# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Alan Ashworth to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Alan Ashworth to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Alan Ashworth to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Alan Ashworth to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: I thought about a career in medicine, but after studying chemistry, I became very, very interested in understanding basic mechanisms of biology. I became a research scientist and got my own lab when I was very young, at age 27. I was so naïve; I didn't think there was anything particularly unusual about it!

I wasn't focused on breast cancer until a friend of mine in the U.K., Mike Stratton, asked if I could help him with a project. Basically, he needed more hands on a search for a high-risk gene in breast cancer. This was in late 1994. At that point, BRCA-1 had already been discovered, and together we found BRCA-2 by the end of that year. Things were happening so fast, we found the gene and it was published three weeks later! This was thrilling, but what happened next was even more of a revelation: within days of discovery of the gene, a woman was tested for it at Royal Marsden hospital in London. She had already been scheduled for a prophylactic mastectomy because of breast cancer in her family, but because she could be tested which revealed that she didn't have the gene, she didn't have the surgery. New knowledge steered her and her doctor in decision-making. I then became much more interested in applying basic biology to breast cancer research.

Q: You are known for your important discovery that drugs called PARP inhibitors could be used to treat BRCA-1 and BRCA-2 - related cancers. How did this come about?

A: All cell types sustain DNA damage in their lifespan and need to fix it in order to keep dividing and keep the cell type going. Cancer cells are no different. As with most cells, there are multiple pathways the cancer relies upon for this repair. PARP is one of these pathways.

Not long after our discovery, I had one of those coincidental encounters that change your life: I met someone who wanted to talk to me about some drugs - and by that I mean drugs that his company was developing! They were PARP Inhibitors from a company called Kudos, which is now part of AstraZeneca. Since our lab studies the BRCA-1 and BRCA-2 breast cancer cells, we put the experimental drug on them. What we found was astonishing. The BRCA cells were one thousand times more vulnerable to these drugs than normal cells! They couldn't survive. Their high sensitivity means that the drug could be very effective. The BRCA cells have a different liability than normal cells and PARP Inhibitors target that liability.

Q: What makes the BRCA1 and BRCA2 cells different?

A: BRCA1 and BRCA2 have a mutation that turns them into cancer cells. But because of this difference, they also have one DNA repair pathway that is compromised. Treating the tumor with a PARP Inhibitor blocks the BRCA cells' secondary DNA repair pathway. This second level of failure is more than the BRCA cells can handle, and provokes cell death. This is a win for breast cancer treatment because it shrinks the tumor dramatically. PARP Inhibitors take advantage of the tumor's known liability.

Q: Will PARP Inhibitors work in other kinds of breast cancer?

A: Yes, they should and we've seen evidence suggesting this is the case. In other breast cancers, there are likely faulty DNA repair mechanisms that PARP Inhibitors will exploit. We just happen to know that this is the case with BRCA1 and BRCA2 cancers.

There are also ways to provoke faulty DNA repair and other kinds of challenges in tumor cells. This is what happens with chemotherapy, and we are studying whether or not adding PARP Inhibitors to chemotherapy will exponentially kill cancer cells. Early results are promising.

PARP Inhibitors may change the entire landscape of cancer treatment. For example, 80 percent of uterine cancers, 25 percent of colon cancers and 25 percent of melanomas have mutations to a gene called PTEN that causes DNA repair damage. PARP Inhibitors should be effective wherever there is compromised DNA repair.

PARP Inhibitors will likely be relevant to up to 50 percent of ovarian cancers. Ovarian cancers are known to be sensitive to platinum drugs. Platinum, a metal found in existing therapies like cisplatin and carboplatin, works like a "dirty" PARP Inhibitor. So, PARP Inhibitors may do the same job, only better.

Q: Do PARP Inhibitors have any side effects?

A: So far, they are relatively non-toxic compared to chemotherapy. It is too soon to know the long-term effects, if there are any. The patients in Phase I clinical trials--with us, and with other groups--are essentially incurable. PARP Inhibitors are helping these patients extend their survival. Right now we are looking at PARP Inhibitors in a relatively small fraction of breast cancer patients, and possibly a larger fraction of ovarian cancer. Our priority is to figure out how to use this new drug successfully in a larger group of patients, and earlier in the disease to achieve a cure.

Q: How will you accomplish this?

A: This is where BCRF is indispensable. Whenever there is a new drug that is effective and safe, even in part of a cancer population, it quickly becomes a standard and some opportunities to refine its use are slowed or lost. PARP Inhibitors are so dramatic in what they do that they should be used to aid as many breast and other cancers as possible. Part of this will rest on figuring out which sensitizing drugs to pair them with. We are already conducting quite a few obvious and important clinical trials with PARP Inhibitors, but want to design the next wave of clinical trials based on real data about which drugs and what dosages will be the most reliable with PARP Inhibitors.

To this end, we are conducting a massive screening of all possible combinations of drugs with PARP Inhibitors. We are looking at thousands of drugs and many more thousands of combinations. It would take many years of human labor to get this data, but with a robotic system that we are using, we hope to get it within months. Without BCRF funding, this step would not be possible. BCRF has given us the ability to fast track something really important.

Q: Are PARP Inhibitors going to cure breast cancer?

A: We don't know, but with this kind of discovery, I think we're getting closer. You see, we already have the means to generate all the answers we need. Think of the mapping power of the human genome project applied to thousands of tumors, giving us all the genetic information for hundreds of different kinds of cancer. This is where we're going. If we can manage the huge amount of data that we are generating for ourselves, we'll continue to make significant progress. But this is no small task.

Q: What's stopping us from just getting all the work done?

A: If you take an average tumor, be it breast or colon cancer, there are about 20,000 genetic changes in that tumor's DNA compared to normal DNA. Much of those changes is noise; perhaps in all 20,000, only 20 or 50 are functionally needed for the tumor. This is the challenge. We need better ways of identifying these "mission-critical" changes, so that we can focus our attention where it will be the most effective.

Q: What advice would you give to young researchers?

A: First take on an important problem. Then, if you are interested in a disease like breast cancer try to understand the biology of the whole disease as well as focusing on a small aspect. Finally, think very hard about data analysis. Now, in science, there are a lot fewer people doing the experiments and a lot more people analyzing data because there are great tools for generating data, and so much of it. As a researcher in biology today, you absolutely have to have a very strong grounding in mathematical methods in order to concentrate on choosing the clever experiments and the clever ways to manage and interpret data.

Q: Did you ever seriously consider another kind of career than that of the sciences?

A: No, since I started studying the basics of how molecules work and applying it to treating disease, I have never thought of doing anything else. I love my job!

Read more about Dr. Ashworth's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Alan Ashworth to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: I thought about a career in medicine, but after studying chemistry, I became very, very interested in understanding basic mechanisms of biology. I became a research scientist and got my own lab when I was very young, at age 27. I was so naïve; I didn't think there was anything particularly unusual about it!

I wasn't focused on breast cancer until a friend of mine in the U.K., Mike Stratton, asked if I could help him with a project. Basically, he needed more hands on a search for a high-risk gene in breast cancer. This was in late 1994. At that point, BRCA-1 had already been discovered, and together we found BRCA-2 by the end of that year. Things were happening so fast, we found the gene and it was published three weeks later! This was thrilling, but what happened next was even more of a revelation: within days of discovery of the gene, a woman was tested for it at Royal Marsden hospital in London. She had already been scheduled for a prophylactic mastectomy because of breast cancer in her family, but because she could be tested which revealed that she didn't have the gene, she didn't have the surgery. New knowledge steered her and her doctor in decision-making. I then became much more interested in applying basic biology to breast cancer research.

Q: You are known for your important discovery that drugs called PARP inhibitors could be used to treat BRCA-1 and BRCA-2 - related cancers. How did this come about?

A: All cell types sustain DNA damage in their lifespan and need to fix it in order to keep dividing and keep the cell type going. Cancer cells are no different. As with most cells, there are multiple pathways the cancer relies upon for this repair. PARP is one of these pathways.

Not long after our discovery, I had one of those coincidental encounters that change your life: I met someone who wanted to talk to me about some drugs - and by that I mean drugs that his company was developing! They were PARP Inhibitors from a company called Kudos, which is now part of AstraZeneca. Since our lab studies the BRCA-1 and BRCA-2 breast cancer cells, we put the experimental drug on them. What we found was astonishing. The BRCA cells were one thousand times more vulnerable to these drugs than normal cells! They couldn't survive. Their high sensitivity means that the drug could be very effective. The BRCA cells have a different liability than normal cells and PARP Inhibitors target that liability.

Q: What makes the BRCA1 and BRCA2 cells different?

A: BRCA1 and BRCA2 have a mutation that turns them into cancer cells. But because of this difference, they also have one DNA repair pathway that is compromised. Treating the tumor with a PARP Inhibitor blocks the BRCA cells' secondary DNA repair pathway. This second level of failure is more than the BRCA cells can handle, and provokes cell death. This is a win for breast cancer treatment because it shrinks the tumor dramatically. PARP Inhibitors take advantage of the tumor's known liability.

Q: Will PARP Inhibitors work in other kinds of breast cancer?

A: Yes, they should and we've seen evidence suggesting this is the case. In other breast cancers, there are likely faulty DNA repair mechanisms that PARP Inhibitors will exploit. We just happen to know that this is the case with BRCA1 and BRCA2 cancers.

There are also ways to provoke faulty DNA repair and other kinds of challenges in tumor cells. This is what happens with chemotherapy, and we are studying whether or not adding PARP Inhibitors to chemotherapy will exponentially kill cancer cells. Early results are promising.

PARP Inhibitors may change the entire landscape of cancer treatment. For example, 80 percent of uterine cancers, 25 percent of colon cancers and 25 percent of melanomas have mutations to a gene called PTEN that causes DNA repair damage. PARP Inhibitors should be effective wherever there is compromised DNA repair.

PARP Inhibitors will likely be relevant to up to 50 percent of ovarian cancers. Ovarian cancers are known to be sensitive to platinum drugs. Platinum, a metal found in existing therapies like cisplatin and carboplatin, works like a "dirty" PARP Inhibitor. So, PARP Inhibitors may do the same job, only better.

Q: Do PARP Inhibitors have any side effects?

A: So far, they are relatively non-toxic compared to chemotherapy. It is too soon to know the long-term effects, if there are any. The patients in Phase I clinical trials--with us, and with other groups--are essentially incurable. PARP Inhibitors are helping these patients extend their survival. Right now we are looking at PARP Inhibitors in a relatively small fraction of breast cancer patients, and possibly a larger fraction of ovarian cancer. Our priority is to figure out how to use this new drug successfully in a larger group of patients, and earlier in the disease to achieve a cure.

Q: How will you accomplish this?

A: This is where BCRF is indispensable. Whenever there is a new drug that is effective and safe, even in part of a cancer population, it quickly becomes a standard and some opportunities to refine its use are slowed or lost. PARP Inhibitors are so dramatic in what they do that they should be used to aid as many breast and other cancers as possible. Part of this will rest on figuring out which sensitizing drugs to pair them with. We are already conducting quite a few obvious and important clinical trials with PARP Inhibitors, but want to design the next wave of clinical trials based on real data about which drugs and what dosages will be the most reliable with PARP Inhibitors.

To this end, we are conducting a massive screening of all possible combinations of drugs with PARP Inhibitors. We are looking at thousands of drugs and many more thousands of combinations. It would take many years of human labor to get this data, but with a robotic system that we are using, we hope to get it within months. Without BCRF funding, this step would not be possible. BCRF has given us the ability to fast track something really important.

Q: Are PARP Inhibitors going to cure breast cancer?

A: We don't know, but with this kind of discovery, I think we're getting closer. You see, we already have the means to generate all the answers we need. Think of the mapping power of the human genome project applied to thousands of tumors, giving us all the genetic information for hundreds of different kinds of cancer. This is where we're going. If we can manage the huge amount of data that we are generating for ourselves, we'll continue to make significant progress. But this is no small task.

Q: What's stopping us from just getting all the work done?

A: If you take an average tumor, be it breast or colon cancer, there are about 20,000 genetic changes in that tumor's DNA compared to normal DNA. Much of those changes is noise; perhaps in all 20,000, only 20 or 50 are functionally needed for the tumor. This is the challenge. We need better ways of identifying these "mission-critical" changes, so that we can focus our attention where it will be the most effective.

Q: What advice would you give to young researchers?

A: First take on an important problem. Then, if you are interested in a disease like breast cancer try to understand the biology of the whole disease as well as focusing on a small aspect. Finally, think very hard about data analysis. Now, in science, there are a lot fewer people doing the experiments and a lot more people analyzing data because there are great tools for generating data, and so much of it. As a researcher in biology today, you absolutely have to have a very strong grounding in mathematical methods in order to concentrate on choosing the clever experiments and the clever ways to manage and interpret data.

Q: Did you ever seriously consider another kind of career than that of the sciences?

A: No, since I started studying the basics of how molecules work and applying it to treating disease, I have never thought of doing anything else. I love my job!

Read more about Dr. Ashworth's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Alan Ashworth to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Lewis C. Cantley to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Lewis C. Cantley to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Lewis C. Cantley to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Lewis C. Cantley to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: My first love was chemistry, so I did my doctorate in Physical Chemistry at Cornell University. But once I started doing research, I realized that all the excitement surrounded biology, because biology is chemistry in action. I went from trying to understand how cells make an energy source called ATP, to how cells regulate the uptake of molecules like glucose or sodium or potassium, which then led me to signaling pathways, and then to cancer research and biology.

In the course of this work, I discovered an enzymatic activity that led to tumor formation in laboratory models. The chemical reaction carried out by this enzyme (called PI3-kinase, or PI3K) had not been found before in nature so this discovery opened up a new field of cancer research. The signaling network controlled by PI3K is complex and akin the complex wiring diagram of your computer or radio. We have been chasing down all the wires (i.e. signaling pathways) going in all directions inside the cell that are controlled by PI3K in order to understand how it causes cancer and how best to intervene with drugs. It turns out that the PI3K signaling network is the most mutated in breast cancers and is commonly mutated in the majority of other cancers. More recently, we began to focus much of our research towards drugs that target PI3K, some of which are now going to clinical trials.

Currently, there are roughly 20 PI3K inhibitors in clinical trials. This has set a record for a drug target where no drug has yet been approved but almost every pharmaceutical company simultaneously has at least one drug in the clinic that targets PI3K. The reason is that PI3K is the most mutated pathway in all cancers. Yet, it is also clear from early studies that this is not going to be simple. So the responses being observed in early-phase clinical trials have everyone very excited, but it is still not clear how to identify the patients who are most likely to respond.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: BCRF is helping us with preclinical studies that predict the biomarkers likely to tell us which patients are going to respond to the novel PI3K inhibitors and how to use these drugs. We are collaborating with two different labs: Gerburg Wulf at Beth Israel Deaconness and Charles Sawyers at Memorial Sloan-Kettering Cancer Center (MSKCC). Dr. Wulf and I are giving drugs to laboratory models that are genetically engineered to have the same mutations that we commonly find in human breast cancer. We are trying to figure out which mutations generate tumors that respond to PI3K inhibitors as single drugs and which require that we combine PI3K inhibitors with other drugs. Dr. Sawyers and I have several grants together, including one on prostate cancer, which is another disease with many mutations in the PI3K pathway. In the case of prostate cancer, the mutations are more frequently in an enzyme called PTEN, which is a braking system to PI3K.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advances can help to enhance your progress?

A: What we are doing today could not possibly have been done ten or even five years ago. First and foremost is our ability to sequence the human genome, which now has become cost-effective enough to identify mutational events that occur in genes and cancer genes in every patient. Decoding the genetic mutations of patients allows us to predict who is likely to benefit or not on standard of care and who should be in what clinical trial. In some cases, drugs that have been approved for other cancers might be appropriate for a patient. This is an example of personalized cancer in a very accurate and detailed way.

Breast cancer has really led the way in personalized therapy. Breast cancers have been divided into subsets (estrogen receptor positive [ER+], HER2+, triple negative) and distinct therapies have been developed for each subset, rather than treating all patients in the same way. This really is the reason why so much progress has been made in this disease. But we need to further divide the disease into additional subsets, and genomic sequencing technology is making that feasible.

Another type of technology that has helped us to tease out which drugs are likely to work in which particular mutational background is the engineering of laboratory models that mimic the exact same types of cancers seen in the clinic. This advance has made it possible for us to do what we call "co-clinical trials" in the lab. It saves people from going on inappropriate trials. We want every patient going on a trial to either benefit from the trial or at least to teach us something if the treatment does not demonstrate benefit.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: Every cancer patient will eventually be analyzed for all mutations in the oncogenes and tumor suppressor genes that s/he has. This analysis will help determine which drugs are likely to work for the individual. Because there will be circumstances where an unexpected form of mechanism of resistance to therapy will come about, I envision that we will develop self-learning computer programs that are able to suggest drug combinations based on the individual's set of mutations. The patient will go on this regimen, and then there will be a follow-up to see whether a patient is responding to that therapy. At that point, if it is clear that the patient is not benefiting from treatment, then the computer can generate a second choice, and one could then go in with that therapy very quickly. This way, we do not spend months on therapies that are unlikely to work and can switch to a new one as quickly as possible. The successes and failures will then be fed back into the computer, allowing it to be smarter in predicting the correct therapy for the next set of patients.

Q: What other projects are you currently working on?

A: My laboratory is mainly focusing on cancers with aberrations in the PI3K pathway. We have an NCI funded P01 grant in prostate cancer with collaborators at Beth Israel Deaconess, Dana-Farber Cancer Institute, and MSKCC. We are also participating in P01 and SPORE grants in the area of colorectal cancer, lung cancer, melanoma, and pancreatic cancer, and a Stand Up To Cancer grant in the area of breast, endometrial, and ovarian cancers. These are all cancers where we know that the PI3K pathway plays an important role, yet they are all somewhat different: in some cases it may be mutations in PTEN; in others, mutations in PI3K are turned on by mutations in EGFR or HER2 or KRAS. Hence, they are unlikely to respond to the same drugs. By generating laboratory models, we can figure out ultimately what drug combinations are more likely to work.

Q: How close are we to preventing and curing all forms of breast cancer?

A: It is very exciting how much progress has been made in breast cancer over the last 15 years. The progress is coming from novel targeted therapies and figuring out how to use them at the right stage. For example, trastuzumab (Herceptin®) was originally approved for end-stage disease and demonstrated a rather minor effect, extending life by 3-4 months. But then, it became clear that by prescribing it to patients in the adjuvant (post-surgery) setting for a year, recurrence rates in patients would begin dropping dramatically. Now that took years to figure out because recurrence might take five years, so you have to look over seven years or so years to determine whether the subset who were taking this drug had a lower rate of recurrence. That process is too long. Analyzing the patients' genes, we can get the right drugs to the right patients earlier.

Also, these targeted therapies, as opposed to systemic ones such as radiation or chemotherapy, cause fewer side effects. These very aggressive chemotherapies and radiation treatments can themselves turn on new cancers, and so the hope is that these targeted therapies will not have the secondary damaging effects of chemotherapies and radiation therapy that can actually initiate new cancers. But we have to figure out which ones are going to be effective in these adjuvant therapies. At the end, that is I think where we will have the impact.

Another challenge is that, although we have a rationale for adjuvant therapies and drug combinations in ER+ and HER2+ breast cancers, we have not made as much progress in triple negative disease. It is more difficult to figure out what the best targets for drugs are in triple negative breast cancer than the other subtypes. But we have initiated some very exciting trials that could be very promising in triple negative setting, and they again use PI3K inhibitors in combination with a second drug.

I do not want to say that we are going to cure all cancers or all breast cancers, but I think that the odds of recurrence after surgery are going to drop precipitously over the next ten years as we figure out how to use drugs better in the adjuvant setting, and that is where we are going to see an impact.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: I like to think of our efforts in cancer research as comparable to our efforts in going to the moon. If we had decided to go to the moon in 1930, we would have had no prayer of achieving it, because nobody had figured out the physics yet or had rockets or jet propulsion systems. We did not know what would be required. By 1960, we knew exactly how to achieve going to the moon, and it became a matter of engineering to make it happen. I think we are at the same position right now in cancer where we do not yet know everything, but we know what we should be doing. There is a logical approach we can take. Every clinical trial should be scientifically designed so that you learn something from your failures as much as from your successes. And what BCRF has done for us at this time, when we really know efficiently how we should be spending our money, is providing it to us at a time when the National Cancer Institute is reducing funding. The real dollars we have from the NCI to do research right now are less than what we had ten years ago. And that never happened before, in real dollars where actually we have less to work with, at the time when we know how to use the money correctly. For BCRF to step up and help fill that gap and move us forward at a time when we most know how to use that money is just fantastic.

Read more about Dr. Cantley's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Lewis C. Cantley to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: My first love was chemistry, so I did my doctorate in Physical Chemistry at Cornell University. But once I started doing research, I realized that all the excitement surrounded biology, because biology is chemistry in action. I went from trying to understand how cells make an energy source called ATP, to how cells regulate the uptake of molecules like glucose or sodium or potassium, which then led me to signaling pathways, and then to cancer research and biology.

In the course of this work, I discovered an enzymatic activity that led to tumor formation in laboratory models. The chemical reaction carried out by this enzyme (called PI3-kinase, or PI3K) had not been found before in nature so this discovery opened up a new field of cancer research. The signaling network controlled by PI3K is complex and akin the complex wiring diagram of your computer or radio. We have been chasing down all the wires (i.e. signaling pathways) going in all directions inside the cell that are controlled by PI3K in order to understand how it causes cancer and how best to intervene with drugs. It turns out that the PI3K signaling network is the most mutated in breast cancers and is commonly mutated in the majority of other cancers. More recently, we began to focus much of our research towards drugs that target PI3K, some of which are now going to clinical trials.

Currently, there are roughly 20 PI3K inhibitors in clinical trials. This has set a record for a drug target where no drug has yet been approved but almost every pharmaceutical company simultaneously has at least one drug in the clinic that targets PI3K. The reason is that PI3K is the most mutated pathway in all cancers. Yet, it is also clear from early studies that this is not going to be simple. So the responses being observed in early-phase clinical trials have everyone very excited, but it is still not clear how to identify the patients who are most likely to respond.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: BCRF is helping us with preclinical studies that predict the biomarkers likely to tell us which patients are going to respond to the novel PI3K inhibitors and how to use these drugs. We are collaborating with two different labs: Gerburg Wulf at Beth Israel Deaconness and Charles Sawyers at Memorial Sloan-Kettering Cancer Center (MSKCC). Dr. Wulf and I are giving drugs to laboratory models that are genetically engineered to have the same mutations that we commonly find in human breast cancer. We are trying to figure out which mutations generate tumors that respond to PI3K inhibitors as single drugs and which require that we combine PI3K inhibitors with other drugs. Dr. Sawyers and I have several grants together, including one on prostate cancer, which is another disease with many mutations in the PI3K pathway. In the case of prostate cancer, the mutations are more frequently in an enzyme called PTEN, which is a braking system to PI3K.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advances can help to enhance your progress?

A: What we are doing today could not possibly have been done ten or even five years ago. First and foremost is our ability to sequence the human genome, which now has become cost-effective enough to identify mutational events that occur in genes and cancer genes in every patient. Decoding the genetic mutations of patients allows us to predict who is likely to benefit or not on standard of care and who should be in what clinical trial. In some cases, drugs that have been approved for other cancers might be appropriate for a patient. This is an example of personalized cancer in a very accurate and detailed way.

Breast cancer has really led the way in personalized therapy. Breast cancers have been divided into subsets (estrogen receptor positive [ER+], HER2+, triple negative) and distinct therapies have been developed for each subset, rather than treating all patients in the same way. This really is the reason why so much progress has been made in this disease. But we need to further divide the disease into additional subsets, and genomic sequencing technology is making that feasible.

Another type of technology that has helped us to tease out which drugs are likely to work in which particular mutational background is the engineering of laboratory models that mimic the exact same types of cancers seen in the clinic. This advance has made it possible for us to do what we call "co-clinical trials" in the lab. It saves people from going on inappropriate trials. We want every patient going on a trial to either benefit from the trial or at least to teach us something if the treatment does not demonstrate benefit.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: Every cancer patient will eventually be analyzed for all mutations in the oncogenes and tumor suppressor genes that s/he has. This analysis will help determine which drugs are likely to work for the individual. Because there will be circumstances where an unexpected form of mechanism of resistance to therapy will come about, I envision that we will develop self-learning computer programs that are able to suggest drug combinations based on the individual's set of mutations. The patient will go on this regimen, and then there will be a follow-up to see whether a patient is responding to that therapy. At that point, if it is clear that the patient is not benefiting from treatment, then the computer can generate a second choice, and one could then go in with that therapy very quickly. This way, we do not spend months on therapies that are unlikely to work and can switch to a new one as quickly as possible. The successes and failures will then be fed back into the computer, allowing it to be smarter in predicting the correct therapy for the next set of patients.

Q: What other projects are you currently working on?

A: My laboratory is mainly focusing on cancers with aberrations in the PI3K pathway. We have an NCI funded P01 grant in prostate cancer with collaborators at Beth Israel Deaconess, Dana-Farber Cancer Institute, and MSKCC. We are also participating in P01 and SPORE grants in the area of colorectal cancer, lung cancer, melanoma, and pancreatic cancer, and a Stand Up To Cancer grant in the area of breast, endometrial, and ovarian cancers. These are all cancers where we know that the PI3K pathway plays an important role, yet they are all somewhat different: in some cases it may be mutations in PTEN; in others, mutations in PI3K are turned on by mutations in EGFR or HER2 or KRAS. Hence, they are unlikely to respond to the same drugs. By generating laboratory models, we can figure out ultimately what drug combinations are more likely to work.

