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Breast Cancer Molecular Etiology

Unraveling the Molecular Etiology of Aggressive vs. Favorable Screening-Detected Breast Cancers via a Novel Linkage between SEER-Medicare Data and Physical Tumor Specimens

Socioeconomic and racial disparities in breast cancer have been reported extensively, with risk factors associated with adverse outcomes including race, ethnicity, education, and access to healthcare. Two dominant and related drivers of disparities in breast cancer outcomes are stage at presentation and whether or not a cancer was detected by screening mammography. Breast cancers presenting due to symptoms or with more advanced stage are associated with far worse outcomes. The ability to understand potential underlying drivers of disparities in outcomes are hindered by the fact that existing databases of breast tumors do not distinguish the method of diagnosis of these tumors. Without the context of detection, it is impossible to distinguish biologically aggressive tumors from those that have been merely neglected. In order to understand the underlying etiologies driving breast cancer disparities, there is a critical need to revisit the genomic progression and etiology of breast cancer within the context of real-world, population-based screening detection. We hope to provide unique insights into the underlying molecular etiologies of aggressive breast cancers that present with more advanced stage and have poor outcomes despite routine screening, as well as identify whether there are etiologies associated with aggressive breast cancers that are more prevalent in patients within lower SES neighborhoods.

Funding source: Yale Cancer Center

Principal Investigator: Michaela Dinan