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Grant Details

Grant Number: 5R01CA204819-05 Interpret this number
Primary Investigator: Pal, Tuya
Organization: Vanderbilt University Medical Center
Project Title: Breast Cancer in Blacks: Impact of Genomics, Healthcare Use and Lifestyle on Outcomes (BRIGHT)
Fiscal Year: 2021


Abstract Young Black women bear a disproportionate burden of breast cancer (BC) mortality compared to Whites and are underrepresented in clinical studies. It remains critical to understand factors that contribute to the high mortality from BC among young Black women in order to improve outcomes. The higher BC mortality rate among young Blacks with BC is partly attributed to the disproportionately higher proportions who develop the aggressive triple-negative (TN) BC subtype. In addition to biologic factors, timely access to care, and lifestyle factors contribute to this disparity. Consequently, it has become imperative to look in detail within the Black population to evaluate the interplay between biologic and non-biologic contributors to existing disparities, and to better characterize the highly aggressive TNBC among young Black women based on distinct molecular subtypes. Ultimately, it is critical to assess both biologic and non-biologic factors in order to fully understand and address existing health disparities in young Black women. Through leveraging a prior population-based study of 460 young Black women with invasive BC in 2009-2012 (and recruitment of a representative sample of an additional 200 women diagnosed in 2013-2014), we plan to: 1) assess the contribution of biologic and non-biologic factors on high mortality rates observed among young Black women with BC and generate a risk score, to help identify those at risk for poorer outcomes, and 2) investigate molecular features of the subgroup with TNBC. We hypothesize that biologic (including tumor gene expression profiling) and non-biologic factors contribute to existing disparities in BC survival among young Black women. Furthermore, we hypothesize that Blacks have a higher proportion of aggressive subtype of TNBC. To our knowledge, this is among the largest population-based cohorts of young Black women with breast cancer. Ultimately, our study presents a unique opportunity to quantify biological and non-biological factors associated with BC-specific survival, and further characterize TNBC among Black women. Given that prior interventions have too narrowly focused on the patient as the agent of change without meaningfully impacting the BC mortality disparity, it is important to consider patient, provider and system level approaches concurrently to drive system change and close the mortality gap.


Germline Pathogenic Variants in Cancer Predisposition Genes Among Women With Invasive Lobular Carcinoma of the Breast.
Authors: Yadav S. , Hu C. , Nathanson K.L. , Weitzel J.N. , Goldgar D.E. , Kraft P. , Gnanaolivu R.D. , Na J. , Huang H. , Boddicker N.J. , et al. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021-12-10; 39(35), p. 3918-3926.
EPub date: 2021-10-21.
PMID: 34672684
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Risk of Breast Cancer Among Carriers of Pathogenic Variants in Breast Cancer Predisposition Genes Varies by Polygenic Risk Score.
Authors: Gao C. , Polley E.C. , Hart S.N. , Huang H. , Hu C. , Gnanaolivu R. , Lilyquist J. , Boddicker N.J. , Na J. , Ambrosone C.B. , et al. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021-08-10; 39(23), p. 2564-2573.
EPub date: 2021-06-08.
PMID: 34101481
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A Pooled Case-only Analysis of Reproductive Risk Factors and Breast Cancer Subtype Among Black Women in the Southeastern United States.
Authors: Sanderson M. , Pal T. , Beeghly-Fadiel A. , Fadden M.K. , Dujon S.A. , Clinton C. , Jimenez C. , Davis J. , Fortune M. , Thompson J. , et al. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2021 Jul; 30(7), p. 1416-1423.
EPub date: 2021-05-04.
PMID: 33947654
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Authors: Hu C. , Hart S.N. , Gnanaolivu R. , Huang H. , Lee K.Y. , Na J. , Gao C. , Lilyquist J. , Yadav S. , Boddicker N.J. , et al. .
Source: The New England journal of medicine, 2021-02-04; 384(5), p. 440-451.
EPub date: 2021-01-20.
PMID: 33471974
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Contribution of Germline Predisposition Gene Mutations to Breast Cancer Risk in African American Women.
Authors: Palmer J.R. , Polley E.C. , Hu C. , John E.M. , Haiman C. , Hart S.N. , Gaudet M. , Pal T. , Anton-Culver H. , Trentham-Dietz A. , et al. .
Source: Journal of the National Cancer Institute, 2020-12-14; 112(12), p. 1213-1221.
PMID: 32427313
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Disparities in Genetic Testing and Care among Black women with Hereditary Breast Cancer.
Authors: Reid S. , Cadiz S. , Pal T. .
Source: Current breast cancer reports, 2020 Sep; 12(3), p. 125-131.
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Source: Genetics in medicine : official journal of the American College of Medical Genetics, 2020 Jun; 22(6), p. 1088-1093.
EPub date: 2020-02-18.
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