Q: How close are we to preventing and curing all forms of breast cancer?

A: It is very exciting how much progress has been made in breast cancer over the last 15 years. The progress is coming from novel targeted therapies and figuring out how to use them at the right stage. For example, trastuzumab (Herceptin®) was originally approved for end-stage disease and demonstrated a rather minor effect, extending life by 3-4 months. But then, it became clear that by prescribing it to patients in the adjuvant (post-surgery) setting for a year, recurrence rates in patients would begin dropping dramatically. Now that took years to figure out because recurrence might take five years, so you have to look over seven years or so years to determine whether the subset who were taking this drug had a lower rate of recurrence. That process is too long. Analyzing the patients' genes, we can get the right drugs to the right patients earlier.

Also, these targeted therapies, as opposed to systemic ones such as radiation or chemotherapy, cause fewer side effects. These very aggressive chemotherapies and radiation treatments can themselves turn on new cancers, and so the hope is that these targeted therapies will not have the secondary damaging effects of chemotherapies and radiation therapy that can actually initiate new cancers. But we have to figure out which ones are going to be effective in these adjuvant therapies. At the end, that is I think where we will have the impact.

Another challenge is that, although we have a rationale for adjuvant therapies and drug combinations in ER+ and HER2+ breast cancers, we have not made as much progress in triple negative disease. It is more difficult to figure out what the best targets for drugs are in triple negative breast cancer than the other subtypes. But we have initiated some very exciting trials that could be very promising in triple negative setting, and they again use PI3K inhibitors in combination with a second drug.

I do not want to say that we are going to cure all cancers or all breast cancers, but I think that the odds of recurrence after surgery are going to drop precipitously over the next ten years as we figure out how to use drugs better in the adjuvant setting, and that is where we are going to see an impact.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: I like to think of our efforts in cancer research as comparable to our efforts in going to the moon. If we had decided to go to the moon in 1930, we would have had no prayer of achieving it, because nobody had figured out the physics yet or had rockets or jet propulsion systems. We did not know what would be required. By 1960, we knew exactly how to achieve going to the moon, and it became a matter of engineering to make it happen. I think we are at the same position right now in cancer where we do not yet know everything, but we know what we should be doing. There is a logical approach we can take. Every clinical trial should be scientifically designed so that you learn something from your failures as much as from your successes. And what BCRF has done for us at this time, when we really know efficiently how we should be spending our money, is providing it to us at a time when the National Cancer Institute is reducing funding. The real dollars we have from the NCI to do research right now are less than what we had ten years ago. And that never happened before, in real dollars where actually we have less to work with, at the time when we know how to use the money correctly. For BCRF to step up and help fill that gap and move us forward at a time when we most know how to use that money is just fantastic.

Read more about Dr. Cantley's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Lewis C. Cantley to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Eduardo Cazap to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Eduardo Cazap to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: You've been an oncologist in Argentina for over 30 years. What brought you to breast cancer research?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Eduardo Cazap to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: You've been an oncologist in Argentina for over 30 years. What brought you to breast cancer research?

# data[].attributes.body.value
BCRF sat down with Dr. Eduardo Cazap to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: You've been an oncologist in Argentina for over 30 years. What brought you to breast cancer research?

A: Cancer is a global problem. This may seem like a simple statement, but it's not. If you consider the world, there is a troubling gap between the advancement of scientific knowledge and applicable knowledge to populations. No longer can we talk about this problem in terms of rich and poor countries; that's not a useful distinction to make because even so-called rich countries, like the United States, have big challenges in delivering medical resources for all the population. Patients do not have equal access to quality care.

With breast cancer, an example of this inconsistency is the use of mastectomy as a treatment. Despite scientific advances, mastectomy remains the most common treatment for breast disease throughout the world. This is not always a good medical practice, and it is a result of very practical problems. In many places there are simply no pathologists, or there are so few that the reports are delayed to the point of being unhelpful-in some cases, many months. Doctors in these situations have little choice beyond treating their patients with mastectomy, even if they know that many would be better treated with less radical surgeries.

With BCRF support, I am pursuing the question of how to analyze the conditions of care in a given country or region - in my case 12 countries in Latin America and the Caribbean: Mexico, Brazil, Argentina, Peru, Chile, Colombia, Venezuela, Paraguay, Uruguay, Panama, Honduras and Bolivia. Once we analyze the situation, we can begin to improve the continuous delivery of good medical care in this region. It comes down to identifying the best strategies for improving delivery of breast cancer treatment.

The lack of information was the basis of our research.

Q: How does this process work in the project that you initiated?

A: The first phase of our research was a survey, which was published with analyses in a special issue of Cancer in October 2008. We initially lacked basic data about the conditions of care throughout the region. For the survey, an advisory board of the Latin American and Caribbean Society of Medical Oncology (SLACOM) generated 65 questions about breast cancer related to epidemiology, screening, diagnosis, treatment, research, palliative care, and medical education. Phone interviews with 100 experts in the 12 countries - this ranged from directors of cancer centers, to heads of scientific societies, to established surgeons and oncologists-gave us a detailed description of breast cancer in the region. Our panel reviewed the survey and came up with results that we can use as a basis to focus our attention on improvement.

The second phase is a comparison between the experts' assessment of the state of breast cancer and what governments say they are doing in the area of breast cancer. National cancer plans and better epidemiologic data are needed for all countries. The World Health Organization and the International Union Against Cancer has deemed them an urgent priority. A complete review of countries' capacities is necessary before determining the best approaches to bringing governments and the private sector into stronger collaborations to improve breast cancer care.

Q: What has the initial survey revealed?

A: Many things, some of them alarming. It is known that Latin America has a lower incidence of breast cancer than that of more developed countries, but the mortality rate is higher. Our survey provided a window on why that may be the case. We learned that an overwhelming majority of breast cancer suspicion in these countries (79%) is identified by the patient herself. Hand in hand with this finding is the fact that there are almost no laws or guidelines in the countries surveyed for mandatory mammographic screening. Mammography exists in most locales, but its use is limited. We believe that women are detecting breast cancers themselves when the disease is more advanced because they are not routinely screened for the disease. This reality contributes to poorer outcomes. This situation is closely related to poor medical and general population education.

We also learned that while there are research activities and data collection going on in the region, projects are limited and only 1% of these activities are conducted in the formal academic setting of a university. To date, there is very poor support from governments for cancer research in Latin American and Caribbean countries.

On the positive side, three quarters of the experts surveyed indicated that some type of population-based cancer registry with incidence data from the last five years was available. Without the survey we never would have known that this data exists. We are now devoting resources to bringing this data together in a standardized, accessible format.

Q: What is your outlook on whether breast cancer can be prevented and cured on a global level?

A: Things will improve when there are established national cancer plans throughout the region. I believe we can prevent and cure cancer as good access to care for as many people as possible increases.

Q: How has BCRF helped you?

A: To my knowledge, BCRF was the first organization to fund independent research in breast cancer in Latin America and the Caribbean at the regional level in the time that I have practiced oncology.

Q: What do you see as the biggest challenge in cancer research?

A: Governments worldwide increasingly lack the political will to improve health care systems to the extent that is needed. This is primarily due to lack of adequate budgets. There should be more regional and national medical collaborations, with funding from governments.

Q: What advice would you give to young physician-researchers?

A: To be open-minded and to look for new strategies suited to our populations and local resources.

Read more about Dr. Cazap's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Eduardo Cazap to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: You've been an oncologist in Argentina for over 30 years. What brought you to breast cancer research?

A: Cancer is a global problem. This may seem like a simple statement, but it's not. If you consider the world, there is a troubling gap between the advancement of scientific knowledge and applicable knowledge to populations. No longer can we talk about this problem in terms of rich and poor countries; that's not a useful distinction to make because even so-called rich countries, like the United States, have big challenges in delivering medical resources for all the population. Patients do not have equal access to quality care.

With breast cancer, an example of this inconsistency is the use of mastectomy as a treatment. Despite scientific advances, mastectomy remains the most common treatment for breast disease throughout the world. This is not always a good medical practice, and it is a result of very practical problems. In many places there are simply no pathologists, or there are so few that the reports are delayed to the point of being unhelpful-in some cases, many months. Doctors in these situations have little choice beyond treating their patients with mastectomy, even if they know that many would be better treated with less radical surgeries.

With BCRF support, I am pursuing the question of how to analyze the conditions of care in a given country or region - in my case 12 countries in Latin America and the Caribbean: Mexico, Brazil, Argentina, Peru, Chile, Colombia, Venezuela, Paraguay, Uruguay, Panama, Honduras and Bolivia. Once we analyze the situation, we can begin to improve the continuous delivery of good medical care in this region. It comes down to identifying the best strategies for improving delivery of breast cancer treatment.

The lack of information was the basis of our research.

Q: How does this process work in the project that you initiated?

A: The first phase of our research was a survey, which was published with analyses in a special issue of Cancer in October 2008. We initially lacked basic data about the conditions of care throughout the region. For the survey, an advisory board of the Latin American and Caribbean Society of Medical Oncology (SLACOM) generated 65 questions about breast cancer related to epidemiology, screening, diagnosis, treatment, research, palliative care, and medical education. Phone interviews with 100 experts in the 12 countries - this ranged from directors of cancer centers, to heads of scientific societies, to established surgeons and oncologists-gave us a detailed description of breast cancer in the region. Our panel reviewed the survey and came up with results that we can use as a basis to focus our attention on improvement.

The second phase is a comparison between the experts' assessment of the state of breast cancer and what governments say they are doing in the area of breast cancer. National cancer plans and better epidemiologic data are needed for all countries. The World Health Organization and the International Union Against Cancer has deemed them an urgent priority. A complete review of countries' capacities is necessary before determining the best approaches to bringing governments and the private sector into stronger collaborations to improve breast cancer care.

Q: What has the initial survey revealed?

A: Many things, some of them alarming. It is known that Latin America has a lower incidence of breast cancer than that of more developed countries, but the mortality rate is higher. Our survey provided a window on why that may be the case. We learned that an overwhelming majority of breast cancer suspicion in these countries (79%) is identified by the patient herself. Hand in hand with this finding is the fact that there are almost no laws or guidelines in the countries surveyed for mandatory mammographic screening. Mammography exists in most locales, but its use is limited. We believe that women are detecting breast cancers themselves when the disease is more advanced because they are not routinely screened for the disease. This reality contributes to poorer outcomes. This situation is closely related to poor medical and general population education.

We also learned that while there are research activities and data collection going on in the region, projects are limited and only 1% of these activities are conducted in the formal academic setting of a university. To date, there is very poor support from governments for cancer research in Latin American and Caribbean countries.

On the positive side, three quarters of the experts surveyed indicated that some type of population-based cancer registry with incidence data from the last five years was available. Without the survey we never would have known that this data exists. We are now devoting resources to bringing this data together in a standardized, accessible format.

Q: What is your outlook on whether breast cancer can be prevented and cured on a global level?

A: Things will improve when there are established national cancer plans throughout the region. I believe we can prevent and cure cancer as good access to care for as many people as possible increases.

Q: How has BCRF helped you?

A: To my knowledge, BCRF was the first organization to fund independent research in breast cancer in Latin America and the Caribbean at the regional level in the time that I have practiced oncology.

Q: What do you see as the biggest challenge in cancer research?

A: Governments worldwide increasingly lack the political will to improve health care systems to the extent that is needed. This is primarily due to lack of adequate budgets. There should be more regional and national medical collaborations, with funding from governments.

Q: What advice would you give to young physician-researchers?

A: To be open-minded and to look for new strategies suited to our populations and local resources.

Read more about Dr. Cazap's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Eduardo Cazap to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Andrew Dannenberg to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Andrew Dannenberg to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Andrew Dannenberg to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Andrew Dannenberg to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I have had a longstanding interest in cancer prevention with an emphasis on the connections between chronic inflammation and cancer. My research has focused on a class of bioactive lipids known as prostaglandins which have been linked to both inflammation and numerous malignancies. Approximately 15 years ago, we showed that when breast cells became malignant and formed tumors, a gene known as cyclooxygenase-2 (COX-2) was turned on leading to increased production of prostaglandins. This simple finding sparked a focused effort in breast cancer research with the overarching goal of developing evidence-based risk reduction strategies. Simply stated, we believe that by inhibiting the formation of prostaglandins, it may be possible to reduce the formation, growth and spread of breast cancers.

I never seriously considered a career outside of the sciences. After attending medical school and being trained as an internist, I needed to decide whether to pursue clinical medicine or laboratory science. I love asking questions and gain enormous satisfaction from finding answers. Ultimately, this passion led me to pursue a laboratory research career but with a focus on clinically relevant questions.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: The use of inhibitors of cyclooxygenase (COX) enzymes including aspirin has been associated with a reduced risk of breast cancer. The prostaglandin products of COX enzymes stimulate the formation of aromatase, the enzyme that makes estrogen (this female hormone can drive breast cancer formation and growth). Because widely available anti-inflammatory drugs inhibit COX enzymes and therefore may lower estrogen levels, our work helps to explain the observation that the risk of estrogen receptor-positive breast cancer may be reduced among aspirin users. Recently, in collaboration with Dr. Clifford Hudis of Memorial Sloan-Kettering Cancer Center, with BCRF support we have extended this line of investigation to try to understand the link between obesity, inflammation and breast cancer. In a relatively short period of time, we have been able to translate some of our preclinical findings to women. Ultimately, we hope to be able to develop mechanism-based risk reduction strategies.

I am absolutely convinced that science will lead to effective preventive interventions. Like virtually everyone else, I have had loved ones develop breast cancer. Some but not all have been cured. I can think of no better way to spend my time and energy than pursuing ways to reduce the breast cancer burden.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: Like many others, we employ a variety of broad experimental approaches called "-omics" in our research. These large-scale studies include genomics (studying genes), proteomics (studying proteins), lipidomics (studying lipids, or fats) and metabolomics (studying metabolism), all of which continue to develop. One of my goals is to noninvasively image inflammation but this is likely to require additional technological advances. The ability to noninvasively image inflammation would enable us to monitor the efficacy of anti-inflammatory agents, an important step in preventive drug development.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: Continued research will allow us to personalize not only therapy as is already happening but also prevention. These advances in risk reduction will be meaningful sooner than many observers now believe.

Q: What other projects are you currently working on?

A: In conjunction with Dr. Clifford Hudis, we are attempting to elucidate the role of inflammation in driving the spread (metastasis) of established breast cancers. Based on our preclinical findings, we have initiated a human study. By targeting inflammation, we may be able to suppress both tumor formation and metastasis. In a complementary line of investigation, we are exploring the potential of dietary factors to modulate the expression of genes implicated in inflammation. A dietary intervention is obviously an attractive approach (and long sought!) to prevention.

Q: How close are we to preventing and curing all forms of breast cancer?

A: Breast cancer represents multiple diseases. I believe we will continue to see significant incremental advances including many more cures. We already know we can prevent some kinds of breast cancer using anti-estrogen therapies, and there is every reason to believe that similar approaches will be validated for other subtypes.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF is a very important organization that is catalyzing important advances. Funding from BCRF provides investigators with the flexibility and freedom to pursue innovative science that wouldn't otherwise be possible. As an organization, BCRF helps to break down barriers and catalyze collaborative team science. Certainly, funding from BCRF has made an enormous difference in helping our laboratory to make progress.

Preclinical results from this study was published online in Cancer Prevention Research, a journal of the American Association for Cancer Research, on March 3, 2011. Stephen Hursting, PhD, BCRF grantee at The University of Texas, was the editorialist on this article.

Read more about Dr. Dannenberg's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Andrew Dannenberg to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I have had a longstanding interest in cancer prevention with an emphasis on the connections between chronic inflammation and cancer. My research has focused on a class of bioactive lipids known as prostaglandins which have been linked to both inflammation and numerous malignancies. Approximately 15 years ago, we showed that when breast cells became malignant and formed tumors, a gene known as cyclooxygenase-2 (COX-2) was turned on leading to increased production of prostaglandins. This simple finding sparked a focused effort in breast cancer research with the overarching goal of developing evidence-based risk reduction strategies. Simply stated, we believe that by inhibiting the formation of prostaglandins, it may be possible to reduce the formation, growth and spread of breast cancers.

I never seriously considered a career outside of the sciences. After attending medical school and being trained as an internist, I needed to decide whether to pursue clinical medicine or laboratory science. I love asking questions and gain enormous satisfaction from finding answers. Ultimately, this passion led me to pursue a laboratory research career but with a focus on clinically relevant questions.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: The use of inhibitors of cyclooxygenase (COX) enzymes including aspirin has been associated with a reduced risk of breast cancer. The prostaglandin products of COX enzymes stimulate the formation of aromatase, the enzyme that makes estrogen (this female hormone can drive breast cancer formation and growth). Because widely available anti-inflammatory drugs inhibit COX enzymes and therefore may lower estrogen levels, our work helps to explain the observation that the risk of estrogen receptor-positive breast cancer may be reduced among aspirin users. Recently, in collaboration with Dr. Clifford Hudis of Memorial Sloan-Kettering Cancer Center, with BCRF support we have extended this line of investigation to try to understand the link between obesity, inflammation and breast cancer. In a relatively short period of time, we have been able to translate some of our preclinical findings to women. Ultimately, we hope to be able to develop mechanism-based risk reduction strategies.

I am absolutely convinced that science will lead to effective preventive interventions. Like virtually everyone else, I have had loved ones develop breast cancer. Some but not all have been cured. I can think of no better way to spend my time and energy than pursuing ways to reduce the breast cancer burden.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: Like many others, we employ a variety of broad experimental approaches called "-omics" in our research. These large-scale studies include genomics (studying genes), proteomics (studying proteins), lipidomics (studying lipids, or fats) and metabolomics (studying metabolism), all of which continue to develop. One of my goals is to noninvasively image inflammation but this is likely to require additional technological advances. The ability to noninvasively image inflammation would enable us to monitor the efficacy of anti-inflammatory agents, an important step in preventive drug development.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: Continued research will allow us to personalize not only therapy as is already happening but also prevention. These advances in risk reduction will be meaningful sooner than many observers now believe.

Q: What other projects are you currently working on?

A: In conjunction with Dr. Clifford Hudis, we are attempting to elucidate the role of inflammation in driving the spread (metastasis) of established breast cancers. Based on our preclinical findings, we have initiated a human study. By targeting inflammation, we may be able to suppress both tumor formation and metastasis. In a complementary line of investigation, we are exploring the potential of dietary factors to modulate the expression of genes implicated in inflammation. A dietary intervention is obviously an attractive approach (and long sought!) to prevention.

Q: How close are we to preventing and curing all forms of breast cancer?

A: Breast cancer represents multiple diseases. I believe we will continue to see significant incremental advances including many more cures. We already know we can prevent some kinds of breast cancer using anti-estrogen therapies, and there is every reason to believe that similar approaches will be validated for other subtypes.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF is a very important organization that is catalyzing important advances. Funding from BCRF provides investigators with the flexibility and freedom to pursue innovative science that wouldn't otherwise be possible. As an organization, BCRF helps to break down barriers and catalyze collaborative team science. Certainly, funding from BCRF has made an enormous difference in helping our laboratory to make progress.

Preclinical results from this study was published online in Cancer Prevention Research, a journal of the American Association for Cancer Research, on March 3, 2011. Stephen Hursting, PhD, BCRF grantee at The University of Texas, was the editorialist on this article.

Read more about Dr. Dannenberg's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Andrew Dannenberg to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Nancy E. Davidson to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Nancy E. Davidson to discuss her current work and interest in breast cancer research. Read on to learn more.
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Nancy E. Davidson to discuss her current work and interest in breast cancer research. Read on to learn more.
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Nancy E. Davidson to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: Since high school, I've been very interested in biology. Because of a weekend program at the National Naval Medical Center I decided that I wanted to study it in college. Then, I had the chance to work in a liver cancer research lab as an undergraduate, so that brought me into the field of cancer. Because of that job and through a happy series of coincidences, after my first year at Harvard Medical School I found myself at a summer job at the National Cancer Institute with Drs. Marc Lippman (University of Miami) and Kent Osborne (Baylor College of Medicine), two other people who have been really helped by BCRF support. They were very interested in things that might make these breast cancer cells grow in the laboratory, such as estrogen and peptide growth factors, so at the time they were studying a lot of the signaling pathways that we now target when we treat women with breast cancer.

That summer job made me absolutely fall in love with breast cancer. The connection between the science and the potential clinical implications made me decide that I wanted to be a breast cancer researcher, which then dictated how I developed the rest of my medical career. After my internal medicine training at Harvard, I went back to work with Dr. Lippman to specialize in medical oncology, especially breast cancer. This is a wonderful example of how you know you have some idea of what you want to do, but then over time things fall into place, you have great opportunities and you are really influenced by visionary people like Marc and Kent.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: I've been funded by BCRF for 13 years in several different capacities, each very different but equally important in terms of the impact on our field - as an independent investigator; as a co-founder of the Translational Breast Cancer Research Consortium (TBCRC), a consortium of investigators across North America/United States; and as an investigator as part of an international collaboration.

As an independent investigator, my laboratory's project has changed over time as science has changed over time. Most recently, we have focused on epigenetics in breast cancer. The concept here is that all cancers, including breast cancer, come about because of an accumulation of changes. Many of those are genetic changes, changes in the DNA sequence, but some of them are what we call epigenetic changes, which come about either because of a little tag called a methyl group that can be put on the DNA that might change the way it behaves or because of changes in proteins that are associated with DNA called the histones. And the important thing about these epigenetic changes is that they are potentially reversible whereas genetic ones are not.

It turns out that these epigenetic changes can change either the methyl group or the histone proteins in a way that DNA is not transcribed, or it's not read, in the way that it normally should be. We think some of these blocks might actually contribute to the process of developing a disease like breast cancer. And so we wonder if we could reverse these blocks, might we be able to have the cancer cells revert to a more normal type of behavior? There are already drugs that can reverse these changes, called methyltransferase inhibitors and histone deacetylase inhibitors. In the laboratory, we've looked at these drugs, individually and then in combination, and we've been able to show that using these drugs leads to a decrease in breast cancer cell growth in the laboratory. This also leads to a change in the gene expression patterns in the laboratory, and we wonder whether or not the change in DNA methylation and conformation and gene expression patterns might lead to a more favorable kind of profile that would lend itself to halting growth of the tumor or perhaps even tumor death.

We also wonder whether these kinds of drugs can make tumor cells more susceptible to other kinds of drugs, such as tamoxifen or aromatase inhibitors. Extending our work through the Translational Breast Cancer Research Consortium, whose studies are partially funded by BCRF, my colleague Dr. Vered Stearns (Johns Hopkins University) just finished a trial on that concept, looking at women with breast cancer where half of them take routine neoadjuvant (pre-operative) chemotherapy and the other half take chemotherapy with one of these epigenetic-modifying drugs to see whether or not it would enhance the effects of chemotherapy. Epigenetics is an area that has really gone from the bench to the bedside and now we're taking some of these bedside observations back to the bench again.

Another area where we are grateful to BCRF is the investment that they've made to forge interactions around the world. For eight years, BCRF has been funding a collaboration between the North American Breast Cancer Group, which is comprised of leaders of the National Cancer Institute (NCI) clinical trials cooperative groups across North America, along with leaders in the Breast International Group, comprised of leaders across the globe, to allow us to think about things that are important to all of us as investigators. So far the group has been very influential in putting out some major guidelines, such as how to measure Ki-67, which is an increasingly important biomarker for breast cancer. We needed to have some international perspective about the best way to measure such a test. We also presented results of that study at the 2012 San Antonio Breast Cancer Symposium.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: Our BCRF funding has allowed us to work to put epigenetics on the map as an important component of the breast cancer process, and that would not have been so easy to do without BCRF. This is an area that was slower to take hold than some others. Working to understand some of these mechanisms in epigenetics ourselves and to share this work so that others can see this information as well has been important. And I think this recognition of the importance of epigenetics has become much broader across breast cancer as a consequence of the work we've been able to do and the investment that BCRF has made in helping us to do that work.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: When I look at what we've accomplished over the last decade, in terms of trying to reduce the burden of breast cancer, I think that we've made enormous progress in trying to "right size" therapy, prevention, and detection. We've been trying to provide care that is the most appropriate for each individual woman and her particular kind of cancer. And I think we've done a nice job at trying to limit therapy, to try to make sure that we do just enough but not too much. And so I think that our progress over the next decade is going to continue along these lines, whether you want to call it personalized cancer care, precision care, or individualized care. We're going to be able to learn about the cancer and the individual, both from a biological perspective but also from a psychological perspective, as you need to know what makes that person tick to be able to provide her with the best possible counsel for what she needs to do.

Also, though it's a very challenging area, I hope that we will see ever more attention to prevention strategies. We'll be able to think even more about the kind of lifestyle changes or the lifestyles that people need to pursue. And I hope that we will be able to utilize the information that we already have about using prevention strategies, drugs like tamoxifen or raloxifene, appropriately.

