From the Desk of Catherine Thomsen, Program Director.
As 2017 comes to a close, I want to reflect on some of the things that I’ve learned this year. Perhaps the most obvious thing is that despite years of effort, it is still not possible to determine whether you personally are at higher or lower risk of breast cancer (genetic testing is useful but limited, accounting for 10% of risk at most), so at ZBC we encourage you to focus on healthy changes that reduce risk for all.
From 2002-2105, ZBC was involved with the Breast Cancer and the Environment Research Program (BCERP) looking at why girls are experiencing earlier puberty (a breast cancer risk factor.) At the November BCERP Annual Meeting in Southern California, we networked with the new grantees and learned about the work of a consortium focusing on even better ways of translating research into useful and effective actions. ZBC is planning on joining this group in 2018 to better serve you.
Also at the BCERP Annual Meeting was our very own Dipsea Hike team leader & participant Polly Marshall of Breast Cancer Over Time. Polly spoke very passionately about preventing breast cancer in our daughters and the value of community participatory research into personal care products and their impact on healthy human breast cells. Finally you would have been so inspired, as were we, by some amazing students and post-docs working with youth; we are excited to collaborate with them on our teen programs.
From the National Institute for Environmental Health Sciences’ Sister Study, we learned that wood or natural gas burning indoors (for cooking and heating) was associated with a moderate increase in breast cancer risk. The study also found a link between vitamin D supplementation and lower risk for post-menopausal breast cancer and more evidence that physical activity in girls 5-19 years old decreases risk of breast cancer later in life. Another study found an association between an inflammatory diet during puberty and premenopausal breast cancer risk.
At the San Antonio Breast Cancer Symposium (SABCS), the Alamo Breast Cancer Foundation hosts an excellent set of programs for patient advocates, complementing the clinical and basic biology sessions. The 2017 efforts to increase patient engagement were evident, particularly from the Food and Drug Administration (FDA.) Genetic risks were a hot topic, including the relevance of family history and BRCA mutation location (Kuchenbaecker, JAMA 2017) and how risk can change as genes are turned on or off over time and across generations (epigenetics.)
Other SABCS sessions addressed why African-American women have worse outcomes of breast cancer, including mortality. Dr. Katherine Reeder-Hayes reported that biology accounts for about 60% of the difference, leaving an unacceptable 40% attributable to lack of adequate health services. Her research to improve the health care and treatment is vital. ZBC believes that with individual and community-level interventions, it should be possible to reduce the biological part of that difference as well.
Dr. Amelie Ramirez presented data and introduced “A Patient Navigation Manual for Latino Audiences: The Redes En Acción Experience” at the SABCS. Our collaborative Breast Cancer Survivorship Navigation Project (with our excellent partners from clinical and social service organizations across the San Francisco Bay Area) is looking at that peer model as we explore ways to improve the transition out of breast cancer care for under-served women.
Perhaps most of all this year, I’ve learned that we have much work left to do and that I am thankful to be in this field with so many wonderful, passionate people.
My very best wishes for 2018,