Breast Cancer Prognostic Factors/Pathobiology

Kathleen E. Malone, Ph.D.
Fred Hutchinson Cancer Research Center
Cancer Epidemiology Research Group
Seattle, Wash.
Funded since 2004

Breast cancer mortality is the second leading cause of cancer death in women. In spite of improvements in stage and advances in treatment, mortality from breast cancer continues to be substantial, and there exists a paucity of insights regarding factors that influence disease progression and mortality. In particular, little is known about how patient and tumor characteristics relate to mortality in middle- and older-aged women.

The investigators are conducting a population-based, molecular-epidemiologic cohort study of factors that predict mortality in women diagnosed with invasive breast cancer at ages 45 through 79. The overall goal is to evaluate patient and tumor characteristics for their relationship with risk of breast cancer mortality.

The cohort consists of 2,337 women diagnosed with a first invasive breast cancer at ages 45-79 during 1993-1999, all of whom previously completed an extensive interview regarding exposures prior to diagnosis and will now be followed for mortality. Telephone interviews and medical record reviews will be used to collect information on exposures after diagnosis, disease recurrences, and treatment details. Tumor characteristics and markers will be assessed in relation to both mortality and patient factors as a basis for understanding determinants of prognosis.

The aims are to:

• determine if patient characteristics and exposures (before and after diagnosis), including some which are potentially modifiable, are related to the risk of dying from breast cancer;
• determine if patient characteristics and exposures prior to diagnosis are associated with histopathologic features and tumor markers;
• assess the relationship of histopathologic factors and tumor markers, including both well-characterized prognostic markers and less well-characterized cell cycle proteins, with the risk of dying from breast cancer;
• build tissue microarrays that will allow rapid assessment of future markers as they are identified; and
• build a comprehensive resource for future ancillary studies.

The investigation of tumor and patient characteristics in relation to mortality could provide etiologic and clinical insights on determinants of prognosis, and help to generate clues on the biology of breast cancer progression.