In addition, I hope that we're going to be able to do ever less surgery for women. I hope that we're going to be able to be very, very tailored about how we think about our drug therapy and that we're going to be in a position where we can try to limit both under-treatment and over-treatment as much as possible. And I surely hope that we're going to be able to make more headway in the field of metastatic breast cancer than we've been able to do, both in terms of trying to prevent it from happening and having better therapies if it does develop. These are all areas that I'm really excited about.

Q: What other projects are you currently working on?

A: One of the enormous pleasures for me from the perspective of a cancer center director, has been to be able to take a larger leadership role in the cancer community. For the last several years, I've been the director of one of the nation's 41 comprehensive cancer centers. That means a lot of the projects that I'm doing are, of course, related to cancer more generally. One of the reasons why I think that I've been able to do that is because so many of the things we've learned to do in breast cancer are now coming true across all of oncology, so that connections between the pathways and the science and medicine are really permeating throughout oncology. I'm very excited about those projects.

When I came to the University of Pittsburgh, the generosity of BCRF allowed me to found our Women's Cancer Research Center, which is a group of investigators heavily focused on women's cancers. Support from BCRF allowed us to recruit additional scientists, one of whom is Dr. Steffi Oesterreich, who is now a BCRF investigator in her own right with a particular focus on the biology of invasive lobular cancer.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: What I love about BCRF funding is that it's allowed me to pursue an area that I think is really important but was viewed as a little bit "out there." BCRF grants have allowed us to do the work that eventually led to more traditional funding mechanisms and then ultimately impact clinical practice. For example, when I was at Johns Hopkins, our SPORE grant at the time had a project that was the clinical spin-off of how to take some of these epigenetics treatments and actually put them into clinical trials - this clinical application through the SPORE was made possible by foundational support from BCRF for the preclinical science.

These funds have also allowed me along the way, at times when I thought it was important to make a critical strategic investment in somebody else's work, to make a big difference so their work could go forward. Here at Pitt, I had the chance, for example, to help support a young investigator who is really interested in DNA repair and why it is that cancer cells don't repair themselves in the way that they should and how it is we can actually take advantage of that defective repair - how it might be an Achilles heel for some cancers. I was able to use BCRF funding to help to support his work at a key moment in his work to allow him to move his work forward and obtain funding from the National Institutes of Health.

The other fabulous thing about BCRF is that the organization has been really open to innovative partnerships. In 2005, many of us breast cancer investigators in SPORE initiatives wanted to be able to band together more routinely and work together over long periods of time. So that led to the founding of the Translational Breast Cancer Research Consortium. BCRF provided the pivotal gift to launch that particular organization, and it's been a very successful unification of now 17 different cancer centers around the country. TBCRC has allowed us to try to do small, very scientifically-driven, often very resource- and specimen-intense clinical trials across the members of our consortium. Our first trials are now in press in the breast cancer literature. We've had several well-received presentations at the Annual Meeting of the American Society of Clinical Oncology (ASCO) and at other big international meetings over a short period of time.

Also, I want to put on my hat as former ASCO president for a moment and talk about what an unbelievably great partner BCRF has been for ASCO. I am, personally, incredibly grateful for the support that BCRF has given to several ASCO career development activities, including the Young Investigator Award, the Career Development Award (CDA), and the Advanced Clinical Research Award. Currently, I work with Dr. Shannon Puhalla, who is using her BCRF-funded CDA grant to develop her credentials and experience as a clinical investigator. At Johns Hopkins, I worked with Dr. Vered Stearns, who was the first Advanced Clinical Research Award winner in breast cancer supported by BCRF. The ways that BCRF connects the oncology field for me are very, very palpable. I see how BCRF has touched our field. I see how it's touched individuals, and I know how grateful everybody is for the support that BCRF provides - both financial support and networking support. We owe so much to Evelyn Lauder for her vision for BCRF and what it has accomplished and will continue to do.

Read more about Dr. Davidson's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Nancy E. Davidson to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: Since high school, I've been very interested in biology. Because of a weekend program at the National Naval Medical Center I decided that I wanted to study it in college. Then, I had the chance to work in a liver cancer research lab as an undergraduate, so that brought me into the field of cancer. Because of that job and through a happy series of coincidences, after my first year at Harvard Medical School I found myself at a summer job at the National Cancer Institute with Drs. Marc Lippman (University of Miami) and Kent Osborne (Baylor College of Medicine), two other people who have been really helped by BCRF support. They were very interested in things that might make these breast cancer cells grow in the laboratory, such as estrogen and peptide growth factors, so at the time they were studying a lot of the signaling pathways that we now target when we treat women with breast cancer.

That summer job made me absolutely fall in love with breast cancer. The connection between the science and the potential clinical implications made me decide that I wanted to be a breast cancer researcher, which then dictated how I developed the rest of my medical career. After my internal medicine training at Harvard, I went back to work with Dr. Lippman to specialize in medical oncology, especially breast cancer. This is a wonderful example of how you know you have some idea of what you want to do, but then over time things fall into place, you have great opportunities and you are really influenced by visionary people like Marc and Kent.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: I've been funded by BCRF for 13 years in several different capacities, each very different but equally important in terms of the impact on our field - as an independent investigator; as a co-founder of the Translational Breast Cancer Research Consortium (TBCRC), a consortium of investigators across North America/United States; and as an investigator as part of an international collaboration.

As an independent investigator, my laboratory's project has changed over time as science has changed over time. Most recently, we have focused on epigenetics in breast cancer. The concept here is that all cancers, including breast cancer, come about because of an accumulation of changes. Many of those are genetic changes, changes in the DNA sequence, but some of them are what we call epigenetic changes, which come about either because of a little tag called a methyl group that can be put on the DNA that might change the way it behaves or because of changes in proteins that are associated with DNA called the histones. And the important thing about these epigenetic changes is that they are potentially reversible whereas genetic ones are not.

It turns out that these epigenetic changes can change either the methyl group or the histone proteins in a way that DNA is not transcribed, or it's not read, in the way that it normally should be. We think some of these blocks might actually contribute to the process of developing a disease like breast cancer. And so we wonder if we could reverse these blocks, might we be able to have the cancer cells revert to a more normal type of behavior? There are already drugs that can reverse these changes, called methyltransferase inhibitors and histone deacetylase inhibitors. In the laboratory, we've looked at these drugs, individually and then in combination, and we've been able to show that using these drugs leads to a decrease in breast cancer cell growth in the laboratory. This also leads to a change in the gene expression patterns in the laboratory, and we wonder whether or not the change in DNA methylation and conformation and gene expression patterns might lead to a more favorable kind of profile that would lend itself to halting growth of the tumor or perhaps even tumor death.

We also wonder whether these kinds of drugs can make tumor cells more susceptible to other kinds of drugs, such as tamoxifen or aromatase inhibitors. Extending our work through the Translational Breast Cancer Research Consortium, whose studies are partially funded by BCRF, my colleague Dr. Vered Stearns (Johns Hopkins University) just finished a trial on that concept, looking at women with breast cancer where half of them take routine neoadjuvant (pre-operative) chemotherapy and the other half take chemotherapy with one of these epigenetic-modifying drugs to see whether or not it would enhance the effects of chemotherapy. Epigenetics is an area that has really gone from the bench to the bedside and now we're taking some of these bedside observations back to the bench again.

Another area where we are grateful to BCRF is the investment that they've made to forge interactions around the world. For eight years, BCRF has been funding a collaboration between the North American Breast Cancer Group, which is comprised of leaders of the National Cancer Institute (NCI) clinical trials cooperative groups across North America, along with leaders in the Breast International Group, comprised of leaders across the globe, to allow us to think about things that are important to all of us as investigators. So far the group has been very influential in putting out some major guidelines, such as how to measure Ki-67, which is an increasingly important biomarker for breast cancer. We needed to have some international perspective about the best way to measure such a test. We also presented results of that study at the 2012 San Antonio Breast Cancer Symposium.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: Our BCRF funding has allowed us to work to put epigenetics on the map as an important component of the breast cancer process, and that would not have been so easy to do without BCRF. This is an area that was slower to take hold than some others. Working to understand some of these mechanisms in epigenetics ourselves and to share this work so that others can see this information as well has been important. And I think this recognition of the importance of epigenetics has become much broader across breast cancer as a consequence of the work we've been able to do and the investment that BCRF has made in helping us to do that work.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: When I look at what we've accomplished over the last decade, in terms of trying to reduce the burden of breast cancer, I think that we've made enormous progress in trying to "right size" therapy, prevention, and detection. We've been trying to provide care that is the most appropriate for each individual woman and her particular kind of cancer. And I think we've done a nice job at trying to limit therapy, to try to make sure that we do just enough but not too much. And so I think that our progress over the next decade is going to continue along these lines, whether you want to call it personalized cancer care, precision care, or individualized care. We're going to be able to learn about the cancer and the individual, both from a biological perspective but also from a psychological perspective, as you need to know what makes that person tick to be able to provide her with the best possible counsel for what she needs to do.

Also, though it's a very challenging area, I hope that we will see ever more attention to prevention strategies. We'll be able to think even more about the kind of lifestyle changes or the lifestyles that people need to pursue. And I hope that we will be able to utilize the information that we already have about using prevention strategies, drugs like tamoxifen or raloxifene, appropriately.

In addition, I hope that we're going to be able to do ever less surgery for women. I hope that we're going to be able to be very, very tailored about how we think about our drug therapy and that we're going to be in a position where we can try to limit both under-treatment and over-treatment as much as possible. And I surely hope that we're going to be able to make more headway in the field of metastatic breast cancer than we've been able to do, both in terms of trying to prevent it from happening and having better therapies if it does develop. These are all areas that I'm really excited about.

Q: What other projects are you currently working on?

A: One of the enormous pleasures for me from the perspective of a cancer center director, has been to be able to take a larger leadership role in the cancer community. For the last several years, I've been the director of one of the nation's 41 comprehensive cancer centers. That means a lot of the projects that I'm doing are, of course, related to cancer more generally. One of the reasons why I think that I've been able to do that is because so many of the things we've learned to do in breast cancer are now coming true across all of oncology, so that connections between the pathways and the science and medicine are really permeating throughout oncology. I'm very excited about those projects.

When I came to the University of Pittsburgh, the generosity of BCRF allowed me to found our Women's Cancer Research Center, which is a group of investigators heavily focused on women's cancers. Support from BCRF allowed us to recruit additional scientists, one of whom is Dr. Steffi Oesterreich, who is now a BCRF investigator in her own right with a particular focus on the biology of invasive lobular cancer.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: What I love about BCRF funding is that it's allowed me to pursue an area that I think is really important but was viewed as a little bit "out there." BCRF grants have allowed us to do the work that eventually led to more traditional funding mechanisms and then ultimately impact clinical practice. For example, when I was at Johns Hopkins, our SPORE grant at the time had a project that was the clinical spin-off of how to take some of these epigenetics treatments and actually put them into clinical trials - this clinical application through the SPORE was made possible by foundational support from BCRF for the preclinical science.

These funds have also allowed me along the way, at times when I thought it was important to make a critical strategic investment in somebody else's work, to make a big difference so their work could go forward. Here at Pitt, I had the chance, for example, to help support a young investigator who is really interested in DNA repair and why it is that cancer cells don't repair themselves in the way that they should and how it is we can actually take advantage of that defective repair - how it might be an Achilles heel for some cancers. I was able to use BCRF funding to help to support his work at a key moment in his work to allow him to move his work forward and obtain funding from the National Institutes of Health.

The other fabulous thing about BCRF is that the organization has been really open to innovative partnerships. In 2005, many of us breast cancer investigators in SPORE initiatives wanted to be able to band together more routinely and work together over long periods of time. So that led to the founding of the Translational Breast Cancer Research Consortium. BCRF provided the pivotal gift to launch that particular organization, and it's been a very successful unification of now 17 different cancer centers around the country. TBCRC has allowed us to try to do small, very scientifically-driven, often very resource- and specimen-intense clinical trials across the members of our consortium. Our first trials are now in press in the breast cancer literature. We've had several well-received presentations at the Annual Meeting of the American Society of Clinical Oncology (ASCO) and at other big international meetings over a short period of time.

Also, I want to put on my hat as former ASCO president for a moment and talk about what an unbelievably great partner BCRF has been for ASCO. I am, personally, incredibly grateful for the support that BCRF has given to several ASCO career development activities, including the Young Investigator Award, the Career Development Award (CDA), and the Advanced Clinical Research Award. Currently, I work with Dr. Shannon Puhalla, who is using her BCRF-funded CDA grant to develop her credentials and experience as a clinical investigator. At Johns Hopkins, I worked with Dr. Vered Stearns, who was the first Advanced Clinical Research Award winner in breast cancer supported by BCRF. The ways that BCRF connects the oncology field for me are very, very palpable. I see how BCRF has touched our field. I see how it's touched individuals, and I know how grateful everybody is for the support that BCRF provides - both financial support and networking support. We owe so much to Evelyn Lauder for her vision for BCRF and what it has accomplished and will continue to do.

Read more about Dr. Davidson's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Nancy E. Davidson to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Angelo Di Leo to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Angelo Di Leo to discuss his current work and interest in breast cancer research. Read on to learn more.
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Angelo Di Leo to discuss his current work and interest in breast cancer research. Read on to learn more.
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Angelo Di Leo to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I started with an interest in cancer as a student in high school, where I was fascinated by the biology of the tumor cell and decided then that I wanted to become a doctor. Because of my mother, I became very interested in breast cancer. In the second year of medical school, she became a breast cancer patient at the very young age of 46. Since I was still living with my family, I had the opportunity to see exactly what breast cancer is and began to understand how it impacts people.

I was also interested because I realized then that breast cancer is a disease where there are many things that doctors can actually do to try and help patients. At the time in 1984, there was clearly room for improvement in clinical care. Patients were all receiving chemotherapy, as part of standard practice, but chemotherapy causes many side effects. Since I was already fascinated by tumor cell biology, I started to study with more interest the biology of breast cancer cells - how they proliferate or spread to other parts of the body. When I was completing medical school, there was no doubt that I was going to become a breast cancer specialist. After a few years, I decided to move to Brussels, where Martine Piccart, MD, PhD, a fellow BCRF grantee, was starting her studies in the breast cancer field at Institut Jules Bordet. So I had the opportunity to work with her and started training in breast cancer.

As a result, I am a fully committed medical oncologist and breast cancer oncologist.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: The starting point of our BCRF research is that the biology of metastatic breast cancer is different from the biology of primary breast cancer. A woman whose breast cancer returns ("relapses" or "metastasizes") a few years later will have a different form of the disease than the one she had when her primary breast cancer was discovered. It is, therefore, extremely important to look at the biological characteristics of the metastatic breast tumors if you want to personalize or tailor the treatment of metastatic disease or to make substantial progress in the field of metastatic breast cancer treatment.

Now, with the help of technology, we have the potential to isolate circulating tumor cells (CTCs) from the blood of metastatic breast cancer patients and to study these cells. This is a very important advance because CTCs are thought to cause breast cancer relapse and spread. And CTCs are extremely rare - estimated at one CTC per billion normal blood cells. If we can actually isolate the CTCs from the blood, not only can we spare the patient from undergoing the biopsy of her metastatic tumor, which is a quite aggressive procedure, we can also investigate the biology of the origin of metastatic breast cancer. With the BCRF grant, we aim to find specific biomarkers from CTCs which ultimately can be used to help develop targeted therapy for treating metastatic breast cancer and will help lead to individualized therapies for patients.

Another branch of our studies focuses on a completely different aspect of metastatic breast cancer. Unfortunately, the way we are predicting the risk of disease relapse is still not very precise, because we sometimes tend to over-estimate this risk. As a consequence, some patients are receiving more treatment than they need and are being exposed to unnecessary side effects. In collaboration with a team at Memorial Sloan-Kettering Cancer Center (MSKCC) - specifically Monica Fornier, MD, Clifford Hudis, MD, Patrick Morris, MD, and Larry Norton, MD - our centers have been collecting blood samples from patients immediately following their tumor removal to identify specific metabolites, or small molecules, that are produced by tumors. Theoretically, after the primary tumor has been removed, there should be very few metabolites detected. The presence of these metabolites would therefore suggest that there are still tumor cells in the patient and, perhaps, additional interventions or closer monitoring may be necessary. This method can be used to help predict the risk of relapse more precisely than markers, such as tumor size, the involvement of the axillary nodes, or the hormone receptor status, used in current practice.

The technology we are using is called metabolomics, and it actually seems to be able to detect signals produced by metastatic lesions, even tiny micrometastatic ones that cannot be found by any standard radiology or even sophisticated imaging equipment. The reason why we collect blood after breast cancer surgery is because the blood collected before surgery still contains the metabolites that are produced by the primary tumor. This metabolomics technology looks really very promising, and collecting just a few milliliters of blood for a sample is not as invasive, as a biopsy for instance. Our findings show that if you look at the metabolites of early breast cancer patients, you can make a more specific estimate of the risk of disease relapse than using traditional factors. If our findings are confirmed in a large set of patients, which is exactly what we are doing now with MSKCC, it means that in the future we might have a more specific, more precise estimate of risk of disease relapse. This would translate into a less intensive treatment after breast cancer surgery for some patients.

We have recently completed the first part of the work and together with the MSKCC team just finalized a manuscript which will be submitted to scientific journals.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advances can help to enhance your progress?

A: The isolation of the circulating tumor cells was something that ten years ago was absolutely impossible. Now thanks to new technology, we can do this almost routinely.

In detecting metabolites in the peripheral blood, once again thanks to advances in the field of nuclear resonance magnetics, we can now identify small metabolites that ten years ago could not be identified. Technology is absolutely central in our research once we have clearly defined what the clinical problems are. This area is something that technology cannot help. Once you have identified your primary questions, the technology can be helpful to isolate the CTCs and the metabolites and to identify micro-metastases that otherwise cannot be identified.

Continuing to make advances in all areas is important. A specific one is developing a more sophisticated way to analyze DNA. When we isolate a CTC, we isolate also its DNA to analyze it. Now, with the technology of new next generation sequencing, we have a more specific, more detailed picture of the DNA of the tumor cell. And this is absolutely key if we want to create more targeted treatment for metastatic breast cancer patients.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: I think in the next ten years without doubt we are going to have more and more personalized treatment. When I started 25 years ago, breast cancer was considered a single disease. Fifteen years ago, we started to understand that breast cancer is not one disease but at least four. A couple of years ago, we reached the conclusion that we are actually speaking about ten diseases.

I am convinced that in the next ten years, we will speak about several different types of breast cancer or very tiny subgroups of breast cancers that are characterized by the presence of key alterations or by key biomarkers. New technologies are helping us understand that there are specific DNA changes that occur only in one or two percent of the breast cancer population. So, we should treat this one or two percent of patients in a very specific, targeted way. This phenomenon has many implications for us in the clinical research field. One is that we will need to collaborate more and more. Let's say you see two thousand breast cancer patients a year at your cancer center. If you are studying a new drug that is estimated to work on only 2% of the population, you will have perhaps only 30 or 40 patients per year who are good candidates for this particular drug. Unfortunately, with this limited number, you cannot draw any definitive conclusions.

What we will need to do is to join forces internationally, across clinical trials groups and across the oceans. We need to pool together all of our results in order to demonstrate the activity of this new drug so that if it works, there will be enough statistical support to help pass regulations and become available to patients. In April, we had a very interesting meeting with Drs. Norton and Hudis and many other investigators from Europe and the US at which we discussed exactly this issue of reinforcing international collaboration. This is definitely in the future. There is no way that we will continue to run trials where we assume all patients have the same type of breast cancer. Even the pharmaceutical companies are starting to understand this. So in ten years, we will see more tailored approaches towards breast cancer.

Q: How close are we to preventing and curing all forms of breast cancer?

A: This is a really difficult question to answer because I am pretty sure that we are making progress on a daily basis; however, estimating the day on which our world will be breast cancer free is very difficult. We can now cure most cases of primary breast cancer. It is more difficult to treat metastatic disease. But, I am ready to say that the next ten years, we will dramatically improve treatment for patients with metastatic breast cancer.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has impacted breast cancer research in three ways. One, the financial help allows us to pursue research that is completely independent of any pressure that could potentially come from the pharmaceutical industry. BCRF enables pure, independent research by investigators who are focused on curing breast cancer.

Another way BCRF has dramatically improved my laboratory's work is by putting us in contact with an extensive network of outstanding breast cancer scientists from all over the world. This connection, established through the annual retreat that we have in New York, has facilitated collaborations and is instrumental to improving the way we do research.

Last but not least, I work in Italy, a country where there is not as much support for breast cancer research as there is in other countries, especially in the US. When our local authorities realized that our research is funded by such a prestigious organization as BCRF, we got very positive feedback. They started to improve the financial support to our center for breast cancer research because they realize that our research is at the international level. The way that BCRF has improved our progress in breast cancer research is multi-fold, and it depends not only on the financial support but also the many other things that follow when we become part of this wonderful network.

Read more about Dr. Di Leo's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Angelo Di Leo to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I started with an interest in cancer as a student in high school, where I was fascinated by the biology of the tumor cell and decided then that I wanted to become a doctor. Because of my mother, I became very interested in breast cancer. In the second year of medical school, she became a breast cancer patient at the very young age of 46. Since I was still living with my family, I had the opportunity to see exactly what breast cancer is and began to understand how it impacts people.

I was also interested because I realized then that breast cancer is a disease where there are many things that doctors can actually do to try and help patients. At the time in 1984, there was clearly room for improvement in clinical care. Patients were all receiving chemotherapy, as part of standard practice, but chemotherapy causes many side effects. Since I was already fascinated by tumor cell biology, I started to study with more interest the biology of breast cancer cells - how they proliferate or spread to other parts of the body. When I was completing medical school, there was no doubt that I was going to become a breast cancer specialist. After a few years, I decided to move to Brussels, where Martine Piccart, MD, PhD, a fellow BCRF grantee, was starting her studies in the breast cancer field at Institut Jules Bordet. So I had the opportunity to work with her and started training in breast cancer.

As a result, I am a fully committed medical oncologist and breast cancer oncologist.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: The starting point of our BCRF research is that the biology of metastatic breast cancer is different from the biology of primary breast cancer. A woman whose breast cancer returns ("relapses" or "metastasizes") a few years later will have a different form of the disease than the one she had when her primary breast cancer was discovered. It is, therefore, extremely important to look at the biological characteristics of the metastatic breast tumors if you want to personalize or tailor the treatment of metastatic disease or to make substantial progress in the field of metastatic breast cancer treatment.

Now, with the help of technology, we have the potential to isolate circulating tumor cells (CTCs) from the blood of metastatic breast cancer patients and to study these cells. This is a very important advance because CTCs are thought to cause breast cancer relapse and spread. And CTCs are extremely rare - estimated at one CTC per billion normal blood cells. If we can actually isolate the CTCs from the blood, not only can we spare the patient from undergoing the biopsy of her metastatic tumor, which is a quite aggressive procedure, we can also investigate the biology of the origin of metastatic breast cancer. With the BCRF grant, we aim to find specific biomarkers from CTCs which ultimately can be used to help develop targeted therapy for treating metastatic breast cancer and will help lead to individualized therapies for patients.

Another branch of our studies focuses on a completely different aspect of metastatic breast cancer. Unfortunately, the way we are predicting the risk of disease relapse is still not very precise, because we sometimes tend to over-estimate this risk. As a consequence, some patients are receiving more treatment than they need and are being exposed to unnecessary side effects. In collaboration with a team at Memorial Sloan-Kettering Cancer Center (MSKCC) - specifically Monica Fornier, MD, Clifford Hudis, MD, Patrick Morris, MD, and Larry Norton, MD - our centers have been collecting blood samples from patients immediately following their tumor removal to identify specific metabolites, or small molecules, that are produced by tumors. Theoretically, after the primary tumor has been removed, there should be very few metabolites detected. The presence of these metabolites would therefore suggest that there are still tumor cells in the patient and, perhaps, additional interventions or closer monitoring may be necessary. This method can be used to help predict the risk of relapse more precisely than markers, such as tumor size, the involvement of the axillary nodes, or the hormone receptor status, used in current practice.

The technology we are using is called metabolomics, and it actually seems to be able to detect signals produced by metastatic lesions, even tiny micrometastatic ones that cannot be found by any standard radiology or even sophisticated imaging equipment. The reason why we collect blood after breast cancer surgery is because the blood collected before surgery still contains the metabolites that are produced by the primary tumor. This metabolomics technology looks really very promising, and collecting just a few milliliters of blood for a sample is not as invasive, as a biopsy for instance. Our findings show that if you look at the metabolites of early breast cancer patients, you can make a more specific estimate of the risk of disease relapse than using traditional factors. If our findings are confirmed in a large set of patients, which is exactly what we are doing now with MSKCC, it means that in the future we might have a more specific, more precise estimate of risk of disease relapse. This would translate into a less intensive treatment after breast cancer surgery for some patients.

We have recently completed the first part of the work and together with the MSKCC team just finalized a manuscript which will be submitted to scientific journals.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advances can help to enhance your progress?

A: The isolation of the circulating tumor cells was something that ten years ago was absolutely impossible. Now thanks to new technology, we can do this almost routinely.

In detecting metabolites in the peripheral blood, once again thanks to advances in the field of nuclear resonance magnetics, we can now identify small metabolites that ten years ago could not be identified. Technology is absolutely central in our research once we have clearly defined what the clinical problems are. This area is something that technology cannot help. Once you have identified your primary questions, the technology can be helpful to isolate the CTCs and the metabolites and to identify micro-metastases that otherwise cannot be identified.

