
EPub date: 2012 Apr 5.
PMID: 22487337
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Change in physical activity during active treatment in a prospective study of breast cancer survivors.
Authors: Kwan ML, Sternfeld B, Ergas IJ, Timperi AW, Roh JM, Hong CC, Quesenberry CP, Kushi LH
Source: Breast Cancer Res Treat, 2012 Jan;131(2), p. 679-90.
EPub date: 2011 Sep 28.
PMID: 21953007
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Racial/ethnic differences in initiation of adjuvant hormonal therapy among women with hormone receptor-positive breast cancer.
Authors: Livaudais JC, Hershman DL, Habel L, Kushi L, Gomez SL, Li CI, Neugut AI, Fehrenbacher L, Thompson B, Coronado GD
Source: Breast Cancer Res Treat, 2012 Jan;131(2), p. 607-17.
EPub date: 2011 Sep 16.
PMID: 21922245
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Parity and lactation in relation to estrogen receptor negative breast cancer in African American women.
Authors: Palmer JR, Boggs DA, Wise LA, Ambrosone CB, Adams-Campbell LL, Rosenberg L
Source: Cancer Epidemiol Biomarkers Prev, 2011 Sep;20(9), p. 1883-91.
EPub date: 2011 Aug 16.
PMID: 21846820
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Associations of physical activity with quality of life and functional ability in breast cancer patients during active adjuvant treatment: the Pathways Study.
Authors: Mandelblatt JS, Luta G, Kwan ML, Makgoeng SB, Ergas IJ, Roh JM, Sternfeld B, Adams-Campbell LL, Kushi LH
Source: Breast Cancer Res Treat, 2011 Sep;129(2), p. 521-9.
EPub date: 2011 Apr 8.
PMID: 21476003
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Risk factors for lymphedema in a prospective breast cancer survivorship study: the Pathways Study.
Authors: Kwan ML, Darbinian J, Schmitz KH, Citron R, Partee P, Kutner SE, Kushi LH
Source: Arch Surg, 2010 Nov;145(11), p. 1055-63.
PMID: 21079093
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A practical method for collecting food record data in a prospective cohort study of breast cancer survivors.
Authors: Kwan ML, Kushi LH, Song J, Timperi AW, Boynton AM, Johnson KM, Standley J, Kristal AR
Source: Am J Epidemiol, 2010 Dec 1;172(11), p. 1315-23.
EPub date: 2010 Oct 11.
PMID: 20937633
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Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer.
Authors: Hershman DL, Shao T, Kushi LH, Buono D, Tsai WY, Fehrenbacher L, Kwan M, Gomez SL, Neugut AI
Source: Breast Cancer Res Treat, 2011 Apr;126(2), p. 529-37.
EPub date: 2010 Aug 28.
PMID: 20803066
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Breast cancer DNA methylation profiles are associated with tumor size and alcohol and folate intake.
Authors: Christensen BC, Kelsey KT, Zheng S, Houseman EA, Marsit CJ, Wrensch MR, Wiemels JL, Nelson HH, Karagas MR, Kushi LH, Kwan ML, Wiencke JK
Source: PLoS Genet, 2010 Jul 29;6(7), p. e1001043.
EPub date: 2010 Jul 29.
PMID: 20686660
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Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8,769 early-stage breast cancer patients.
Authors: Hershman DL, Kushi LH, Shao T, Buono D, Kershenbaum A, Tsai WY, Fehrenbacher L, Gomez SL, Miles S, Neugut AI
Source: J Clin Oncol, 2010 Sep 20;28(27), p. 4120-8.
EPub date: 2010 Jun 28.
PMID: 20585090
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Quality of life among women recently diagnosed with invasive breast cancer: the Pathways Study.
Authors: Kwan ML, Ergas IJ, Somkin CP, Quesenberry CP Jr, Neugut AI, Hershman DL, Mandelblatt J, Pelayo MP, Timperi AW, Miles SQ, Kushi LH
Source: Breast Cancer Res Treat, 2010 Sep;123(2), p. 507-24.
EPub date: 2010 Feb 6.
PMID: 20140494
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Differentiation of lung adenocarcinoma, pleural mesothelioma, and nonmalignant pulmonary tissues using DNA methylation profiles.
Authors: Christensen BC, Marsit CJ, Houseman EA, Godleski JJ, Longacker JL, Zheng S, Yeh RF, Wrensch MR, Wiemels JL, Karagas MR, Bueno R, Sugarbaker DJ, Nelson HH, Wiencke JK, Kelsey KT
Source: Cancer Res, 2009 Aug 1;69(15), p. 6315-21.
EPub date: 2009 Jul 28.
PMID: 19638575
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Epidemiology of breast cancer subtypes in two prospective cohort studies of breast cancer survivors.
Authors: Kwan ML, Kushi LH, Weltzien E, Maring B, Kutner SE, Fulton RS, Lee MM, Ambrosone CB, Caan BJ
Source: Breast Cancer Res, 2009;11(3), p. R31.
EPub date: 2009 May 22.
PMID: 19463150
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Complementary and alternative therapy use before and after breast cancer diagnosis: the Pathways Study.
Authors: Greenlee H, Kwan ML, Ergas IJ, Sherman KJ, Krathwohl SE, Bonnell C, Lee MM, Kushi LH
Source: Breast Cancer Res Treat, 2009 Oct;117(3), p. 653-65.
EPub date: 2009 Jan 31.
PMID: 19184414
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The Pathways Study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California.
Authors: Kwan ML, Ambrosone CB, Lee MM, Barlow J, Krathwohl SE, Ergas IJ, Ashley CH, Bittner JR, Darbinian J, Stronach K, Caan BJ, Davis W, Kutner SE, Quesenberry CP, Somkin CP, Sternfeld B, Wiencke JK, Zheng S, Kushi LH
Source: Cancer Causes Control, 2008 Dec;19(10), p. 1065-76.
EPub date: 2008 May 14.
PMID: 18478338
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Lifestyle factors and survival in women with breast cancer.
Authors: Kushi LH, Kwan ML, Lee MM, Ambrosone CB
Source: J Nutr, 2007 Jan;137(1 Suppl), p. 236S-242S.
PMID: 17182833
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