Continuing to make advances in all areas is important. A specific one is developing a more sophisticated way to analyze DNA. When we isolate a CTC, we isolate also its DNA to analyze it. Now, with the technology of new next generation sequencing, we have a more specific, more detailed picture of the DNA of the tumor cell. And this is absolutely key if we want to create more targeted treatment for metastatic breast cancer patients.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: I think in the next ten years without doubt we are going to have more and more personalized treatment. When I started 25 years ago, breast cancer was considered a single disease. Fifteen years ago, we started to understand that breast cancer is not one disease but at least four. A couple of years ago, we reached the conclusion that we are actually speaking about ten diseases.

I am convinced that in the next ten years, we will speak about several different types of breast cancer or very tiny subgroups of breast cancers that are characterized by the presence of key alterations or by key biomarkers. New technologies are helping us understand that there are specific DNA changes that occur only in one or two percent of the breast cancer population. So, we should treat this one or two percent of patients in a very specific, targeted way. This phenomenon has many implications for us in the clinical research field. One is that we will need to collaborate more and more. Let's say you see two thousand breast cancer patients a year at your cancer center. If you are studying a new drug that is estimated to work on only 2% of the population, you will have perhaps only 30 or 40 patients per year who are good candidates for this particular drug. Unfortunately, with this limited number, you cannot draw any definitive conclusions.

What we will need to do is to join forces internationally, across clinical trials groups and across the oceans. We need to pool together all of our results in order to demonstrate the activity of this new drug so that if it works, there will be enough statistical support to help pass regulations and become available to patients. In April, we had a very interesting meeting with Drs. Norton and Hudis and many other investigators from Europe and the US at which we discussed exactly this issue of reinforcing international collaboration. This is definitely in the future. There is no way that we will continue to run trials where we assume all patients have the same type of breast cancer. Even the pharmaceutical companies are starting to understand this. So in ten years, we will see more tailored approaches towards breast cancer.

Q: How close are we to preventing and curing all forms of breast cancer?

A: This is a really difficult question to answer because I am pretty sure that we are making progress on a daily basis; however, estimating the day on which our world will be breast cancer free is very difficult. We can now cure most cases of primary breast cancer. It is more difficult to treat metastatic disease. But, I am ready to say that the next ten years, we will dramatically improve treatment for patients with metastatic breast cancer.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has impacted breast cancer research in three ways. One, the financial help allows us to pursue research that is completely independent of any pressure that could potentially come from the pharmaceutical industry. BCRF enables pure, independent research by investigators who are focused on curing breast cancer.

Another way BCRF has dramatically improved my laboratory's work is by putting us in contact with an extensive network of outstanding breast cancer scientists from all over the world. This connection, established through the annual retreat that we have in New York, has facilitated collaborations and is instrumental to improving the way we do research.

Last but not least, I work in Italy, a country where there is not as much support for breast cancer research as there is in other countries, especially in the US. When our local authorities realized that our research is funded by such a prestigious organization as BCRF, we got very positive feedback. They started to improve the financial support to our center for breast cancer research because they realize that our research is at the international level. The way that BCRF has improved our progress in breast cancer research is multi-fold, and it depends not only on the financial support but also the many other things that follow when we become part of this wonderful network.

Read more about Dr. Di Leo's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Angelo Di Leo to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Mitch Dowsett to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Mitch Dowsett to discuss his current work and interest in breast cancer research. Read on to learn more.
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Mitch Dowsett to discuss his current work and interest in breast cancer research. Read on to learn more.
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Mitch Dowsett to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I never seriously considered another career other than one involved in science. In fact, I can recall even before the age of ten saying that I wanted to be a scientist. I had a book given to me as a Christmas present, Science and Discovery, which grabbed my imagination. So that really turned me onto science in general, and as I progressed through school, I continued to feel an empathy with science. The thing that really turned me onto biological sciences and still astonishes me is the genetic code, which was unraveled not that many years before I was in secondary school. I am fascinated and find remarkable that the makeup of not just humans but any biological living being was actually coded for in some chemical form. That really sparked my imagination so I took a degree in Zoology, which was actually a mixture of different biological sciences with a twist towards biochemistry and genetics.

The thing that got me involved with cancer and breast cancer was a course run at Imperial College, where I was studying, by the nearby Institute of Cancer Research. I was particularly attracted by the idea that one could begin to use some of this genetic information in relation to clinical treatment. As a result of that course, I applied to the PhD program at the Institute of Cancer Research, with which I am still associated. My dissertation was on trying to understand the mechanisms of why breast cancer interacts with bone and causes it to break down when the cancer metastasizes to that region. I got involved in what we call "translational research" very early where we would take small breast tumor biopsies from the next-door Royal Marsden Hospital and put them into culture with small pieces of bone and try to understand how they interacted. So, I have had a pretty longitudinal career where I started working on breast cancer very early all the way through to the present.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: Our work in general relates to exploiting the biomarkers which change in breast cancer during pre-surgical exposure of patients' tumors to a variety of different agents. Specifically, our BCRF-funded project of the moment builds on some observations we made a few years ago that if we were to expose hormone receptor-positive breast tumors to an aromatase inhibitor in situ, or other endocrine agents, we saw a profound fall in the proliferation of cancer cells, which is measured by a marker called Ki67. We rationalized that the degree of fall might be indicative of the benefit that the patient will get from that specific treatment. So, Professor Ian Smith and I set up a clinical trial called IMPACT, which showed firstly that those changes in Ki67 did indeed predict the outcome of patients in the ATAC trial, a much, much larger study comparing the effectiveness of the endocrine therapies, aromatase inhibitors and tamoxifen, after surgery. Based on the IMPACT results, we believe that generally one can use Ki67 as an intermediate measurement of treatment effectiveness for an individual patient.

I was inspired to work with Ian on the IMPACT study, because of my involvement with the development of the ATAC trial. ATAC was the first trial conducted and reported on the comparison of aromatase inhibitor versus tamoxifen, versus the combination of these two drugs. It was the first big clinical trial that I was involved with, and I was struck by just how enormous the trial had to be. ATAC eventually required over 9,000 patients to be randomized and to be treated for at least two and a half years before we had any indication of whether one treatment was better than the other. And the measure of that success was based on approximately 900 patients having to relapse with their breast cancer before we knew whether one or the other was better to restrict that relapse. These difficulties seemed to be something that we should be able to improve upon by designing clinical trials that use markers, such as Ki67, to predict patient benefit. And that is where the IMPACT trial came in. IMPACT involved just 330 patients and three months treatment duration. In fact, because we took biopsies after two weeks, we could show changes in Ki67 at the very earliest stage, and were able to show that the combination of aromatase inhibitor and tamoxifen was actually poorer than just the aromatase inhibitor very quickly. So the ATAC experience was something that really did stimulate or inspire my work on IMPACT. Currently, Professor Smith and I are again co-PIs on a new trial called POETIC, which builds on IMPACT to find whether giving patients an aromatase inhibitor prior to surgery and then measuring their Ki67 level may allow us to better predict during routine care the outcome of those patients in the long term.

With BCRF funding, specifically we are doing a study in premenopausal women, on whom you cannot use aromatase inhibitors because they are ineffective and cause significant adverse effects. But we thought the way around the problem was that we might be able to use the changes in hormonal stimulation of the breast tumor, occurring as a result of the menstrual cycle in these premenopausal women. We thought it might be possible to allow the menstrual cycle, instead of a drug, to stimulate certain genes in these women's breast tumors and indicate their responsiveness to treatment. We have some background data on our study, and a paper has just been published in the journal Breast Cancer Research and Treatment. These data were also presented at the 2012 San Antonio Breast Cancer Symposium. We have also launched a prospective trial to test this with colleagues in the UK and Vietnam.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: The studies I mentioned are based on fairly standard technologies. The POETIC study, however, requires us to implement a collection of tissues essentially as soon as a patient is diagnosed and then again at the time of surgery, which in the UK has required a certain amount of change in the infrastructure. The POETIC trial involves 120 centers, and we just reached our targeted recruitment of 4,000 patients.

In terms of the future, including our work using the menstrual cycle to stimulate the effectiveness of breast cancer drugs, we are using high throughput multiplex molecular technologies, to search a larger number of genes to see whether we can get better signals of response to therapy than what we have gotten so far. Also, we just started doing next generation sequencing on some of the samples from the POETIC trial to identify any mutations existing in those tumors related to outcome. So, we are embracing these new molecular technologies and are beginning to apply them in our studies.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: The big thing that has been happening over the last few years is the application of next generation sequencing and massive parallel sequencing to identify genetic mutations and then to profile mutations in tumors. This work has revealed some surprises, such as that there are numerous mutations but with relatively low prevalence in any particular population of breast cancers. This "diversity" creates a real challenge as to how we can bring that information to clinical benefit. But trials are now being designed to see how we link those mutations to the applications of some targeted therapies. There is a real challenge, recognized by many people, in the heterogeneity of those mutations within any single subtype of breast cancer. This may mean that there are "escape routes" or populations of tumor cells that either do not contain those mutations or have additional mutations that make treatments ineffective. We must address those issues as we move forward.

The thing I would really like to see come forward in a big way is the measurement of tumor DNA in the blood, because I think that could be a game-changer in terms of the way we manage breast cancer. This essentially would be a very sensitive, highly specific tumor marker which would reflect whether or not after surgery significant amounts of tumor cells continue to reside in the patient and therefore need additional medical treatment. At the present time, we are treating patients after surgery essentially blind of whether they have residual tumor, and blind to response of that tumor. If we had had a marker of the sort, it would radically change the way we direct our therapies. I think the prospects for that occurring are good but probably a few years away.

Q: What other projects are you currently working on?

A: The POETIC trial is one of our major efforts. We will have in the laboratory all the tissue samples from the 4,000 participants, which is an enormous resource for trying to work out the mechanisms of resistance to endocrine therapy. This is a unique set of materials to help us to truly understand tumor heterogeneity and the different mechanisms of resistance to endocrine therapy and the degrees to which these are important in any patient.

Another project that we are working on is predictors of late recurrence in estrogen receptor-positive breast cancer (late in this case being defined as after five years of the patient being free of breast cancer). We have just submitted our first manuscript on this and presented data for the first time late last year at the European Society of Medical Oncology (ESMO) meeting. The observation was made a few years ago that the risk of breast cancer continues for many years in the estrogen receptor-positive patients. The convention up until recently has been to treat these patients for five years. Work has now shown that continued recurrence after five years can be markedly reduced by the introduction of further endocrine treatment at the end of five years. But the challenge is to identify which patients really need that continued treatment. Five years is already a long time to be taking treatment and recommending it to be taken further is not to be made without serious consideration. And there are some markers that are coming through that we should be able to bring to bear. But specifically trying to identify molecular markers that could be useful in that scenario is a recent research development. The markers that we have been testing out so far and have valuable prognostic or predictive characteristics have been found to have some prognostic value for late recurrence but were "discovered" in a way by chance, rather than by design. We expect to be able to improve on these by dedicated research in this area.

Q: How close are we to preventing and curing all forms of breast cancer?

A: That is a tough question. If we think about "cure" at least in terms of preventing death from breast cancer, data show that we are making substantial progress. Some twenty years ago, 16,000 women were dying of breast cancer in the UK each year, and the most recent data from two years ago were that 12,000 women died of breast cancer each year. These survivors would have been diagnosed several years prior, so going forward patients diagnosed nowadays have much better prospects, including better treatments that would lead to much reduced risk of breast cancer mortality. So in terms of reducing mortality, I think the chances are that few patients will be dying from breast cancer twenty years from now. I believe breast cancer will become a disease that is much less feared than it has been as we move through the next two decades.

I do not think that the approaches we are presently taking are likely to lead to major increases in prevention over the next few years. First, detection is not the same as prevention. Being able to detect breast cancer earlier does allow doctors to treat patients earlier and gives the patients a better chance of surviving the disease. But early detection is de facto not geared towards prevention. My optimism is more directed to thinking that the disease will be managed much, much better, such that the fear will be taken out of the diagnosis of breast cancer. Prevention is likely to have some importance by being targeted at those at highest risk.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: I think BCRF has had major beneficial impact. The direct effect is, of course, in the provision of funding to investigators who already have either shown some promise or with established careers and trusting those people really to spend that money well. BCRF is not bureaucratic, which means much more of the money and time can be spent on the research itself rather than with people having to spend their time and effort on reports. I think the trust that BCRF has in its grantees is well-placed and that trust imposes a degree of responsibility on the investigators.

BCRF funding has also produced some indirect benefits. For example, the types of projects that BCRF enables one to do are those sometimes considered high risk but high pay-off, and I think the study that we are doing trying to establish whether or not we can use the menstrual cycle as a probe for the hormone responsiveness of the breast tumor is very much along those "high risk, high reward" lines. If it works out, it will be a major benefit and a terrific advance, but it is high risk. The data we have derived so far supports us moving forward, and it is decreasing the risk as we move forward. I think it would have been difficult to secure funding from another agency for this project.

Another thing I might say about BCRF is the genuine feeling of family it creates amongst the investigators. At the meeting in October, the interactions are very warm, and our meeting at that particular time is welcomed by all of us. We all travel to New York and I think we both enjoy and get reward from interacting with the advocates and the fundraisers. This meeting really does stimulate people and creates a patient-orientated focus in the participants' research as well.

Read more about Dr. Dowsett's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Mitch Dowsett to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I never seriously considered another career other than one involved in science. In fact, I can recall even before the age of ten saying that I wanted to be a scientist. I had a book given to me as a Christmas present, Science and Discovery, which grabbed my imagination. So that really turned me onto science in general, and as I progressed through school, I continued to feel an empathy with science. The thing that really turned me onto biological sciences and still astonishes me is the genetic code, which was unraveled not that many years before I was in secondary school. I am fascinated and find remarkable that the makeup of not just humans but any biological living being was actually coded for in some chemical form. That really sparked my imagination so I took a degree in Zoology, which was actually a mixture of different biological sciences with a twist towards biochemistry and genetics.

The thing that got me involved with cancer and breast cancer was a course run at Imperial College, where I was studying, by the nearby Institute of Cancer Research. I was particularly attracted by the idea that one could begin to use some of this genetic information in relation to clinical treatment. As a result of that course, I applied to the PhD program at the Institute of Cancer Research, with which I am still associated. My dissertation was on trying to understand the mechanisms of why breast cancer interacts with bone and causes it to break down when the cancer metastasizes to that region. I got involved in what we call "translational research" very early where we would take small breast tumor biopsies from the next-door Royal Marsden Hospital and put them into culture with small pieces of bone and try to understand how they interacted. So, I have had a pretty longitudinal career where I started working on breast cancer very early all the way through to the present.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: Our work in general relates to exploiting the biomarkers which change in breast cancer during pre-surgical exposure of patients' tumors to a variety of different agents. Specifically, our BCRF-funded project of the moment builds on some observations we made a few years ago that if we were to expose hormone receptor-positive breast tumors to an aromatase inhibitor in situ, or other endocrine agents, we saw a profound fall in the proliferation of cancer cells, which is measured by a marker called Ki67. We rationalized that the degree of fall might be indicative of the benefit that the patient will get from that specific treatment. So, Professor Ian Smith and I set up a clinical trial called IMPACT, which showed firstly that those changes in Ki67 did indeed predict the outcome of patients in the ATAC trial, a much, much larger study comparing the effectiveness of the endocrine therapies, aromatase inhibitors and tamoxifen, after surgery. Based on the IMPACT results, we believe that generally one can use Ki67 as an intermediate measurement of treatment effectiveness for an individual patient.

I was inspired to work with Ian on the IMPACT study, because of my involvement with the development of the ATAC trial. ATAC was the first trial conducted and reported on the comparison of aromatase inhibitor versus tamoxifen, versus the combination of these two drugs. It was the first big clinical trial that I was involved with, and I was struck by just how enormous the trial had to be. ATAC eventually required over 9,000 patients to be randomized and to be treated for at least two and a half years before we had any indication of whether one treatment was better than the other. And the measure of that success was based on approximately 900 patients having to relapse with their breast cancer before we knew whether one or the other was better to restrict that relapse. These difficulties seemed to be something that we should be able to improve upon by designing clinical trials that use markers, such as Ki67, to predict patient benefit. And that is where the IMPACT trial came in. IMPACT involved just 330 patients and three months treatment duration. In fact, because we took biopsies after two weeks, we could show changes in Ki67 at the very earliest stage, and were able to show that the combination of aromatase inhibitor and tamoxifen was actually poorer than just the aromatase inhibitor very quickly. So the ATAC experience was something that really did stimulate or inspire my work on IMPACT. Currently, Professor Smith and I are again co-PIs on a new trial called POETIC, which builds on IMPACT to find whether giving patients an aromatase inhibitor prior to surgery and then measuring their Ki67 level may allow us to better predict during routine care the outcome of those patients in the long term.

With BCRF funding, specifically we are doing a study in premenopausal women, on whom you cannot use aromatase inhibitors because they are ineffective and cause significant adverse effects. But we thought the way around the problem was that we might be able to use the changes in hormonal stimulation of the breast tumor, occurring as a result of the menstrual cycle in these premenopausal women. We thought it might be possible to allow the menstrual cycle, instead of a drug, to stimulate certain genes in these women's breast tumors and indicate their responsiveness to treatment. We have some background data on our study, and a paper has just been published in the journal Breast Cancer Research and Treatment. These data were also presented at the 2012 San Antonio Breast Cancer Symposium. We have also launched a prospective trial to test this with colleagues in the UK and Vietnam.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: The studies I mentioned are based on fairly standard technologies. The POETIC study, however, requires us to implement a collection of tissues essentially as soon as a patient is diagnosed and then again at the time of surgery, which in the UK has required a certain amount of change in the infrastructure. The POETIC trial involves 120 centers, and we just reached our targeted recruitment of 4,000 patients.

In terms of the future, including our work using the menstrual cycle to stimulate the effectiveness of breast cancer drugs, we are using high throughput multiplex molecular technologies, to search a larger number of genes to see whether we can get better signals of response to therapy than what we have gotten so far. Also, we just started doing next generation sequencing on some of the samples from the POETIC trial to identify any mutations existing in those tumors related to outcome. So, we are embracing these new molecular technologies and are beginning to apply them in our studies.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: The big thing that has been happening over the last few years is the application of next generation sequencing and massive parallel sequencing to identify genetic mutations and then to profile mutations in tumors. This work has revealed some surprises, such as that there are numerous mutations but with relatively low prevalence in any particular population of breast cancers. This "diversity" creates a real challenge as to how we can bring that information to clinical benefit. But trials are now being designed to see how we link those mutations to the applications of some targeted therapies. There is a real challenge, recognized by many people, in the heterogeneity of those mutations within any single subtype of breast cancer. This may mean that there are "escape routes" or populations of tumor cells that either do not contain those mutations or have additional mutations that make treatments ineffective. We must address those issues as we move forward.

The thing I would really like to see come forward in a big way is the measurement of tumor DNA in the blood, because I think that could be a game-changer in terms of the way we manage breast cancer. This essentially would be a very sensitive, highly specific tumor marker which would reflect whether or not after surgery significant amounts of tumor cells continue to reside in the patient and therefore need additional medical treatment. At the present time, we are treating patients after surgery essentially blind of whether they have residual tumor, and blind to response of that tumor. If we had had a marker of the sort, it would radically change the way we direct our therapies. I think the prospects for that occurring are good but probably a few years away.

Q: What other projects are you currently working on?

A: The POETIC trial is one of our major efforts. We will have in the laboratory all the tissue samples from the 4,000 participants, which is an enormous resource for trying to work out the mechanisms of resistance to endocrine therapy. This is a unique set of materials to help us to truly understand tumor heterogeneity and the different mechanisms of resistance to endocrine therapy and the degrees to which these are important in any patient.

Another project that we are working on is predictors of late recurrence in estrogen receptor-positive breast cancer (late in this case being defined as after five years of the patient being free of breast cancer). We have just submitted our first manuscript on this and presented data for the first time late last year at the European Society of Medical Oncology (ESMO) meeting. The observation was made a few years ago that the risk of breast cancer continues for many years in the estrogen receptor-positive patients. The convention up until recently has been to treat these patients for five years. Work has now shown that continued recurrence after five years can be markedly reduced by the introduction of further endocrine treatment at the end of five years. But the challenge is to identify which patients really need that continued treatment. Five years is already a long time to be taking treatment and recommending it to be taken further is not to be made without serious consideration. And there are some markers that are coming through that we should be able to bring to bear. But specifically trying to identify molecular markers that could be useful in that scenario is a recent research development. The markers that we have been testing out so far and have valuable prognostic or predictive characteristics have been found to have some prognostic value for late recurrence but were "discovered" in a way by chance, rather than by design. We expect to be able to improve on these by dedicated research in this area.

Q: How close are we to preventing and curing all forms of breast cancer?

A: That is a tough question. If we think about "cure" at least in terms of preventing death from breast cancer, data show that we are making substantial progress. Some twenty years ago, 16,000 women were dying of breast cancer in the UK each year, and the most recent data from two years ago were that 12,000 women died of breast cancer each year. These survivors would have been diagnosed several years prior, so going forward patients diagnosed nowadays have much better prospects, including better treatments that would lead to much reduced risk of breast cancer mortality. So in terms of reducing mortality, I think the chances are that few patients will be dying from breast cancer twenty years from now. I believe breast cancer will become a disease that is much less feared than it has been as we move through the next two decades.

I do not think that the approaches we are presently taking are likely to lead to major increases in prevention over the next few years. First, detection is not the same as prevention. Being able to detect breast cancer earlier does allow doctors to treat patients earlier and gives the patients a better chance of surviving the disease. But early detection is de facto not geared towards prevention. My optimism is more directed to thinking that the disease will be managed much, much better, such that the fear will be taken out of the diagnosis of breast cancer. Prevention is likely to have some importance by being targeted at those at highest risk.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: I think BCRF has had major beneficial impact. The direct effect is, of course, in the provision of funding to investigators who already have either shown some promise or with established careers and trusting those people really to spend that money well. BCRF is not bureaucratic, which means much more of the money and time can be spent on the research itself rather than with people having to spend their time and effort on reports. I think the trust that BCRF has in its grantees is well-placed and that trust imposes a degree of responsibility on the investigators.

BCRF funding has also produced some indirect benefits. For example, the types of projects that BCRF enables one to do are those sometimes considered high risk but high pay-off, and I think the study that we are doing trying to establish whether or not we can use the menstrual cycle as a probe for the hormone responsiveness of the breast tumor is very much along those "high risk, high reward" lines. If it works out, it will be a major benefit and a terrific advance, but it is high risk. The data we have derived so far supports us moving forward, and it is decreasing the risk as we move forward. I think it would have been difficult to secure funding from another agency for this project.

Another thing I might say about BCRF is the genuine feeling of family it creates amongst the investigators. At the meeting in October, the interactions are very warm, and our meeting at that particular time is welcomed by all of us. We all travel to New York and I think we both enjoy and get reward from interacting with the advocates and the fundraisers. This meeting really does stimulate people and creates a patient-orientated focus in the participants' research as well.

Read more about Dr. Dowsett's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Mitch Dowsett to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. H. Shelton Earp to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research. 
A: I started doing research while in medical school and have always been fascinated with the molecules that make cells grow. In the 1990's, my research gravitated towards the epidermal growth factor (EGF) receptor family and the role its members play in breast cancer. My interest in combining basic and clinical research led me to administrative roles, as Director of the University of North Carolina's Lineberger Comprehensive Cancer Center and Principal Investigator of UNC's Breast Cancer SPORE grant. However, it is my laboratory and my fascination with research that keeps me sane, and support from the BCRF allows me to study the intricacies of breast cancer biology and its application to patient care.
Q: Briefly describe your research project. 
A: BCRF funds support studies into Human EGF Receptor-4, HER4, which we believe may be a tumor suppressor and predict a good prognosis in breast cancer. We work to understand the mechanism by which HER4 suppresses breast cancer growth, reasoning that this will help develop new therapies. Our BCRF funds also support a HER2 breast cancer vaccine project, designed to treat advanced HER2-positive breast cancer. Lastly, we support a long-term project, collecting DNA and clinical history from over 1,000 women (patients and controls) to study the effect of genes on predisposition to breast cancer.
Q: What are your primary goals for this research? 
A: Our goals are to understand: i) predisposition to cancer; ii) how certain growth factor receptors modify breast cancer behavior; and iii) how we may use the immune system to help treat advanced breast cancer.
Q: Who do you think will benefit from your research? 
A: The beneficiaries, we hope, will include women at risk for breast cancer and those who have been diagnosed with the disease.
Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field? 
A: During the last six to seven years, we have focused on the same three projects, but have changed aims and technology with advances in our research. BCRF supports a long-term project looking at breast cancer predisposition. We started with a cohort of 100 women and now have a group of 1,000 women enrolled. Clinical data and the biologic samples will provide advances for years to come. Our HER4 project has evolved not only in knowledge but in creating reagents and new antibodies with which we can study HER4 in human tissues in a precise way. None of this would have been possible without BCRF, particularly at a time of decreasing federal funding. Our cancer vaccine project has completed one trial, used data and laboratory models to refine our approach, and launched a second trial.
Q: How close do you think we are to preventing or finding a cure for breast cancer? 
A: UNC has contributed much to the concept that breast cancer is really a family of at least five diseases. Each has distinctive biology and may have different needs for prevention, early detection, and therapy. For that reason, it is hard to predict when we will prevent or cure breast cancer, but BCRF and the scientific community have made remarkable progress. If we can keep reducing the death rate for breast cancer at 1-2% per year through a combination of early detection, prevention, and better therapy, we will get to our goal.
Read more about Dr. Earp's current research project funded by BCRF. 

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. H. Shelton Earp to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. H. Shelton Earp to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. H. Shelton Earp to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I started doing research while in medical school and have always been fascinated with the molecules that make cells grow. In the 1990's, my research gravitated towards the epidermal growth factor (EGF) receptor family and the role its members play in breast cancer. My interest in combining basic and clinical research led me to administrative roles, as Director of the University of North Carolina's Lineberger Comprehensive Cancer Center and Principal Investigator of UNC's Breast Cancer SPORE grant. However, it is my laboratory and my fascination with research that keeps me sane, and support from the BCRF allows me to study the intricacies of breast cancer biology and its application to patient care.

Q: Briefly describe your research project.

A: BCRF funds support studies into Human EGF Receptor-4, HER4, which we believe may be a tumor suppressor and predict a good prognosis in breast cancer. We work to understand the mechanism by which HER4 suppresses breast cancer growth, reasoning that this will help develop new therapies. Our BCRF funds also support a HER2 breast cancer vaccine project, designed to treat advanced HER2-positive breast cancer. Lastly, we support a long-term project, collecting DNA and clinical history from over 1,000 women (patients and controls) to study the effect of genes on predisposition to breast cancer.

Q: What are your primary goals for this research?

A: Our goals are to understand: i) predisposition to cancer; ii) how certain growth factor receptors modify breast cancer behavior; and iii) how we may use the immune system to help treat advanced breast cancer.

Q: Who do you think will benefit from your research?

A: The beneficiaries, we hope, will include women at risk for breast cancer and those who have been diagnosed with the disease.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: During the last six to seven years, we have focused on the same three projects, but have changed aims and technology with advances in our research. BCRF supports a long-term project looking at breast cancer predisposition. We started with a cohort of 100 women and now have a group of 1,000 women enrolled. Clinical data and the biologic samples will provide advances for years to come. Our HER4 project has evolved not only in knowledge but in creating reagents and new antibodies with which we can study HER4 in human tissues in a precise way. None of this would have been possible without BCRF, particularly at a time of decreasing federal funding. Our cancer vaccine project has completed one trial, used data and laboratory models to refine our approach, and launched a second trial.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: UNC has contributed much to the concept that breast cancer is really a family of at least five diseases. Each has distinctive biology and may have different needs for prevention, early detection, and therapy. For that reason, it is hard to predict when we will prevent or cure breast cancer, but BCRF and the scientific community have made remarkable progress. If we can keep reducing the death rate for breast cancer at 1-2% per year through a combination of early detection, prevention, and better therapy, we will get to our goal.

Read more about Dr. Earp's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. H. Shelton Earp to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I started doing research while in medical school and have always been fascinated with the molecules that make cells grow. In the 1990's, my research gravitated towards the epidermal growth factor (EGF) receptor family and the role its members play in breast cancer. My interest in combining basic and clinical research led me to administrative roles, as Director of the University of North Carolina's Lineberger Comprehensive Cancer Center and Principal Investigator of UNC's Breast Cancer SPORE grant. However, it is my laboratory and my fascination with research that keeps me sane, and support from the BCRF allows me to study the intricacies of breast cancer biology and its application to patient care.

Q: Briefly describe your research project.

A: BCRF funds support studies into Human EGF Receptor-4, HER4, which we believe may be a tumor suppressor and predict a good prognosis in breast cancer. We work to understand the mechanism by which HER4 suppresses breast cancer growth, reasoning that this will help develop new therapies. Our BCRF funds also support a HER2 breast cancer vaccine project, designed to treat advanced HER2-positive breast cancer. Lastly, we support a long-term project, collecting DNA and clinical history from over 1,000 women (patients and controls) to study the effect of genes on predisposition to breast cancer.

Q: What are your primary goals for this research?

A: Our goals are to understand: i) predisposition to cancer; ii) how certain growth factor receptors modify breast cancer behavior; and iii) how we may use the immune system to help treat advanced breast cancer.

Q: Who do you think will benefit from your research?

A: The beneficiaries, we hope, will include women at risk for breast cancer and those who have been diagnosed with the disease.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: During the last six to seven years, we have focused on the same three projects, but have changed aims and technology with advances in our research. BCRF supports a long-term project looking at breast cancer predisposition. We started with a cohort of 100 women and now have a group of 1,000 women enrolled. Clinical data and the biologic samples will provide advances for years to come. Our HER4 project has evolved not only in knowledge but in creating reagents and new antibodies with which we can study HER4 in human tissues in a precise way. None of this would have been possible without BCRF, particularly at a time of decreasing federal funding. Our cancer vaccine project has completed one trial, used data and laboratory models to refine our approach, and launched a second trial.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: UNC has contributed much to the concept that breast cancer is really a family of at least five diseases. Each has distinctive biology and may have different needs for prevention, early detection, and therapy. For that reason, it is hard to predict when we will prevent or cure breast cancer, but BCRF and the scientific community have made remarkable progress. If we can keep reducing the death rate for breast cancer at 1-2% per year through a combination of early detection, prevention, and better therapy, we will get to our goal.

Read more about Dr. Earp's current research project funded by BCRF.

# data[].attributes.field_caption
Photo: University of North Carolina at Chapel Hill

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Matthew J. Ellis to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Matthew J. Ellis to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Matthew J. Ellis to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Matthew J. Ellis to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I have always known that I wanted to do medical research. As a young doctor in training in London, Oxford, and Cambridge, I was struck by the number of patients with metastatic breast cancer. When I approached my mentors about a career in cancer, they largely discouraged it and suggested instead gastroenterology or cardiology as "more promising" medical specialties. There was still the pessimistic attitude in the '80s towards cancer that it was a disease we could never understand and therefore it was hopeless to treat.

But yet as I cared for these women, seeing them respond to chemotherapy and endocrine (or anti-hormone) therapy, I got the impression that breast cancer was not hopeless at all. Inspired by the discovery of "cancer genes" (oncogenes), I decided to also pursue a doctoral degree focusing on fundamental molecular biology. I hoped that by marrying knowledge on disease etiology with clinical aspects of breast cancer, I could make a difference. When I finished my PhD, I met Dr. Marc Lippman (a BCRF grantee since 1995), who has become one of my lifelong mentors, and he encouraged me to come to the United States to work with him at the Lombardi Comprehensive Cancer Center of Georgetown University in Washington, DC.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: Well, breast cancer is a complex set of diseases, so it made sense to focus on one subtype. I zeroed in on the estrogen receptor positive (ER+) subset. The majority of women with breast cancer are ER+, which also means that the majority of women dying from breast cancer die despite targeting ER with tamoxifen or estrogen-lowering agents (aromatase inhibitors). In the late 1990s, I developed a new treatment protocol for patients with ER+ breast cancer: instead of operating on them immediately, we gave them a few months of endocrine therapy before surgery, which resulted in shrinkage of the tumors, making it possible for patients to avoid mastectomy and instead undergo breast conserving surgery.

We also preserved the patients' generously donated tissue samples, so we could study them in the lab to get at fundamental issues, for example, why some women with ER+ breast cancer respond well to endocrine therapy but others do not. In 2004, through the National Cancer Institute-designated cooperative group ACOSOG, now part of the Alliance for Clinical Trials in Oncology, we opened a neoadjuvant trial comparing the effectiveness of the different aromatase inhibitors, a class of endocrine therapy. More fundamentally, we were trying to understand why there was such a great variability in the response to treatment. BCRF funding gave us the means to collect the highest-quality specimens at different treatment intervals so we could apply genomic techniques to see exactly how these breast cancers were re-coded as a result of all the mutations that occur during the genesis of a tumor. Federal funding for clinical trials remains inadequate for this kind of longitudinal specimen acquisition.

Recently, we applied "whole genome sequencing" on these specimens, which consisted of both healthy and cancer tissues from patients. This means that we sequenced entire genomes of tumors and compared them with the genomes of healthy tissues from the same person. So far, we have completed 46 cases and have also used partial genome sequencing techniques with data currently complete on 77 cases in total. Now, we have a list of all the common and rare mutations that occur during the development of cancer from a normal cell. We also have begun to relate the presence of these mutations with the clinical behavior of the tumors and look at responses to therapy, histological growth patterns, and whether the mutations occurred in pathways that could be targeted. A paper describing this work will be presented at the Annual Meeting of the American Society of Clinical Oncology in June and printed in Nature magazine later this year.

During the course of this work, we have discovered entirely new genes involved in the development of ER+ breast cancer. We were not only able to describe genes that were involved in coding aggressive ER+ breast cancers that became resistant to aromatase inhibitor therapy but also families of genes that are associated with slow growing, indolent types of breast cancer. The genetic basis for these slow growing ER+ breast cancers was understudied previously, because the sequencing of cell lines, ER negative tumors and cruder genomic techniques missed this important biology. So our BCRF supported study really did, I think, contribute in a major way to our fundamental understanding of luminal, or ER+, breast cancers. The funding was visionary and critical for this work.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advances can help to enhance your progress?

A: Our research capitalizes on the new technique called massively parallel (or "next gen") sequencing. With this technology, we take tumor DNA and matched normal DNA from a patient and we break these DNAs into tiny fragments and sequence them at random. Computer programs are used to map the sequences to the human genome and to spot differences in the normal and the cancer DNA (mutations). Using this approach, we can identify not only the gene mutations but also the frequency at which these mutations occur. Having access to this type of technology was the primary reason for my move to Washington University in St. Louis. What we have found is that tumors are often quite complex and in the process of evolution, both rare and common mutations are present. The challenge is to determine what changes are biologically relevant and therefore useful for patient stratification and treatment. In terms of the next step, we are beginning a huge effort to maximize the value of next gen sequencing. Discovery using this technology will be largely completed within the next two to four years. Literally thousands of breast cancers are going to be sequenced. We now need to figure out the clinical application of these techniques.

I am also increasingly excited about new developments in proteomics. Our ability to identify proteins, analyze them, and reliably identify modifications of proteins has been rudimentary. But now, faster, more accurate, and computationally better supported proteomics machines are coming online. These "mass spectrometry" machines are going to make the deep impact that the introduction of massively parallel sequencing made two to three years ago. Creating a comprehensive approach that includes both DNA/RNA and protein analysis will get us to the next step, which is an understanding of how the recoding of the cancer genome alters protein function. When we can understand that, we will gain a much clearer picture of how to treat individual patients in a very precise way because we will be able to zero in on the most critical changes that drive the disease outcome.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: What our sequencing efforts are already telling us is that breast cancer is a very heterogeneous disease. It may be as heterogeneous, or even more so, than all the different types of leukemia. Breast cancer will fracture into many subsets, beyond luminal A and B, HER2 positive (HER2+), and triple negative. By using our understanding of the underlying biology of breast cancers, we will be able to determine whether or not certain classes of drugs will benefit patients.

For example in our studies, we found rare activating mutations in genes such as HER2. These tumors are labeled "HER2 normal" because they do not have gene amplification but functionally they are HER positive. Hypothetically in these cases, tumors are likely to be sensitive to such anti-HER2 drugs as lapatinib. But currently these patients would never receive lapatinib based on our standard definition. These HER2 mutations are infrequent, occurring in perhaps 1-2% of breast cancer patients, but because breast cancer is so devastating common, we may be talking about more than 2,000 patients a year in the US alone. These cases are, therefore, a very significant subset to recognize because there may be a treatment already available to help them. The only way to find these patients is through the prospective use of sequencing technology. In reality, most targeted therapies dramatically affect only a relatively small population of patients. However, because of the large numbers of targeted oncology drugs available, I predict there will be increasing numbers of patient subsets who will benefit from improved diagnostic approaches.

Q: What other projects are you currently working on?

A: We are a part of the National Cancer Institute's new program called Clinical Proteomic Technologies for Cancer (CPTC) initiative. This is a consortium of sites working on cancer proteomics. We are beginning to place mass spectrometry-based cancer protein identifications into the context of our knowledge of RNA and DNA, from the next generation sequencing studies, to create a comprehensive approach that includes parallel analysis of DNA, RNA, and protein in each cancer sample.

Another thing that I'm very interested in is taking these genomic approaches and improving the therapy for ER+ breast cancer through the use of combinations of endocrine drugs with targeted therapies. We are studying the combination of endocrine drugs with signaling inhibitors, such as PI3 kinase inhibitors, that can cause rapid activation of cell death programs in cancer cells. The problem with ER+ breast cancer all along has been that endocrine therapies unfortunately are only partial therapies. They suppress the cancer by making tumor cells dormant but in many patients they do not cure. Because these drugs do not get rid of tumor cells entirely, the cancer cells can reactivate and develop secondary mutations, making them resistant to drugs that were formerly effective. The only way to deal with that problem is to find therapies that cause complete regression of a tumor right at the beginning, right at the time of diagnosis.

Q: How close are we to preventing and curing all forms of breast cancer?

A: I think we have already made massive progress in some breast cancer subtypes, for example using trastuzumab (Herceptin®) on HER2+ and third-generation chemotherapy on some forms of triple negative breast cancers. In the ER+ group, I think there are definite possibilities around endocrine drugs combined with other signaling pathway inhibitors. Going forward, I think we need to determine therapy in a "genome forward" way, meaning using the tumors' mutational profiles prospectively to create testable therapeutic hypotheses for each patient. A cure for everybody is our goal, but I think it requires us to completely rethink the way we do clinical trials. We cannot continue to do trials that produce a 4% improvement in survival in a study involving 4,000 patients; the sums don't add up. Prospective identification of subset of patients who would benefit from individual drug approaches involves a lot more diagnostic work, a lot more sequencing, a lot more organization but I don't think it's beyond the wisdom and power of my colleagues to achieve this little transformation. BCRF will be absolutely essential to the effort.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: I think the vision shared by BCRF's co-founders, the late Evelyn Lauder and Dr. Larry Norton, is fantastic. They have created a different and very smart model for research funding. The alternatives, one of which is the competitive grants model, require you to spin a story and propose an "exciting" but self-contained piece of work is cumbersome and slow, as the time from application to delivery of the dollars is typically over a year. Also, clinical trials are an example of the type of study not always amenable to the competitive grants process. For instance, you may need funding to collect, ship, and store tumor specimens, which may sound mundane but is absolutely critical because you cannot do an experiment without these samples. Our work could never have been done without BCRF funding. Another thing is that BCRF invests in individuals and individual groups. With a non-bureaucratic approach, through Larry Norton's vision BCRF has created an "academy of breast cancer researchers." At our annual faculty-only retreat preceding the October Symposium & Awards Luncheon in New York, we get to have interesting and very worthwhile conversations. These opportunities foster camaraderie and collaboration. In our research, BCRF became a critical cog in a very complicated machine to actually achieve the experiment.

Read more about Dr. Ellis' current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Matthew J. Ellis to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I have always known that I wanted to do medical research. As a young doctor in training in London, Oxford, and Cambridge, I was struck by the number of patients with metastatic breast cancer. When I approached my mentors about a career in cancer, they largely discouraged it and suggested instead gastroenterology or cardiology as "more promising" medical specialties. There was still the pessimistic attitude in the '80s towards cancer that it was a disease we could never understand and therefore it was hopeless to treat.

But yet as I cared for these women, seeing them respond to chemotherapy and endocrine (or anti-hormone) therapy, I got the impression that breast cancer was not hopeless at all. Inspired by the discovery of "cancer genes" (oncogenes), I decided to also pursue a doctoral degree focusing on fundamental molecular biology. I hoped that by marrying knowledge on disease etiology with clinical aspects of breast cancer, I could make a difference. When I finished my PhD, I met Dr. Marc Lippman (a BCRF grantee since 1995), who has become one of my lifelong mentors, and he encouraged me to come to the United States to work with him at the Lombardi Comprehensive Cancer Center of Georgetown University in Washington, DC.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: Well, breast cancer is a complex set of diseases, so it made sense to focus on one subtype. I zeroed in on the estrogen receptor positive (ER+) subset. The majority of women with breast cancer are ER+, which also means that the majority of women dying from breast cancer die despite targeting ER with tamoxifen or estrogen-lowering agents (aromatase inhibitors). In the late 1990s, I developed a new treatment protocol for patients with ER+ breast cancer: instead of operating on them immediately, we gave them a few months of endocrine therapy before surgery, which resulted in shrinkage of the tumors, making it possible for patients to avoid mastectomy and instead undergo breast conserving surgery.

We also preserved the patients' generously donated tissue samples, so we could study them in the lab to get at fundamental issues, for example, why some women with ER+ breast cancer respond well to endocrine therapy but others do not. In 2004, through the National Cancer Institute-designated cooperative group ACOSOG, now part of the Alliance for Clinical Trials in Oncology, we opened a neoadjuvant trial comparing the effectiveness of the different aromatase inhibitors, a class of endocrine therapy. More fundamentally, we were trying to understand why there was such a great variability in the response to treatment. BCRF funding gave us the means to collect the highest-quality specimens at different treatment intervals so we could apply genomic techniques to see exactly how these breast cancers were re-coded as a result of all the mutations that occur during the genesis of a tumor. Federal funding for clinical trials remains inadequate for this kind of longitudinal specimen acquisition.

Recently, we applied "whole genome sequencing" on these specimens, which consisted of both healthy and cancer tissues from patients. This means that we sequenced entire genomes of tumors and compared them with the genomes of healthy tissues from the same person. So far, we have completed 46 cases and have also used partial genome sequencing techniques with data currently complete on 77 cases in total. Now, we have a list of all the common and rare mutations that occur during the development of cancer from a normal cell. We also have begun to relate the presence of these mutations with the clinical behavior of the tumors and look at responses to therapy, histological growth patterns, and whether the mutations occurred in pathways that could be targeted. A paper describing this work will be presented at the Annual Meeting of the American Society of Clinical Oncology in June and printed in Nature magazine later this year.

During the course of this work, we have discovered entirely new genes involved in the development of ER+ breast cancer. We were not only able to describe genes that were involved in coding aggressive ER+ breast cancers that became resistant to aromatase inhibitor therapy but also families of genes that are associated with slow growing, indolent types of breast cancer. The genetic basis for these slow growing ER+ breast cancers was understudied previously, because the sequencing of cell lines, ER negative tumors and cruder genomic techniques missed this important biology. So our BCRF supported study really did, I think, contribute in a major way to our fundamental understanding of luminal, or ER+, breast cancers. The funding was visionary and critical for this work.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advances can help to enhance your progress?

A: Our research capitalizes on the new technique called massively parallel (or "next gen") sequencing. With this technology, we take tumor DNA and matched normal DNA from a patient and we break these DNAs into tiny fragments and sequence them at random. Computer programs are used to map the sequences to the human genome and to spot differences in the normal and the cancer DNA (mutations). Using this approach, we can identify not only the gene mutations but also the frequency at which these mutations occur. Having access to this type of technology was the primary reason for my move to Washington University in St. Louis. What we have found is that tumors are often quite complex and in the process of evolution, both rare and common mutations are present. The challenge is to determine what changes are biologically relevant and therefore useful for patient stratification and treatment. In terms of the next step, we are beginning a huge effort to maximize the value of next gen sequencing. Discovery using this technology will be largely completed within the next two to four years. Literally thousands of breast cancers are going to be sequenced. We now need to figure out the clinical application of these techniques.

I am also increasingly excited about new developments in proteomics. Our ability to identify proteins, analyze them, and reliably identify modifications of proteins has been rudimentary. But now, faster, more accurate, and computationally better supported proteomics machines are coming online. These "mass spectrometry" machines are going to make the deep impact that the introduction of massively parallel sequencing made two to three years ago. Creating a comprehensive approach that includes both DNA/RNA and protein analysis will get us to the next step, which is an understanding of how the recoding of the cancer genome alters protein function. When we can understand that, we will gain a much clearer picture of how to treat individual patients in a very precise way because we will be able to zero in on the most critical changes that drive the disease outcome.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: What our sequencing efforts are already telling us is that breast cancer is a very heterogeneous disease. It may be as heterogeneous, or even more so, than all the different types of leukemia. Breast cancer will fracture into many subsets, beyond luminal A and B, HER2 positive (HER2+), and triple negative. By using our understanding of the underlying biology of breast cancers, we will be able to determine whether or not certain classes of drugs will benefit patients.

For example in our studies, we found rare activating mutations in genes such as HER2. These tumors are labeled "HER2 normal" because they do not have gene amplification but functionally they are HER positive. Hypothetically in these cases, tumors are likely to be sensitive to such anti-HER2 drugs as lapatinib. But currently these patients would never receive lapatinib based on our standard definition. These HER2 mutations are infrequent, occurring in perhaps 1-2% of breast cancer patients, but because breast cancer is so devastating common, we may be talking about more than 2,000 patients a year in the US alone. These cases are, therefore, a very significant subset to recognize because there may be a treatment already available to help them. The only way to find these patients is through the prospective use of sequencing technology. In reality, most targeted therapies dramatically affect only a relatively small population of patients. However, because of the large numbers of targeted oncology drugs available, I predict there will be increasing numbers of patient subsets who will benefit from improved diagnostic approaches.

Q: What other projects are you currently working on?

A: We are a part of the National Cancer Institute's new program called Clinical Proteomic Technologies for Cancer (CPTC) initiative. This is a consortium of sites working on cancer proteomics. We are beginning to place mass spectrometry-based cancer protein identifications into the context of our knowledge of RNA and DNA, from the next generation sequencing studies, to create a comprehensive approach that includes parallel analysis of DNA, RNA, and protein in each cancer sample.

Another thing that I'm very interested in is taking these genomic approaches and improving the therapy for ER+ breast cancer through the use of combinations of endocrine drugs with targeted therapies. We are studying the combination of endocrine drugs with signaling inhibitors, such as PI3 kinase inhibitors, that can cause rapid activation of cell death programs in cancer cells. The problem with ER+ breast cancer all along has been that endocrine therapies unfortunately are only partial therapies. They suppress the cancer by making tumor cells dormant but in many patients they do not cure. Because these drugs do not get rid of tumor cells entirely, the cancer cells can reactivate and develop secondary mutations, making them resistant to drugs that were formerly effective. The only way to deal with that problem is to find therapies that cause complete regression of a tumor right at the beginning, right at the time of diagnosis.

Q: How close are we to preventing and curing all forms of breast cancer?

A: I think we have already made massive progress in some breast cancer subtypes, for example using trastuzumab (Herceptin®) on HER2+ and third-generation chemotherapy on some forms of triple negative breast cancers. In the ER+ group, I think there are definite possibilities around endocrine drugs combined with other signaling pathway inhibitors. Going forward, I think we need to determine therapy in a "genome forward" way, meaning using the tumors' mutational profiles prospectively to create testable therapeutic hypotheses for each patient. A cure for everybody is our goal, but I think it requires us to completely rethink the way we do clinical trials. We cannot continue to do trials that produce a 4% improvement in survival in a study involving 4,000 patients; the sums don't add up. Prospective identification of subset of patients who would benefit from individual drug approaches involves a lot more diagnostic work, a lot more sequencing, a lot more organization but I don't think it's beyond the wisdom and power of my colleagues to achieve this little transformation. BCRF will be absolutely essential to the effort.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: I think the vision shared by BCRF's co-founders, the late Evelyn Lauder and Dr. Larry Norton, is fantastic. They have created a different and very smart model for research funding. The alternatives, one of which is the competitive grants model, require you to spin a story and propose an "exciting" but self-contained piece of work is cumbersome and slow, as the time from application to delivery of the dollars is typically over a year. Also, clinical trials are an example of the type of study not always amenable to the competitive grants process. For instance, you may need funding to collect, ship, and store tumor specimens, which may sound mundane but is absolutely critical because you cannot do an experiment without these samples. Our work could never have been done without BCRF funding. Another thing is that BCRF invests in individuals and individual groups. With a non-bureaucratic approach, through Larry Norton's vision BCRF has created an "academy of breast cancer researchers." At our annual faculty-only retreat preceding the October Symposium & Awards Luncheon in New York, we get to have interesting and very worthwhile conversations. These opportunities foster camaraderie and collaboration. In our research, BCRF became a critical cog in a very complicated machine to actually achieve the experiment.

Read more about Dr. Ellis' current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Matthew J. Ellis to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Laura Esserman to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Laura Esserman to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Laura Esserman to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Laura Esserman to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: I was always interested in the science and the biology of cancer. I'm also a people person! I realized early on that while you may not be able to alter biology, you make a difference every day in clinical medicine. You can alter the experience of the person; caring always makes a difference. What drew me specifically to the field of breast cancer was my experience as a post-doctoral fellow in Ron Levy's laboratory at Stanford University - his lab was taking what I thought were the most innovative approaches to treatments, developing targeted, less toxic therapies based on biology. He happened to be concentrating on lymphoma, which isn't a surgical disease, and I was a surgery fellow so I wanted to focus on a different type of cancer. I also knew that women with breast cancer were frustrated with the kind of care they were getting and with the treatment options. I decided that instead of taking care of many areas of disease, I was going to take care of one: breast cancer.

Q: You have an MBA as well as a PhD and an MD. How has having an MBA helped or altered your experience as a surgeon and researcher?

A: Getting my MBA helped me figure out how I was going to put it all together. Before I even got to that point, however, I paid my way through medical school by working as a research assistant for David Eddy, a mathematician and surgeon known for his modeling of health care delivery and performance. From Eddy's health policy analyses, I learned that managing cancer is all about the understanding the disease biology, and specifically, how to screen effectively for all the different types of cancer. I also learned that good medical care is about coming up with creative options for people based on the disease they have, not the disease medicine has figured out how to treat.

After medical school I was recruited to business school by Alain Enthoven who is known for his work on organized systems for competing on quality modern management techniques. A lot of physicians don't regard management as a science; Enthoven encouraged me to apply management expertise to medicine. Management science works very well in breast cancer treatment. Once I finished the MBA, the next step was to put together a center that would cater to patients' needs. It replaces the model of a center for research OR a center for patient care. We should no longer have centers where it's either/or. And to measure the quality, every year you should be able to do things better than you did the year before. The new model is to build systems that allow you to tailor care to patients' biology, patient preferences, and according to performance of the clinical interventions, with women involved in every stage of the decision-making.

In addition to the center I direct in San Francisco, I organize and run a lot of very big, multi-center studies. In business school I learned about teamwork - specifically how important teamwork is in medicine and in research. We need to become better at working together and overcoming barriers. I can show people how to do that through good management.

Q: You are known for your discovery that a kind of immune system cell - called a proliferating macrophage, or ProMac - hangs out in the same environment where there are certain kinds of aggressive cancer cells. Can you tell us more about this discovery and how it can help prevent and treat certain breast cancers?

A: This is a discovery based on working your way backwards from the cancer to the screening technology. For some cancers, we have very little to work with in terms of screening. I was looking at fast-growing breast cancers and asking myself: is there something in there that we can see and target, even if it is not causing the cancer? That's where these ProMacs come in. They are part of the immune system's interaction with the breast tissues in the presence of these high-grade, aggressive cancers. We can find the ProMacs, and when we do, we know to start looking for that type of breast cancer. We don't have anything that prevents these cancers - screening is not prevention - but if we can start to anticipate them better, we can strategize how to treat them better, by disrupting the environment that supports their growth. If that works and we can sort out who is at risk for these cancers, maybe we can work on preventing them.

Q: Could you describe your recent research on statins, a class of drugs known for treating cholesterol and heart disease, and what role they may play in preventing cancer?

A: I had proposed testing statins, which are known, safe drugs for treating high cholesterol, because we had seen that some of them can inhibit cancer cells. Our initial hypothesis was that statins might be particularly effective as a tumor prevention for women with DCIS who are at risk for developing aggressive, ER-negative tumors. These are the types of tumors that we have fewer treatments for, and poorer outcomes. Unfortunately, the National Cancer Institute turned down my initial request for funding, saying that there wasn't enough evidence to support my hypothesis. BCRF stepped in with funding for a pilot trial and in the process we learned a lot. Turns out it's really only the high-grade tumors that are affected by statins, not the low-grade DCIS. That's okay! That's important to know! Based on this study, we learned more about the biology of these ER-negative tumors and really developed a cool new concept. We are studying "nesting" statins in as a treatment before surgery to see if they will inhibit tumors before we remove them. This may reduce the time it takes us to learn which agents work for prevention and help us realize better outcomes for our patients.

I often think about an article that Intel founder Andy Grove published in the Journal of the American Medical Association in 2005, called "A View from the Outside." It is apropos in terms of how we should be thinking. Grove challenged us to consider whether we really want our "knowledge turn" to be 20 years - that is, 20 years from the spark of a new idea to a resulting safe and effective treatment. He asked whether it is too risky to do something different, or whether the real risk is not to push for more rapid change. My feeling is that we should constantly try to turn the existing model on its ear - 20 years is too long from my perspective and though the alternatives may not be perfect, it is so important to look for all opportunities to accelerate learning for the prevention of breast cancer!

Q: How can laypeople better understand the significance of statins and macrophages as surrogate markers for breast cancer outcomes?

A: All cancers, and breast cancer is no different, can be likened to a bunch of criminals. Some commit petty crimes and some are killers. We try to understand the criminals, especially the bad ones-that is, the tumors, but we also must take advantage of understanding the "neighborhoods" where the criminals hang out. In other words, where are these criminals hanging out and with whom? This is exactly the right analogy for how we found the immune system cells called ProMacs. They show up consistently in the same vicinity with a certain type of fast-growing breast cancer. So our strategy is to try to clean up the neighborhood to prevent a crime.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: When we are willing to get more into the details of particular cancers, we will make better progress. If you are at risk for an ER-negative breast cancer, for example, you can't use the screening strategies in place for ER-positive tumors. This is partly why ER-negative breast cancer outcomes have been so poor. We've been using inappropriate screening strategies. We need a different strategy or strategies based on the details of the kinds of cancer that present as large masses between normal screens - so-called interval cancers. That is what I have been working on. Our challenges are in clarifying the risks for some of these less understood breast cancers and then figuring out what things we can do to either prevent them or detect them earlier.

Also, we need to learn how to tailor treatment to the biology of the particular breast cancer and to the patient. Cancer doesn't happen to a body part; it happens to a person.

Q: How has BCRF been helpful to you?

A: BCRF rewards people for being thoughtful and it helps overcome a lot of barriers. My colleague Funmi Olapade took our macrophage study and validated it in a patient population in her work with patients in Africa who need better screening for their particular type of breast cancer. BCRF allowed me to do one arm of this research that I thought was important and allowed Funmi to do the other arm of it. Both are necessary and now we are publishing our results together. Creative ideas can die without the proper support and BCRF gives resources to people with creative ideas and lets them do what they think is important.

BCRF's legacy thus far is as an incubator. They help grow innovative ideas in a similar way that small biotech firms incubate ideas and make rapid progress on them before the heftier process of pharmaceutical companies get involved. It's important in the non-commercial sectors of medicine that people know there is a funding outlet for what they do and that they will be rewarded for being thoughtful.

Q: What are the biggest challenges in cancer research?

A: That's easy: unbelievably inefficient systems for the collection of information. We need better systems for getting data collected correctly once and then shared forever.

Another challenge is making sure that we are communicating what the real problems and issues are in breast cancer prevention, screening and treatment. Without proper identification and communication of the needs and challenges of the field we are going to move unnecessarily slowly.

Q: What advice would you give to young researchers entering the cancer research field?

A: Passion and perseverance are key! I feel privileged to do what I'm doing every day. Patients sense when you truly care about them. To be successful in clinical medicine you must become an advocate for your patient, not for your research or your specialty. Do I get frustrated when patients don't do well? Of course, but research is a good antidote for the frustrations of clinical medicine.

As far as research is concerned, good ideas are abundant, but people who can turn those ideas into something in the end win the day. Collaboration and long term gains are much better than solo personal accomplishment in research. I hope we can change our ways of promoting people and consistently reward them for collaborating. The bottom line: making a difference in a patient's life is much more important than any publication.

Read more about Dr. Esserman's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Laura Esserman to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: I was always interested in the science and the biology of cancer. I'm also a people person! I realized early on that while you may not be able to alter biology, you make a difference every day in clinical medicine. You can alter the experience of the person; caring always makes a difference. What drew me specifically to the field of breast cancer was my experience as a post-doctoral fellow in Ron Levy's laboratory at Stanford University - his lab was taking what I thought were the most innovative approaches to treatments, developing targeted, less toxic therapies based on biology. He happened to be concentrating on lymphoma, which isn't a surgical disease, and I was a surgery fellow so I wanted to focus on a different type of cancer. I also knew that women with breast cancer were frustrated with the kind of care they were getting and with the treatment options. I decided that instead of taking care of many areas of disease, I was going to take care of one: breast cancer.

Q: You have an MBA as well as a PhD and an MD. How has having an MBA helped or altered your experience as a surgeon and researcher?

A: Getting my MBA helped me figure out how I was going to put it all together. Before I even got to that point, however, I paid my way through medical school by working as a research assistant for David Eddy, a mathematician and surgeon known for his modeling of health care delivery and performance. From Eddy's health policy analyses, I learned that managing cancer is all about the understanding the disease biology, and specifically, how to screen effectively for all the different types of cancer. I also learned that good medical care is about coming up with creative options for people based on the disease they have, not the disease medicine has figured out how to treat.

After medical school I was recruited to business school by Alain Enthoven who is known for his work on organized systems for competing on quality modern management techniques. A lot of physicians don't regard management as a science; Enthoven encouraged me to apply management expertise to medicine. Management science works very well in breast cancer treatment. Once I finished the MBA, the next step was to put together a center that would cater to patients' needs. It replaces the model of a center for research OR a center for patient care. We should no longer have centers where it's either/or. And to measure the quality, every year you should be able to do things better than you did the year before. The new model is to build systems that allow you to tailor care to patients' biology, patient preferences, and according to performance of the clinical interventions, with women involved in every stage of the decision-making.

In addition to the center I direct in San Francisco, I organize and run a lot of very big, multi-center studies. In business school I learned about teamwork - specifically how important teamwork is in medicine and in research. We need to become better at working together and overcoming barriers. I can show people how to do that through good management.

Q: You are known for your discovery that a kind of immune system cell - called a proliferating macrophage, or ProMac - hangs out in the same environment where there are certain kinds of aggressive cancer cells. Can you tell us more about this discovery and how it can help prevent and treat certain breast cancers?

A: This is a discovery based on working your way backwards from the cancer to the screening technology. For some cancers, we have very little to work with in terms of screening. I was looking at fast-growing breast cancers and asking myself: is there something in there that we can see and target, even if it is not causing the cancer? That's where these ProMacs come in. They are part of the immune system's interaction with the breast tissues in the presence of these high-grade, aggressive cancers. We can find the ProMacs, and when we do, we know to start looking for that type of breast cancer. We don't have anything that prevents these cancers - screening is not prevention - but if we can start to anticipate them better, we can strategize how to treat them better, by disrupting the environment that supports their growth. If that works and we can sort out who is at risk for these cancers, maybe we can work on preventing them.

Q: Could you describe your recent research on statins, a class of drugs known for treating cholesterol and heart disease, and what role they may play in preventing cancer?

A: I had proposed testing statins, which are known, safe drugs for treating high cholesterol, because we had seen that some of them can inhibit cancer cells. Our initial hypothesis was that statins might be particularly effective as a tumor prevention for women with DCIS who are at risk for developing aggressive, ER-negative tumors. These are the types of tumors that we have fewer treatments for, and poorer outcomes. Unfortunately, the National Cancer Institute turned down my initial request for funding, saying that there wasn't enough evidence to support my hypothesis. BCRF stepped in with funding for a pilot trial and in the process we learned a lot. Turns out it's really only the high-grade tumors that are affected by statins, not the low-grade DCIS. That's okay! That's important to know! Based on this study, we learned more about the biology of these ER-negative tumors and really developed a cool new concept. We are studying "nesting" statins in as a treatment before surgery to see if they will inhibit tumors before we remove them. This may reduce the time it takes us to learn which agents work for prevention and help us realize better outcomes for our patients.

I often think about an article that Intel founder Andy Grove published in the Journal of the American Medical Association in 2005, called "A View from the Outside." It is apropos in terms of how we should be thinking. Grove challenged us to consider whether we really want our "knowledge turn" to be 20 years - that is, 20 years from the spark of a new idea to a resulting safe and effective treatment. He asked whether it is too risky to do something different, or whether the real risk is not to push for more rapid change. My feeling is that we should constantly try to turn the existing model on its ear - 20 years is too long from my perspective and though the alternatives may not be perfect, it is so important to look for all opportunities to accelerate learning for the prevention of breast cancer!

Q: How can laypeople better understand the significance of statins and macrophages as surrogate markers for breast cancer outcomes?

A: All cancers, and breast cancer is no different, can be likened to a bunch of criminals. Some commit petty crimes and some are killers. We try to understand the criminals, especially the bad ones-that is, the tumors, but we also must take advantage of understanding the "neighborhoods" where the criminals hang out. In other words, where are these criminals hanging out and with whom? This is exactly the right analogy for how we found the immune system cells called ProMacs. They show up consistently in the same vicinity with a certain type of fast-growing breast cancer. So our strategy is to try to clean up the neighborhood to prevent a crime.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: When we are willing to get more into the details of particular cancers, we will make better progress. If you are at risk for an ER-negative breast cancer, for example, you can't use the screening strategies in place for ER-positive tumors. This is partly why ER-negative breast cancer outcomes have been so poor. We've been using inappropriate screening strategies. We need a different strategy or strategies based on the details of the kinds of cancer that present as large masses between normal screens - so-called interval cancers. That is what I have been working on. Our challenges are in clarifying the risks for some of these less understood breast cancers and then figuring out what things we can do to either prevent them or detect them earlier.

Also, we need to learn how to tailor treatment to the biology of the particular breast cancer and to the patient. Cancer doesn't happen to a body part; it happens to a person.

Q: How has BCRF been helpful to you?

A: BCRF rewards people for being thoughtful and it helps overcome a lot of barriers. My colleague Funmi Olapade took our macrophage study and validated it in a patient population in her work with patients in Africa who need better screening for their particular type of breast cancer. BCRF allowed me to do one arm of this research that I thought was important and allowed Funmi to do the other arm of it. Both are necessary and now we are publishing our results together. Creative ideas can die without the proper support and BCRF gives resources to people with creative ideas and lets them do what they think is important.

BCRF's legacy thus far is as an incubator. They help grow innovative ideas in a similar way that small biotech firms incubate ideas and make rapid progress on them before the heftier process of pharmaceutical companies get involved. It's important in the non-commercial sectors of medicine that people know there is a funding outlet for what they do and that they will be rewarded for being thoughtful.

Q: What are the biggest challenges in cancer research?

A: That's easy: unbelievably inefficient systems for the collection of information. We need better systems for getting data collected correctly once and then shared forever.

Another challenge is making sure that we are communicating what the real problems and issues are in breast cancer prevention, screening and treatment. Without proper identification and communication of the needs and challenges of the field we are going to move unnecessarily slowly.

Q: What advice would you give to young researchers entering the cancer research field?

A: Passion and perseverance are key! I feel privileged to do what I'm doing every day. Patients sense when you truly care about them. To be successful in clinical medicine you must become an advocate for your patient, not for your research or your specialty. Do I get frustrated when patients don't do well? Of course, but research is a good antidote for the frustrations of clinical medicine.

As far as research is concerned, good ideas are abundant, but people who can turn those ideas into something in the end win the day. Collaboration and long term gains are much better than solo personal accomplishment in research. I hope we can change our ways of promoting people and consistently reward them for collaborating. The bottom line: making a difference in a patient's life is much more important than any publication.

Read more about Dr. Esserman's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Laura Esserman to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Carol J. Fabian to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Carol J. Fabian to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences? 
A: My interest in science dates back to my early college days. I was first attracted to psychology, then microbiology, and finally medicine. I never did consider another type of career other than the sciences.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Carol J. Fabian to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences? 
A: My interest in science dates back to my early college days. I was first attracted to psychology, then microbiology, and finally medicine. I never did consider another type of career other than the sciences.

# data[].attributes.body.value
BCRF sat down with Dr. Carol J. Fabian to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: My interest in science dates back to my early college days. I was first attracted to psychology, then microbiology, and finally medicine. I never did consider another type of career other than the sciences.

I became interested in breast cancer research during fellowship training in oncology. Although I was interested in a variety of different types of cancer, I was particularly drawn to breast cancer because it seemed like so many young women at the time were being affected with the disease.

Q: What factors have motivated you to continue studying this field?

A: My interest in risk assessment and prevention research came about 15 years after I started treating cancer patients. When I completed training in the 70's there was tremendous excitement in oncology. We thought almost every woman with early breast cancer could be cured with the right combination of adjuvant treatment - whether chemotherapy, anti-hormone therapy, and radiation, in addition to surgery. We just had to find the right combination. That is still the basic premise of treatment research and we have made tremendous strides in the past 35 years. However, after a decade and a half of oncology practice, it became very painfully obvious to me that many women who had early breast cancer were not going to be cured despite doing everything "right." That is, they got their yearly mammograms, the cancer seemed to have been detected early, and they received aggressive adjuvant therapy; yet, many still relapsed and died. Often, these were younger women with small children. It was heartbreaking to see. In addition, many women who did appear to be cured had lingering side effects which reduced their quality of life. Prevention of breast cancer by blocking or reversing precancerous changes with medication rather than waiting for it to happen seemed to make sense.

The early days (circa 1990) of working in risk assessment and prevention were a little tough. Although the concept of "prevention therapy" was coming into its own, drug therapy has side effects, which for women who are not destined to get the disease could completely avoid. We needed tools to predict who was at highest short-term risk and who was likely to respond to therapy. The model developed by Mitchell Gail at the NCI (National Cancer Institute) was an important step in short-term risk prediction. But while accurate for populations and good for research, the Gail model fell short for individual risk prediction. My team and I refined a fine-needle aspiration (FNA) technique so that we were able to get representative breast tissue, kind of like a "pap smear" for the breast tissue, to test for signs of precancerous change and, thereby, enabling doctors to more accurately assess a person's short-term risk of developing breast cancer and target appropriate women for prevention treatment. While this made infinite sense to us, it did not to most others. Conventional wisdom was that you did not put a needle into a woman's breast unless you had a lump or other abnormality to aim at.

We were, however, eventually able to show that for women who had a family history of breast cancer or who had prior precancerous biopsy, random sampling of her breast tissue by fine needle aspiration could more accurately predict short-term risk than by using risk models alone. In fact, women with both a five-year Gail model risk of >1.67% and who had atypical cells on their random FNA had a five-year risk of DCIS (ductal carcinoma in situ) or invasive breast cancer similar to women with BRCA1 and BRCA2 gene mutations. Once we were able to demonstrate that we could better predict which women were at high short-term risk of developing breast cancer, the challenge became to apply clinical prevention interventions. Concerns over possible side effects keep many women from using standard prevention options such as tamoxifen or raloxifene, or even prophylactic surgery. Consequently, we began early-phase testing of interventions with fewer effects using the fine needle aspiration technique to sample tissue before and after the intervention. One of our goals in developing the technique was to make the aspirations as comfortable as possible so that the patients would come back and get them again.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: My first BCRF project, which is still ongoing, is developing new tissue-based biomarkers for women who are at increased risk of breast cancer but whose tissue samples obtained by fine needle aspiration did not have a high growth (or proliferation) rate even though it might have some atypical looking cells. These women are primarily post-menopausal, overweight women who are not on hormone replacement therapy. Although these women have very low proliferation rate in their benign tissue, they can still develop cancer over time. Part of the reason is that inflammatory cytokines and adipokines may promote survival and more aggressive behavior of atypical cells.

In conjunction with Dr. Stephen Hursting, another BCRF researcher at the University of Texas, we started looking at adipokines, cytokines and other inflammatory markers in breast tissue and blood. We found that we could measure the inflammation markers reliably in the breast tissue. We are currently trying to make sure that in the absence of an intervention (i.e. drugs or weight loss, etc.) that these markers are still consistently expressed over time.

Building on the first two years of our BCRF research, we have developed new pilot trials (one of which is funded by BCRF) using high-dose omega 3 fatty acids (one of which is funded by BCRF) and have proposed trials using energy balance interventions.

Q: What other projects are you currently working on?

A: In general, we are interested in finding new prevention interventions that are associated with reduced side effects. There is a prevention trial funded by the NCI women who need hormone replacement therapy to control their menopause symptoms. This trial is testing an aromatase inhibitor called letrozole to see if it reduces breast tissue growth rates and the proportion of pre-cancerous cells. Another study, which will soon begin, is looking at the effects of the lignan component of flaxseed vs. placebo on tissue risk biomarkers in premenopausal women. The BCRF grants have been very helpful in that they allowed us to develop some of the biomarkers needed for these studies.

Q. How close are we to preventing and curing all forms of breast cancer?

A. I don't know if I can answer that question. But at the time I completed my training in the mid-1970's, 40% or more of the women who developed breast cancer were dying of it. Now fewer than 20% of women who were undergoing regular screening at the time their breast cancer was discovered will ultimately die of their disease. Although that figure is still too high, the change over 35 years is amazing.

For prevention, we have identified drugs that will reduce by half the 5 to 10 year risk of developing breast cancer. The problem is few risk eligible women will take them. So, I think we have to look at multiple prevention strategies, emphasizing interventions likely to be attractive to women at different stages of their life. The emphasis should be on things that women can do themselves which do not require extensive medical monitoring. These interventions ideally should make them look better and feel better (like diet and exercise). We also need to give a map and a toolbox such that they can accomplish their goals. I see prevention going in that direction.

Q. In your opinion, how has BCRF impacted breast cancer research?

A. BCRF has impacted breast cancer research in at least two very important ways. One is that the organization stimulates cross-collaboration by bringing together established breast cancer researchers from various fields. The collaboration between Dr. Hursting's and my group is an example of this inter-disciplinary collaboration.

BCRF also impacts breast cancer research by providing funds to researchers to allow them to quickly develop assessment tools and/or preliminary data for large projects. BCRF is unique in that it supplies funds needed to develop the clinical and translational tools needed to perform research. Having the tools and pilot data accelerates the pace of breast cancer research.

Read more about Dr. Fabian's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Carol J. Fabian to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: My interest in science dates back to my early college days. I was first attracted to psychology, then microbiology, and finally medicine. I never did consider another type of career other than the sciences.

I became interested in breast cancer research during fellowship training in oncology. Although I was interested in a variety of different types of cancer, I was particularly drawn to breast cancer because it seemed like so many young women at the time were being affected with the disease.

Q: What factors have motivated you to continue studying this field?

A: My interest in risk assessment and prevention research came about 15 years after I started treating cancer patients. When I completed training in the 70's there was tremendous excitement in oncology. We thought almost every woman with early breast cancer could be cured with the right combination of adjuvant treatment - whether chemotherapy, anti-hormone therapy, and radiation, in addition to surgery. We just had to find the right combination. That is still the basic premise of treatment research and we have made tremendous strides in the past 35 years. However, after a decade and a half of oncology practice, it became very painfully obvious to me that many women who had early breast cancer were not going to be cured despite doing everything "right." That is, they got their yearly mammograms, the cancer seemed to have been detected early, and they received aggressive adjuvant therapy; yet, many still relapsed and died. Often, these were younger women with small children. It was heartbreaking to see. In addition, many women who did appear to be cured had lingering side effects which reduced their quality of life. Prevention of breast cancer by blocking or reversing precancerous changes with medication rather than waiting for it to happen seemed to make sense.

The early days (circa 1990) of working in risk assessment and prevention were a little tough. Although the concept of "prevention therapy" was coming into its own, drug therapy has side effects, which for women who are not destined to get the disease could completely avoid. We needed tools to predict who was at highest short-term risk and who was likely to respond to therapy. The model developed by Mitchell Gail at the NCI (National Cancer Institute) was an important step in short-term risk prediction. But while accurate for populations and good for research, the Gail model fell short for individual risk prediction. My team and I refined a fine-needle aspiration (FNA) technique so that we were able to get representative breast tissue, kind of like a "pap smear" for the breast tissue, to test for signs of precancerous change and, thereby, enabling doctors to more accurately assess a person's short-term risk of developing breast cancer and target appropriate women for prevention treatment. While this made infinite sense to us, it did not to most others. Conventional wisdom was that you did not put a needle into a woman's breast unless you had a lump or other abnormality to aim at.

We were, however, eventually able to show that for women who had a family history of breast cancer or who had prior precancerous biopsy, random sampling of her breast tissue by fine needle aspiration could more accurately predict short-term risk than by using risk models alone. In fact, women with both a five-year Gail model risk of >1.67% and who had atypical cells on their random FNA had a five-year risk of DCIS (ductal carcinoma in situ) or invasive breast cancer similar to women with BRCA1 and BRCA2 gene mutations. Once we were able to demonstrate that we could better predict which women were at high short-term risk of developing breast cancer, the challenge became to apply clinical prevention interventions. Concerns over possible side effects keep many women from using standard prevention options such as tamoxifen or raloxifene, or even prophylactic surgery. Consequently, we began early-phase testing of interventions with fewer effects using the fine needle aspiration technique to sample tissue before and after the intervention. One of our goals in developing the technique was to make the aspirations as comfortable as possible so that the patients would come back and get them again.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: My first BCRF project, which is still ongoing, is developing new tissue-based biomarkers for women who are at increased risk of breast cancer but whose tissue samples obtained by fine needle aspiration did not have a high growth (or proliferation) rate even though it might have some atypical looking cells. These women are primarily post-menopausal, overweight women who are not on hormone replacement therapy. Although these women have very low proliferation rate in their benign tissue, they can still develop cancer over time. Part of the reason is that inflammatory cytokines and adipokines may promote survival and more aggressive behavior of atypical cells.

In conjunction with Dr. Stephen Hursting, another BCRF researcher at the University of Texas, we started looking at adipokines, cytokines and other inflammatory markers in breast tissue and blood. We found that we could measure the inflammation markers reliably in the breast tissue. We are currently trying to make sure that in the absence of an intervention (i.e. drugs or weight loss, etc.) that these markers are still consistently expressed over time.

Building on the first two years of our BCRF research, we have developed new pilot trials (one of which is funded by BCRF) using high-dose omega 3 fatty acids (one of which is funded by BCRF) and have proposed trials using energy balance interventions.

Q: What other projects are you currently working on?

A: In general, we are interested in finding new prevention interventions that are associated with reduced side effects. There is a prevention trial funded by the NCI women who need hormone replacement therapy to control their menopause symptoms. This trial is testing an aromatase inhibitor called letrozole to see if it reduces breast tissue growth rates and the proportion of pre-cancerous cells. Another study, which will soon begin, is looking at the effects of the lignan component of flaxseed vs. placebo on tissue risk biomarkers in premenopausal women. The BCRF grants have been very helpful in that they allowed us to develop some of the biomarkers needed for these studies.

Q. How close are we to preventing and curing all forms of breast cancer?

A. I don't know if I can answer that question. But at the time I completed my training in the mid-1970's, 40% or more of the women who developed breast cancer were dying of it. Now fewer than 20% of women who were undergoing regular screening at the time their breast cancer was discovered will ultimately die of their disease. Although that figure is still too high, the change over 35 years is amazing.

For prevention, we have identified drugs that will reduce by half the 5 to 10 year risk of developing breast cancer. The problem is few risk eligible women will take them. So, I think we have to look at multiple prevention strategies, emphasizing interventions likely to be attractive to women at different stages of their life. The emphasis should be on things that women can do themselves which do not require extensive medical monitoring. These interventions ideally should make them look better and feel better (like diet and exercise). We also need to give a map and a toolbox such that they can accomplish their goals. I see prevention going in that direction.

Q. In your opinion, how has BCRF impacted breast cancer research?

A. BCRF has impacted breast cancer research in at least two very important ways. One is that the organization stimulates cross-collaboration by bringing together established breast cancer researchers from various fields. The collaboration between Dr. Hursting's and my group is an example of this inter-disciplinary collaboration.

BCRF also impacts breast cancer research by providing funds to researchers to allow them to quickly develop assessment tools and/or preliminary data for large projects. BCRF is unique in that it supplies funds needed to develop the clinical and translational tools needed to perform research. Having the tools and pilot data accelerates the pace of breast cancer research.

Read more about Dr. Fabian's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Carol J. Fabian to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. James M. Ford to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. James M. Ford to discuss his current work and interest in breast cancer research. Read on to learn more.
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. James M. Ford to discuss his current work and interest in breast cancer research. Read on to learn more.
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. James M. Ford to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I have always been interested in the sciences and biology. My parents are biologists, and I grew up doing experiments and looking at things in nature. In college I wanted to be a jazz bass player, but when that didn't work out, becoming a physician was a pretty good back-up plan!

As a student at Yale Medical School, I became very involved in cancer research in Dr. Bill Hait's laboratory, and as an oncology fellow at Stanford I focused on DNA repair with Professor Phil Hanawalt. When I started my own lab as a faculty member at Stanford, my initial studies focused on cancer genetics and cancer susceptibility, particularly in breast cancer. In the clinic, I launched our clinical cancer genetics program, one of the first on the West Coast.

Much of my lab's focus has been on how the BRCA1 and 2 genes are involved in DNA repair and the development of cancer. So, it's been really exciting for me through my career to see how our understanding of DNA repair defects in breast cancer have led to advances in the clinic. Also, our cancer genetics clinic has taken advantage of dramatically increased knowledge of the genetics of breast cancer susceptibility and new technologies to identify changes in those genes and to sequence genes in individuals. We identify and work with families with high cancer risk and try to identify those genes that are causing the risk.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: A very exciting component of my work has been translational research: having the ability to study breast cancer in the lab, discovering fundamental aspects about the disease, and then applying that knowledge to patients in the clinic. The reverse order works, too, where my team and I look at patient information, tissue samples, and cancer biopsies that were gathered in the clinic and study them in the lab to try to learn more about the characteristics of their diseases and how we might be able to better treat or prevent them. Having the ability to take information and discoveries back and forth between the lab and the clinic will help us identify not only new therapies but also ideas for prevention or early detection of cancer.

Our projects funded by BCRF are great examples of translational research. In our earlier work, we observed that oxidative damage has an effect on the progression of breast cancer. Other studies showed that statins, which are cholesterol-lowering drugs, appear to affect the rate of oxidative DNA damage. Putting the two together, we designed a clinical trial using statins as prevention agents for individuals with BRCA mutations at high risk for breast cancer. This study, our first BCRF-funded project, is just wrapping up, and we hope to report the results soon.

Our more recent BCRF-funded project has focused on triple-negative breast cancer (TNBC) and using PARP inhibitors as potential treatment for it. TNBC is of particular interest given the aggressiveness of the disease and the need for new therapies.

Right now, we are trying to identify targets within TNBC that can be used therapeutically. Following on the exciting findings of the BCRF-funded investigator Dr. Alan Ashworth who showed that PARP inhibitors specifically target DNA repair deficient BRCA-mutant tumors, we extended this finding to the larger group of TNBC, not solely those with hereditary BRCA 1 /2 mutations, and showed that they share a number of DNA repair defects with BRCA 1/2 mutant cell lines. They also share sensitivity to certain DNA damaging agents, including the platinum drugs, the chemotherapy drug gemcitabine, and PARP inhibitors. So, our initial work in the lab was brought to the clinic, where we are now conducting a neoadjuvant ("pre-operative") trial of a PARP inhibitor, together with gemcitabine and carboplatin, for women with TNBC. This trial accrued very rapidly, and now we are performing a number of correlative studies in the lab to look for additional genetic changes or alterations in these tumors that might confer sensitivity or drug resistance to these combinations of drugs, and in particular to the PARP inhibitors.

As we learn more about the biology of TNBC, we hope that additional targets with therapeutic benefit will be revealed. Determining the cause of TNBC outside of BRCA 1/2 mutations is very important, as we need to understand better why the rates of TNBC vary in different ethnic populations and how they may also change according to the specific environments where the individuals live.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advance can help to enhance your progress?

A: The major area that has affected my work and interest and will continue to do so is genomics, the study of genes and their functions at a whole genome level. These new technologies, so-called "next generation high throughput DNA sequencing," are allowing us - at a cost that's becoming much more affordable - to look at the genetic sequence in individual tumors and in individual people so that we can try to tailor, or personalize, therapy.

Being able to sequence the entire genome of individuals and individual tumors still seems inconceivable to me, but we have done it. Being able to look at a family with a very complicated family history of cancers that may not be explained by the handful of Mendelian genes we know of, like BRCA1/2, and actually being able to sequence the genome of individuals in that family and track down a genetic change that may be the susceptibility gene, is now well within in the realm of possibility. I think those are amazing advances.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: Much of cancer research is moving in the direction of defining different molecular subtypes within a specific kind of cancer. For breast cancer, this discovery has brought great insights into how we think about treating the disease(s). I think the next steps are going to be identifying more targets specific to the various subtypes of breast cancer. The final extension of that, of course, would be to personalize, or understand, a cancer at the individual level, that is, sequencing all or many of the genes of a tumor and identifying a particular target of treatment that would be most effective for that patient. This is the ultimate form of personalized medicine, and the advances in genomics, as well as in developing targeted therapeutics, will bring us there.

Q: What other projects are you currently working on? A: My lab in general is working on DNA repair processes in a number of tumors, including breast cancer. Dr. Shaveta Vinayak (2010 ASCO Young Investigator, supported by a separate BCRF grant through ASCO) is a post-doctoral oncology fellow pursuing the idea that PARP inhibitors might be used as agents for TNBC prevention, and has developed laboratory models to study this possibility. We also are excited about recent results from a large drug screen that identified several compounds that actually enhance DNA repair activity, and thus might serve to counteract the mutagenic consequences of unrepaired DNA damage, particularly in individuals at high susceptibility due to BRCA1/2 mutations.

Q: How close are we to preventing and curing all forms of breast cancer?

A: I think we have come a long way. Much of the work learned through BCRF-funded investigators provides convincing evidence of the major advances we have been able to make in breast and other cancers. But, of course, we have a long way to go. The technological changes and the scientific advances over the past couple of decades will really accelerate this work. As a result, there will be many new ideas for prevention and many types of cures for cancer. It's the continuum of these discoveries and their combined impact that will make a big impact in curing and preventing cancer.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has had a major impact at numerous levels. As we all know, funding for cancer research is getting harder to come by. Federal funding from the National Institutes of Health and other government resources is being cut because of fiscal difficulties. All of us are having a harder time in finding new sources of funding, so BCRF support is even more important in keeping critical projects going.

Also, the idea of gathering "the best and the brightest" around a particular problem, in this case breast cancer and its treatment and cure, has been incredibly successful. BCRF supports translational research, which is a hugely important area of research both past and future. The Foundation provides the opportunity for multiple investigators to study very deeply the basic science aspects of cancer in tandem with expert clinicians in the care of cancer and every bit in between.

In addition, the research that BCRF funds is often highly investigational and sometimes in its very earliest stages, before it can get funding or acceptance in other settings. Therefore, BCRF has been very much at the cutting edge of novel ideas, pushing research into new areas with many, many examples of success among its investigators. And, BCRF's long-term commitment to investigators, watching their scientific ideas develop and take a translational route, has been incredibly effective. This way, good ideas don't burn out too quickly but can be played out, sometimes in parallel with other ideas.

Furthermore, the general enthusiasm among the BCRF grant recipients sets this organization apart. Bringing all of us together at an annual conference creates a synergistic environment, and many interesting collaborations have come out of those meetings. I think that the enthusiasm from the leaders of BCRF is infectious to all the investigators and has had a major effect on breast cancer research in this country and internationally.

Read more about Dr. Ford's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. James M. Ford to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I have always been interested in the sciences and biology. My parents are biologists, and I grew up doing experiments and looking at things in nature. In college I wanted to be a jazz bass player, but when that didn't work out, becoming a physician was a pretty good back-up plan!

As a student at Yale Medical School, I became very involved in cancer research in Dr. Bill Hait's laboratory, and as an oncology fellow at Stanford I focused on DNA repair with Professor Phil Hanawalt. When I started my own lab as a faculty member at Stanford, my initial studies focused on cancer genetics and cancer susceptibility, particularly in breast cancer. In the clinic, I launched our clinical cancer genetics program, one of the first on the West Coast.

Much of my lab's focus has been on how the BRCA1 and 2 genes are involved in DNA repair and the development of cancer. So, it's been really exciting for me through my career to see how our understanding of DNA repair defects in breast cancer have led to advances in the clinic. Also, our cancer genetics clinic has taken advantage of dramatically increased knowledge of the genetics of breast cancer susceptibility and new technologies to identify changes in those genes and to sequence genes in individuals. We identify and work with families with high cancer risk and try to identify those genes that are causing the risk.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: A very exciting component of my work has been translational research: having the ability to study breast cancer in the lab, discovering fundamental aspects about the disease, and then applying that knowledge to patients in the clinic. The reverse order works, too, where my team and I look at patient information, tissue samples, and cancer biopsies that were gathered in the clinic and study them in the lab to try to learn more about the characteristics of their diseases and how we might be able to better treat or prevent them. Having the ability to take information and discoveries back and forth between the lab and the clinic will help us identify not only new therapies but also ideas for prevention or early detection of cancer.

Our projects funded by BCRF are great examples of translational research. In our earlier work, we observed that oxidative damage has an effect on the progression of breast cancer. Other studies showed that statins, which are cholesterol-lowering drugs, appear to affect the rate of oxidative DNA damage. Putting the two together, we designed a clinical trial using statins as prevention agents for individuals with BRCA mutations at high risk for breast cancer. This study, our first BCRF-funded project, is just wrapping up, and we hope to report the results soon.

Our more recent BCRF-funded project has focused on triple-negative breast cancer (TNBC) and using PARP inhibitors as potential treatment for it. TNBC is of particular interest given the aggressiveness of the disease and the need for new therapies.

Right now, we are trying to identify targets within TNBC that can be used therapeutically. Following on the exciting findings of the BCRF-funded investigator Dr. Alan Ashworth who showed that PARP inhibitors specifically target DNA repair deficient BRCA-mutant tumors, we extended this finding to the larger group of TNBC, not solely those with hereditary BRCA 1 /2 mutations, and showed that they share a number of DNA repair defects with BRCA 1/2 mutant cell lines. They also share sensitivity to certain DNA damaging agents, including the platinum drugs, the chemotherapy drug gemcitabine, and PARP inhibitors. So, our initial work in the lab was brought to the clinic, where we are now conducting a neoadjuvant ("pre-operative") trial of a PARP inhibitor, together with gemcitabine and carboplatin, for women with TNBC. This trial accrued very rapidly, and now we are performing a number of correlative studies in the lab to look for additional genetic changes or alterations in these tumors that might confer sensitivity or drug resistance to these combinations of drugs, and in particular to the PARP inhibitors.

As we learn more about the biology of TNBC, we hope that additional targets with therapeutic benefit will be revealed. Determining the cause of TNBC outside of BRCA 1/2 mutations is very important, as we need to understand better why the rates of TNBC vary in different ethnic populations and how they may also change according to the specific environments where the individuals live.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advance can help to enhance your progress?

A: The major area that has affected my work and interest and will continue to do so is genomics, the study of genes and their functions at a whole genome level. These new technologies, so-called "next generation high throughput DNA sequencing," are allowing us - at a cost that's becoming much more affordable - to look at the genetic sequence in individual tumors and in individual people so that we can try to tailor, or personalize, therapy.

Being able to sequence the entire genome of individuals and individual tumors still seems inconceivable to me, but we have done it. Being able to look at a family with a very complicated family history of cancers that may not be explained by the handful of Mendelian genes we know of, like BRCA1/2, and actually being able to sequence the genome of individuals in that family and track down a genetic change that may be the susceptibility gene, is now well within in the realm of possibility. I think those are amazing advances.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: Much of cancer research is moving in the direction of defining different molecular subtypes within a specific kind of cancer. For breast cancer, this discovery has brought great insights into how we think about treating the disease(s). I think the next steps are going to be identifying more targets specific to the various subtypes of breast cancer. The final extension of that, of course, would be to personalize, or understand, a cancer at the individual level, that is, sequencing all or many of the genes of a tumor and identifying a particular target of treatment that would be most effective for that patient. This is the ultimate form of personalized medicine, and the advances in genomics, as well as in developing targeted therapeutics, will bring us there.

Q: What other projects are you currently working on? A: My lab in general is working on DNA repair processes in a number of tumors, including breast cancer. Dr. Shaveta Vinayak (2010 ASCO Young Investigator, supported by a separate BCRF grant through ASCO) is a post-doctoral oncology fellow pursuing the idea that PARP inhibitors might be used as agents for TNBC prevention, and has developed laboratory models to study this possibility. We also are excited about recent results from a large drug screen that identified several compounds that actually enhance DNA repair activity, and thus might serve to counteract the mutagenic consequences of unrepaired DNA damage, particularly in individuals at high susceptibility due to BRCA1/2 mutations.

Q: How close are we to preventing and curing all forms of breast cancer?

A: I think we have come a long way. Much of the work learned through BCRF-funded investigators provides convincing evidence of the major advances we have been able to make in breast and other cancers. But, of course, we have a long way to go. The technological changes and the scientific advances over the past couple of decades will really accelerate this work. As a result, there will be many new ideas for prevention and many types of cures for cancer. It's the continuum of these discoveries and their combined impact that will make a big impact in curing and preventing cancer.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has had a major impact at numerous levels. As we all know, funding for cancer research is getting harder to come by. Federal funding from the National Institutes of Health and other government resources is being cut because of fiscal difficulties. All of us are having a harder time in finding new sources of funding, so BCRF support is even more important in keeping critical projects going.

Also, the idea of gathering "the best and the brightest" around a particular problem, in this case breast cancer and its treatment and cure, has been incredibly successful. BCRF supports translational research, which is a hugely important area of research both past and future. The Foundation provides the opportunity for multiple investigators to study very deeply the basic science aspects of cancer in tandem with expert clinicians in the care of cancer and every bit in between.

In addition, the research that BCRF funds is often highly investigational and sometimes in its very earliest stages, before it can get funding or acceptance in other settings. Therefore, BCRF has been very much at the cutting edge of novel ideas, pushing research into new areas with many, many examples of success among its investigators. And, BCRF's long-term commitment to investigators, watching their scientific ideas develop and take a translational route, has been incredibly effective. This way, good ideas don't burn out too quickly but can be played out, sometimes in parallel with other ideas.

Furthermore, the general enthusiasm among the BCRF grant recipients sets this organization apart. Bringing all of us together at an annual conference creates a synergistic environment, and many interesting collaborations have come out of those meetings. I think that the enthusiasm from the leaders of BCRF is infectious to all the investigators and has had a major effect on breast cancer research in this country and internationally.

Read more about Dr. Ford's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. James M. Ford to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Patricia A. Ganz to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Patricia A. Ganz to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Patricia A. Ganz to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Patricia A. Ganz to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I became interested in the treatment of breast cancer early on in my career, as there were so many advances that were improving survival for women (early detection, adjuvant therapy, breast conserving treatment). With my move to UCLA's Jonsson Cancer Center (full-time), and the advent of the first breast cancer prevention trial, it was clear to me that we might some day be able to prevent breast cancer in many women. That was really exciting. I also began to follow an increasing number of breast cancer survivors and was interested in preventing and treating some of the side effects they experienced.

Q: Briefly describe your research project.

A: BCRF has been critical in funding innovative research that has allowed us to study the fundamental biological mechanisms associated with fatigue and cognitive changes after breast cancer treatments. Understanding the biology of these late effects is critical to finding strategies to prevent and treat them so that women can feel better as they live longer after breast cancer.

Q: What are your primary goals for this research?

A: To understand who is at risk for side effects from breast cancer treatments and how they can be prevented.

Q: Who do you think will benefit from your research?

A: There are over 2 million breast cancer survivors in the US and many more worldwide. All of them stand to benefit from what we learn.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: I have been able to take more risks and pursue highly innovative studies without pilot data. This has been enormously valuable. Our group is leading the way in understanding biological mechanisms underlying fatigue in breast cancer survivors.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: Prevention is on the horizon, but the side effects of our treatments may make them less acceptable. In addition, we need to target those who are definitely at high risk, so we avoid toxicity in those who are not. Hopefully, some of the research we and others are doing will help.

Read more about Dr. Ganz's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Patricia A. Ganz to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I became interested in the treatment of breast cancer early on in my career, as there were so many advances that were improving survival for women (early detection, adjuvant therapy, breast conserving treatment). With my move to UCLA's Jonsson Cancer Center (full-time), and the advent of the first breast cancer prevention trial, it was clear to me that we might some day be able to prevent breast cancer in many women. That was really exciting. I also began to follow an increasing number of breast cancer survivors and was interested in preventing and treating some of the side effects they experienced.

Q: Briefly describe your research project.

A: BCRF has been critical in funding innovative research that has allowed us to study the fundamental biological mechanisms associated with fatigue and cognitive changes after breast cancer treatments. Understanding the biology of these late effects is critical to finding strategies to prevent and treat them so that women can feel better as they live longer after breast cancer.

Q: What are your primary goals for this research?

A: To understand who is at risk for side effects from breast cancer treatments and how they can be prevented.

Q: Who do you think will benefit from your research?

A: There are over 2 million breast cancer survivors in the US and many more worldwide. All of them stand to benefit from what we learn.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: I have been able to take more risks and pursue highly innovative studies without pilot data. This has been enormously valuable. Our group is leading the way in understanding biological mechanisms underlying fatigue in breast cancer survivors.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: Prevention is on the horizon, but the side effects of our treatments may make them less acceptable. In addition, we need to target those who are definitely at high risk, so we avoid toxicity in those who are not. Hopefully, some of the research we and others are doing will help.

Read more about Dr. Ganz's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Patricia A. Ganz to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Judy E. Garber to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Judy E. Garber to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Judy E. Garber to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Judy E. Garber to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: My mother had breast cancer when I was in the fifth grade. She survived for 40 years despite having had positive nodes, so we can't complain about her radical mastectomy and lymphedema, but I became interested in cancer from that experience.

As I went through school, I realized that I really enjoyed science more than other subjects. Although I've always wanted to be a doctor, along the way I began to think about "doing more," so I started medical school with the intention of entering health administration. However, the summer after my first year, I was offered a position at the National Cancer Institute (NCI) to study epidemiology, looking at patterns of cancer in families. Although this took place before any "formal" cancer genetics program had been established, there were clearly families who had cancers clustered in them, and that fascinated me. This experience convinced me that I wanted to focus on research and I've never looked back.

Today, I am a clinical cancer geneticist and a breast oncologist. My research focus is on identifying individuals at highest risk for breast cancer and helping them prevent the disease. I collaborate with other scientists to try to understand whether treatment should be different for people with inherited risk.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: In our previous BCRF-funded work, we had learned quite a bit about BRCA1. With Dr. David Livingston at Dana-Farber, another BCRF grantee, we were able to do a clinical trial with cisplatin, a drug that targets a specific defect in BRCA 1 function. My group has also worked with other BCRF investigators, Drs. Stuart Schnitt and Nadine Tung at Beth Israel Deaconess and Andrea Richardson at Brigham and Women's Hospital, on triple-negative breast cancer, to see how frequently BRCA1 was mutated in those individuals. These studies have allowed us to say conclusively that individuals with triple-negative breast cancer often have a mutation in their BRCA1 gene.

Our project this year is focused on BRCA2, which is a much bigger gene than BRCA1 and one that leads to estrogen receptor-positive (ER+) and HER2-negative tumors, the most common tumor type. At first examination, BRCA2 tumors look just like other hormone receptor positive, HER2 negative tumors. There is evidence, however, that at the molecular level, they share some important features with BRCA1-related tumors - not a surprise, since the two genes are active in the same pathway of DNA repair. Finding ways to distinguish the BRCA2 tumors from the other ER+, progesterone receptor-positive (PR+), HER2 negative tumors, which comprise about 60% of all breast cancers, has been challenging. We have some new ideas about the cells from which the BRCA2 cancers may arise that may help us find the specific features of the BRCA2 cancers so we can distinguish them more easily.

Our primary goals are twofold: first, being able to characterize features of BRCA2 tumors that would help us distinguish them from among the larger group of tumors that are hormone sensitive; and second, looking at the molecular characterizations of these tumors, we want to look for particular vulnerabilities that we can exploit clinically. Because they are hormone receptor positive, some aspects of the treatment of BRCA2 tumors will be different from BRCA1-associated tumors. Options for prevention may also be different. For example, there are some data that tamoxifen can reduce the risk of BRCA2 tumors. However, some of the BRCA2 tumors, despite their hormone receptors, do not behave like other hormone receptor- positive tumors, and these require different treatment. Moreover, if the basis for the development of BRCA2 tumors is the "BRCA2-ness" more than the hormonal issues, then it makes sense that both the treatment and prevention strategies for them should be different from other hormone-associated breast cancers. But, first, we have to be able to find them easily and reliably. This is why we are focusing on BRCA 2, so we will be able to offer the same kinds of advances to these women as we have been able to for women with BRCA1 mutations.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: Several things happened closely together. First, Dr. Mary-Claire King, another BCRF investigator, identified or mapped the gene for breast and ovarian cancer (BRCA1) the same year that my group, working with Dr. Frederick Li at Dana-Farber, found that the tumor supressor gene p53 was instrumental in the development of the Li-Fraumeni syndrome, named after Dr. Li. Then, the BRCA2 and the colon cancer genes were mapped very quickly afterwards. So, suddenly we went from one gene that might explain cancer in families to four, and two of them involved breast cancer.

Since then, researchers have learned to sequence genes and do microarrays looking at many genes at once. They've learned how to process samples so you can easily store them, retrieve them, and study them. These novel technologies made it possible for us to look at genes more systematically, see more of them at once, and find more relationships that we didn't realize existed before. All of these developments help facilitate our work in genetics.

Also, Dr. Livingston's work on how BRCA1 works in DNA repair made my group think about treatments and changing them to target the specific weakness that BRCA1 causes. When I first started out, it wasn't possible even to imagine being able to do things, such as finding genes, understanding their functions, and then trying to target their errors. This is an amazing time to be working in cancer genetics, when the possibilities seem to be unfolding all the time.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next ten years?

A: I think that we will be able to move even faster now that we understand more about the different subtypes of breast cancer. We now can think about targeting therapies for those particular genes and learning how to combine these targets - one at a time has already been shown to be insufficient.

For my own work, I hope that we will be able to exploit the targeted approach on the prevention side as well. We see many people at risk and we need to be able to offer them more than just screening or tamoxifen. We can see those developments coming along too. Finally, I think we have to learn more about lifestyle factors. Some of the work that BCRF supports is in the direction of helping people find a way to stay well and avoid cancer, along with other health problems. I think there is progress in that area too. So, I'm hopeful.

Q: What other projects are you currently working on?

A: My group is also trying to understand the effectiveness of neo-adjuvant, or pre-surgical, therapies in breast cancers, through a project with Dr. William Kaelin (Dana-Farber), another BCRF investigator. In addition, we are looking at another target in breast cancer, particularly at the breast cancers that develop in individuals with the Li-Fraumeni syndrome. After all these years, we return again to Li-Fraumeni because we have some new clues that may help us to recognize them better and try to deal with those and in people who are at high risk for cancer.

At Dana-Farber we are working on a bigger "personalized medicine" platform looking at people's genes - in their tumors as well as those they are born with - not just their cancer susceptibility genes but also those that are important in metabolizing drugs and affect treatment responses which may help us to "individualize" therapies more effectively for each patient.

Also, I was recently inaugurated President of the American Association for Cancer Research (AACR) for the upcoming year. Planning for next year's AACR meeting and the San Antonio Breast Cancer Symposium will take up a fair amount of my time.

Q: How close are we to preventing and curing all forms of breast cancer?

A: Not close enough! We have certainly made progress in the last 10 or 20 years but we have a long way to go. Although we have succeeded in often making breast cancer a disease that can be "cured" or managed over a very long time, for every woman who gets breast cancer and isn't cured, that's just not enough. There is no doubt that we have made progress, but we are still a while away from "curing" every single person with breast cancer. Progress will continue to be constant as long as we have funding.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: Several of my projects would not have come about without BCRF. From my group's point of view, some of the most important projects we've done, such as the work on platinum, really began because we got some seed money from BCRF. Without that seed money, we never would have been able to work on the prevalence of mutations in triple-negative breast cancer or our current project on Li-Fraumeni. Every researcher will tell you that seed money is the hardest to come by, even though it is critical to moving forward. That's absolute.

Quite a few of my projects even started at BCRF's faculty retreat. When we researchers get together and have the chance to "talk science" or about projects, things happen. I think many BCRF investigators have stories like this.

Furthermore, BCRF has made very important contributions to breast cancer because of the novelty of its funding approach. BCRF funds researchers and ideas; they don't fund projects. That is a very different approach. Nobody else does this. It is an unusual way to fund cancer research but it's investing in people whom BCRF's Scientific Advisors feel have proven themselves as people who make contributions. They are helping that to continue. I think this model and the consistency of BCRF support from year to year have allowed the Foundation to have an impact far beyond what you might have expected from an organization of its size. We are tremendously grateful to BCRF!

Read more about Dr. Garber's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Judy E. Garber to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: My mother had breast cancer when I was in the fifth grade. She survived for 40 years despite having had positive nodes, so we can't complain about her radical mastectomy and lymphedema, but I became interested in cancer from that experience.

As I went through school, I realized that I really enjoyed science more than other subjects. Although I've always wanted to be a doctor, along the way I began to think about "doing more," so I started medical school with the intention of entering health administration. However, the summer after my first year, I was offered a position at the National Cancer Institute (NCI) to study epidemiology, looking at patterns of cancer in families. Although this took place before any "formal" cancer genetics program had been established, there were clearly families who had cancers clustered in them, and that fascinated me. This experience convinced me that I wanted to focus on research and I've never looked back.

Today, I am a clinical cancer geneticist and a breast oncologist. My research focus is on identifying individuals at highest risk for breast cancer and helping them prevent the disease. I collaborate with other scientists to try to understand whether treatment should be different for people with inherited risk.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: In our previous BCRF-funded work, we had learned quite a bit about BRCA1. With Dr. David Livingston at Dana-Farber, another BCRF grantee, we were able to do a clinical trial with cisplatin, a drug that targets a specific defect in BRCA 1 function. My group has also worked with other BCRF investigators, Drs. Stuart Schnitt and Nadine Tung at Beth Israel Deaconess and Andrea Richardson at Brigham and Women's Hospital, on triple-negative breast cancer, to see how frequently BRCA1 was mutated in those individuals. These studies have allowed us to say conclusively that individuals with triple-negative breast cancer often have a mutation in their BRCA1 gene.

Our project this year is focused on BRCA2, which is a much bigger gene than BRCA1 and one that leads to estrogen receptor-positive (ER+) and HER2-negative tumors, the most common tumor type. At first examination, BRCA2 tumors look just like other hormone receptor positive, HER2 negative tumors. There is evidence, however, that at the molecular level, they share some important features with BRCA1-related tumors - not a surprise, since the two genes are active in the same pathway of DNA repair. Finding ways to distinguish the BRCA2 tumors from the other ER+, progesterone receptor-positive (PR+), HER2 negative tumors, which comprise about 60% of all breast cancers, has been challenging. We have some new ideas about the cells from which the BRCA2 cancers may arise that may help us find the specific features of the BRCA2 cancers so we can distinguish them more easily.

Our primary goals are twofold: first, being able to characterize features of BRCA2 tumors that would help us distinguish them from among the larger group of tumors that are hormone sensitive; and second, looking at the molecular characterizations of these tumors, we want to look for particular vulnerabilities that we can exploit clinically. Because they are hormone receptor positive, some aspects of the treatment of BRCA2 tumors will be different from BRCA1-associated tumors. Options for prevention may also be different. For example, there are some data that tamoxifen can reduce the risk of BRCA2 tumors. However, some of the BRCA2 tumors, despite their hormone receptors, do not behave like other hormone receptor- positive tumors, and these require different treatment. Moreover, if the basis for the development of BRCA2 tumors is the "BRCA2-ness" more than the hormonal issues, then it makes sense that both the treatment and prevention strategies for them should be different from other hormone-associated breast cancers. But, first, we have to be able to find them easily and reliably. This is why we are focusing on BRCA 2, so we will be able to offer the same kinds of advances to these women as we have been able to for women with BRCA1 mutations.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: Several things happened closely together. First, Dr. Mary-Claire King, another BCRF investigator, identified or mapped the gene for breast and ovarian cancer (BRCA1) the same year that my group, working with Dr. Frederick Li at Dana-Farber, found that the tumor supressor gene p53 was instrumental in the development of the Li-Fraumeni syndrome, named after Dr. Li. Then, the BRCA2 and the colon cancer genes were mapped very quickly afterwards. So, suddenly we went from one gene that might explain cancer in families to four, and two of them involved breast cancer.

Since then, researchers have learned to sequence genes and do microarrays looking at many genes at once. They've learned how to process samples so you can easily store them, retrieve them, and study them. These novel technologies made it possible for us to look at genes more systematically, see more of them at once, and find more relationships that we didn't realize existed before. All of these developments help facilitate our work in genetics.

Also, Dr. Livingston's work on how BRCA1 works in DNA repair made my group think about treatments and changing them to target the specific weakness that BRCA1 causes. When I first started out, it wasn't possible even to imagine being able to do things, such as finding genes, understanding their functions, and then trying to target their errors. This is an amazing time to be working in cancer genetics, when the possibilities seem to be unfolding all the time.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next ten years?

A: I think that we will be able to move even faster now that we understand more about the different subtypes of breast cancer. We now can think about targeting therapies for those particular genes and learning how to combine these targets - one at a time has already been shown to be insufficient.

For my own work, I hope that we will be able to exploit the targeted approach on the prevention side as well. We see many people at risk and we need to be able to offer them more than just screening or tamoxifen. We can see those developments coming along too. Finally, I think we have to learn more about lifestyle factors. Some of the work that BCRF supports is in the direction of helping people find a way to stay well and avoid cancer, along with other health problems. I think there is progress in that area too. So, I'm hopeful.

Q: What other projects are you currently working on?

A: My group is also trying to understand the effectiveness of neo-adjuvant, or pre-surgical, therapies in breast cancers, through a project with Dr. William Kaelin (Dana-Farber), another BCRF investigator. In addition, we are looking at another target in breast cancer, particularly at the breast cancers that develop in individuals with the Li-Fraumeni syndrome. After all these years, we return again to Li-Fraumeni because we have some new clues that may help us to recognize them better and try to deal with those and in people who are at high risk for cancer.

At Dana-Farber we are working on a bigger "personalized medicine" platform looking at people's genes - in their tumors as well as those they are born with - not just their cancer susceptibility genes but also those that are important in metabolizing drugs and affect treatment responses which may help us to "individualize" therapies more effectively for each patient.

Also, I was recently inaugurated President of the American Association for Cancer Research (AACR) for the upcoming year. Planning for next year's AACR meeting and the San Antonio Breast Cancer Symposium will take up a fair amount of my time.

Q: How close are we to preventing and curing all forms of breast cancer?

A: Not close enough! We have certainly made progress in the last 10 or 20 years but we have a long way to go. Although we have succeeded in often making breast cancer a disease that can be "cured" or managed over a very long time, for every woman who gets breast cancer and isn't cured, that's just not enough. There is no doubt that we have made progress, but we are still a while away from "curing" every single person with breast cancer. Progress will continue to be constant as long as we have funding.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: Several of my projects would not have come about without BCRF. From my group's point of view, some of the most important projects we've done, such as the work on platinum, really began because we got some seed money from BCRF. Without that seed money, we never would have been able to work on the prevalence of mutations in triple-negative breast cancer or our current project on Li-Fraumeni. Every researcher will tell you that seed money is the hardest to come by, even though it is critical to moving forward. That's absolute.

Quite a few of my projects even started at BCRF's faculty retreat. When we researchers get together and have the chance to "talk science" or about projects, things happen. I think many BCRF investigators have stories like this.

Furthermore, BCRF has made very important contributions to breast cancer because of the novelty of its funding approach. BCRF funds researchers and ideas; they don't fund projects. That is a very different approach. Nobody else does this. It is an unusual way to fund cancer research but it's investing in people whom BCRF's Scientific Advisors feel have proven themselves as people who make contributions. They are helping that to continue. I think this model and the consistency of BCRF support from year to year have allowed the Foundation to have an impact far beyond what you might have expected from an organization of its size. We are tremendously grateful to BCRF!

Read more about Dr. Garber's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Judy E. Garber to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Daniel F. Hayes to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Daniel F. Hayes to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Daniel F. Hayes to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Daniel F. Hayes to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I am a practicing medical oncologist who does translational research. As a result, I conduct research in both the clinical and laboratory settings. My principal research interest is the generation and validation of tumor biomarkers for breast cancer patients.

I decided to go to medical school after considering a career teaching high school and coaching sports. I had no interest in oncology early in medical school, but as a junior medical student, I was assigned to the oncology ward at Indiana University - an idea I was originally against. By chance, my attending physician was Dr. Lawrence Einhorn, who is known for his work using cisplatin (platinum-based chemotherapy) to cure testicular cancer. Dr. Einhorn's research greatly increased the survival rate of all testicular cancer patients, even those whose cancer had spread or metastasized. Dr. Einhorn, a very charismatic man, inspired me to become an oncologist, and also encouraged me to go outside of Indiana. I went to University of Texas/Southwestern in Dallas for my residency, and then was selected for my fellowship at Harvard's Dana-Farber Cancer Institute, with the idea of working on testicular cancer.

At Dana-Farber, Dr. Emil Frei, then physician-in-chief, assigned me to the lab of Dr. Donald Kufe, who is known for his work in breast cancer. As our work progressed, I got one foot in the breast cancer clinical program with Dr. Craig Henderson and kept my work going with Dr. Kufe. It was a great opportunity, and I eventually published the first reports concerning the development of the CA15-3 blood test, which is currently used world-wide to monitor the progression of patients with breast cancer and their response to treatment.

All the years I've been in oncology, I have been surrounded by fantastic colleagues, many of whom coincidentally are also BCRF grantees. After I spent 15 years at the Dana-Farber, Dr. Marc Lippman recruited me to join him at Georgetown's Lombardi Cancer Center, and then I moved with him to University of Michigan, where we have a fabulous group of clinicians, clinical researchers, and laboratory investigators interested in breast cancer. It is really a great place to accomplish what we are trying to do: change practice in this disease.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: BCRF funds two projects that I'm involved in: one is on pharmacogenomics, the study of genes for the metabolism of drugs, with my fellow grantee, Dr. James Rae at the University of Michigan, and the other is related to my role as Chair of the Correlative Sciences Committee of the North American Breast Cancer Group (NABCG, formerly known as The Breast Cancer Intergroup). I will focus on my work through the NABCG first.

NABCG is a network of US-based breast cancer clinical trial cooperative groups sponsored by the National Cancer Institute (NCI). BCRF support has been critical in NABCG's activities, particularly those of the Correlative Science Committee (CSC). The CSC was established as a rigorous peer-review committee, which assesses and determines which projects could gain access to the precious biological samples collected from patients who participated in NCI breast cancer trials since the 1990s.

As CSC Chair for several years, I - along with my colleagues - noticed that sometimes projects would be approved but then the researchers couldn't perform the research because of the lack of funding. The costs of some of these projects were very modest, and although the science is superb, they were almost not worth the enormous effort to write a formal NCI grant. With BCRF support, we have been able to provide funding to individual investigators so that they can analyze tissues and new markers for clinical response rapidly and rigorously. Most of these projects aim to help identify people who would or would not benefit from a specific treatment.

In addition, BCRF support has allowed us to convene several workshops on such topics as pharmacogenomics, high throughput sequencing, and the Ki67 marker. The workshop on the Ki67 marker gave us an opportunity to "harmonize" researchers on how to use and assess this marker, which measures how quickly cells are "turning over."

We also collaborate on correlative science activities with Breast International Group (BIG), with whom we are currently building an informational website to link the organizations. This website (which went live in January 2011) will link with the one we already have for correlative sciences in the North American Group, and give lab scientists, from either NABCG or BIG, the ability to learn about the work that has already been done in his/her area of interest. More importantly, researchers can determine what specimens we have available for future studies and how to access them through our peer-review systems.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: I've been a medical oncologist for 26 years, and the advances over the last two and a half decades have been extremely important. Yet, they seem to have come about unbelievably quickly. Investigators such as Drs. Chuck Perou, Matthew Ellis, and Gordon Mills have led us to the realization that "breast cancer" is comprised of many different kinds of disease. This "fragmentation" gives us a better idea of what the different types of breast cancer are and what contributes to their growth. This information has already provided clinically useful tools and in the future will even better help lead to our goal of "personalization" or individualization of therapy.

In addition, collaboration will become more important than ever to progress. Now that we have a clearer picture of the complexity of breast cancer, we also know that all breast cancers cannot be treated, or cured, the same way. Also, the current financial climate has created additional challenges for the research community. Working together and sharing resources is ever more critical to our success.

Q: What other projects are you currently working on?

A: The other BCRF-funded project that I am working on, with Dr. James Rae, examines a woman's genetic makeup in relation to her response to endocrine therapy. Approximately 70% of all breast cancer cases are hormone receptor-positive, the growth of which is mostly fueled by estrogen. About 60% of these patients will respond to some form of endocrine therapy, which seeks to reduce or inhibit the production of estrogen and is divided into anti-estrogens (e.g. tamoxifen or raloxifene) or aromatase inhibitors (AIs). Although there are clear differences among the medications with respect to overall response and side effects, it is not currently possible to identify which patients will benefit the most from either form of therapy.

Therefore, Dr. Rae and I are studying how inherited gene variants affect patients' response. We started (with our colleagues in the Consortium on Breast Cancer Pharmacogenomics) by focusing on CYP2D6 in the metabolism of tamoxifen. Although this has not panned out the way we had hoped, we are now moving on to study other genes, such as CYP19, the gene that encodes for aromatase, which is the target for the aromatase inhibitors (Anastrazole, Exemestane, and Letrozole). This type of work further provides the foundation for personalized medicine by identifying not just differences between the tumors, but also between what the individuals with cancers may have inherited from their parents. We hope this work will help us prevent exposing patients to unnecessary therapies.

I am involved in other biomarker studies to develop new ones in addition to estrogen and progesterone. These projects aim to identify people for whom chemotherapy does not work, so we can eliminate exposing them to unnecessary side effects. We are also developing new methods to test for potential clinical effects before we apply the intervention directly to patients. We are focused on devising new technologies to help us go forward.

Q: How close are we to preventing and curing all forms of breast cancer?

A: The overall mortality rate for breast cancer has dropped a great deal over the last 30 years. However, I think it is important to make the distinction among the different forms of breast cancer when we talk about "cure."

The majority of women with breast cancer today are diagnosed with hormone receptor positive disease; their breast cancer can be managed and even "cured" with existing therapies. Our challenges in treating these women are on how can we "cure" them more effectively while causing fewer negative side effects. More recently, anti-HER2 therapies have further reduced mortality in the small (~15%) group of women whose cancer makes an excess of HER2 protein.

For women with breast cancers that don't make these markers, so-called "triple negative" disease, our efforts are even more fundamental. We must first improve our understanding of what drives the growth of these tumors, so that we can develop more effective and less toxic therapies.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: There are many examples of scientific advances that would not have happened without BCRF. In my own work, many of the NABCG activities mentioned above could not have happened without BCRF support. Groups like the NABCG give the overall cancer research community easy access to information and resources, which is vital to scientific progress. My pharmacogenomics project with Dr. Rae is critical to advancing personalized care, and BCRF funding has been instrumental in that too.

In addition, the pioneering work of people, such as Dr. Christine Ambrosone on breast cancer epidemiology and Dr. Edith Perez on treatment for HER2-positive breast cancer, were made possible by BCRF funding. My colleagues who study lung and gastrointestinal cancers often comment on how they wish for a private organization committed to scientific progress, like BCRF, in their fields.

Read more about Dr. Hayes' current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Daniel F. Hayes to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I am a practicing medical oncologist who does translational research. As a result, I conduct research in both the clinical and laboratory settings. My principal research interest is the generation and validation of tumor biomarkers for breast cancer patients.

I decided to go to medical school after considering a career teaching high school and coaching sports. I had no interest in oncology early in medical school, but as a junior medical student, I was assigned to the oncology ward at Indiana University - an idea I was originally against. By chance, my attending physician was Dr. Lawrence Einhorn, who is known for his work using cisplatin (platinum-based chemotherapy) to cure testicular cancer. Dr. Einhorn's research greatly increased the survival rate of all testicular cancer patients, even those whose cancer had spread or metastasized. Dr. Einhorn, a very charismatic man, inspired me to become an oncologist, and also encouraged me to go outside of Indiana. I went to University of Texas/Southwestern in Dallas for my residency, and then was selected for my fellowship at Harvard's Dana-Farber Cancer Institute, with the idea of working on testicular cancer.

At Dana-Farber, Dr. Emil Frei, then physician-in-chief, assigned me to the lab of Dr. Donald Kufe, who is known for his work in breast cancer. As our work progressed, I got one foot in the breast cancer clinical program with Dr. Craig Henderson and kept my work going with Dr. Kufe. It was a great opportunity, and I eventually published the first reports concerning the development of the CA15-3 blood test, which is currently used world-wide to monitor the progression of patients with breast cancer and their response to treatment.

All the years I've been in oncology, I have been surrounded by fantastic colleagues, many of whom coincidentally are also BCRF grantees. After I spent 15 years at the Dana-Farber, Dr. Marc Lippman recruited me to join him at Georgetown's Lombardi Cancer Center, and then I moved with him to University of Michigan, where we have a fabulous group of clinicians, clinical researchers, and laboratory investigators interested in breast cancer. It is really a great place to accomplish what we are trying to do: change practice in this disease.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: BCRF funds two projects that I'm involved in: one is on pharmacogenomics, the study of genes for the metabolism of drugs, with my fellow grantee, Dr. James Rae at the University of Michigan, and the other is related to my role as Chair of the Correlative Sciences Committee of the North American Breast Cancer Group (NABCG, formerly known as The Breast Cancer Intergroup). I will focus on my work through the NABCG first.

NABCG is a network of US-based breast cancer clinical trial cooperative groups sponsored by the National Cancer Institute (NCI). BCRF support has been critical in NABCG's activities, particularly those of the Correlative Science Committee (CSC). The CSC was established as a rigorous peer-review committee, which assesses and determines which projects could gain access to the precious biological samples collected from patients who participated in NCI breast cancer trials since the 1990s.

As CSC Chair for several years, I - along with my colleagues - noticed that sometimes projects would be approved but then the researchers couldn't perform the research because of the lack of funding. The costs of some of these projects were very modest, and although the science is superb, they were almost not worth the enormous effort to write a formal NCI grant. With BCRF support, we have been able to provide funding to individual investigators so that they can analyze tissues and new markers for clinical response rapidly and rigorously. Most of these projects aim to help identify people who would or would not benefit from a specific treatment.

In addition, BCRF support has allowed us to convene several workshops on such topics as pharmacogenomics, high throughput sequencing, and the Ki67 marker. The workshop on the Ki67 marker gave us an opportunity to "harmonize" researchers on how to use and assess this marker, which measures how quickly cells are "turning over."

We also collaborate on correlative science activities with Breast International Group (BIG), with whom we are currently building an informational website to link the organizations. This website (which went live in January 2011) will link with the one we already have for correlative sciences in the North American Group, and give lab scientists, from either NABCG or BIG, the ability to learn about the work that has already been done in his/her area of interest. More importantly, researchers can determine what specimens we have available for future studies and how to access them through our peer-review systems.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: I've been a medical oncologist for 26 years, and the advances over the last two and a half decades have been extremely important. Yet, they seem to have come about unbelievably quickly. Investigators such as Drs. Chuck Perou, Matthew Ellis, and Gordon Mills have led us to the realization that "breast cancer" is comprised of many different kinds of disease. This "fragmentation" gives us a better idea of what the different types of breast cancer are and what contributes to their growth. This information has already provided clinically useful tools and in the future will even better help lead to our goal of "personalization" or individualization of therapy.

In addition, collaboration will become more important than ever to progress. Now that we have a clearer picture of the complexity of breast cancer, we also know that all breast cancers cannot be treated, or cured, the same way. Also, the current financial climate has created additional challenges for the research community. Working together and sharing resources is ever more critical to our success.

Q: What other projects are you currently working on?

A: The other BCRF-funded project that I am working on, with Dr. James Rae, examines a woman's genetic makeup in relation to her response to endocrine therapy. Approximately 70% of all breast cancer cases are hormone receptor-positive, the growth of which is mostly fueled by estrogen. About 60% of these patients will respond to some form of endocrine therapy, which seeks to reduce or inhibit the production of estrogen and is divided into anti-estrogens (e.g. tamoxifen or raloxifene) or aromatase inhibitors (AIs). Although there are clear differences among the medications with respect to overall response and side effects, it is not currently possible to identify which patients will benefit the most from either form of therapy.

Therefore, Dr. Rae and I are studying how inherited gene variants affect patients' response. We started (with our colleagues in the Consortium on Breast Cancer Pharmacogenomics) by focusing on CYP2D6 in the metabolism of tamoxifen. Although this has not panned out the way we had hoped, we are now moving on to study other genes, such as CYP19, the gene that encodes for aromatase, which is the target for the aromatase inhibitors (Anastrazole, Exemestane, and Letrozole). This type of work further provides the foundation for personalized medicine by identifying not just differences between the tumors, but also between what the individuals with cancers may have inherited from their parents. We hope this work will help us prevent exposing patients to unnecessary therapies.

I am involved in other biomarker studies to develop new ones in addition to estrogen and progesterone. These projects aim to identify people for whom chemotherapy does not work, so we can eliminate exposing them to unnecessary side effects. We are also developing new methods to test for potential clinical effects before we apply the intervention directly to patients. We are focused on devising new technologies to help us go forward.

Q: How close are we to preventing and curing all forms of breast cancer?

A: The overall mortality rate for breast cancer has dropped a great deal over the last 30 years. However, I think it is important to make the distinction among the different forms of breast cancer when we talk about "cure."

The majority of women with breast cancer today are diagnosed with hormone receptor positive disease; their breast cancer can be managed and even "cured" with existing therapies. Our challenges in treating these women are on how can we "cure" them more effectively while causing fewer negative side effects. More recently, anti-HER2 therapies have further reduced mortality in the small (~15%) group of women whose cancer makes an excess of HER2 protein.

For women with breast cancers that don't make these markers, so-called "triple negative" disease, our efforts are even more fundamental. We must first improve our understanding of what drives the growth of these tumors, so that we can develop more effective and less toxic therapies.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: There are many examples of scientific advances that would not have happened without BCRF. In my own work, many of the NABCG activities mentioned above could not have happened without BCRF support. Groups like the NABCG give the overall cancer research community easy access to information and resources, which is vital to scientific progress. My pharmacogenomics project with Dr. Rae is critical to advancing personalized care, and BCRF funding has been instrumental in that too.

In addition, the pioneering work of people, such as Dr. Christine Ambrosone on breast cancer epidemiology and Dr. Edith Perez on treatment for HER2-positive breast cancer, were made possible by BCRF funding. My colleagues who study lung and gastrointestinal cancers often comment on how they wish for a private organization committed to scientific progress, like BCRF, in their fields.

Read more about Dr. Hayes' current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Daniel F. Hayes to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.title
Q&A with Chairman of the Scientific Advisory Board, Dr. Clifford Hudis

# data[].attributes.metatag_normalized[].attributes.content
Q&A with Chairman of the Scientific Advisory Board, Dr. Clifford Hudis | BCRF

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Clifford Hudis to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research. 
A:I became interested in breast cancer the same way I became interested in cancer in general: a happy coincidence of scientific curiosity and a motivated and inspiring mentor. As a resident in Internal Medicine I enjoyed a rotation through my hospital's Oncology Division led by a beloved "American Cancer Society Professor" and saw the clearest implementation of the combination of optimism, increasing technology, and hands-on medicine that first drew me to medicine as a career. When I came to Memorial Sloan-Kettering Cancer Center as a research fellow I was assigned to the new clinic of Larry Norton and he, too, was able to show me a clear example of how evolving technology was going to convert a dreaded disease into a more manageable and ultimately curable problem.
Q: Briefly describe your research project. 
A: My BCRF funded research is conducted in collaboration with the laboratory of Andrew Dannenberg at Weill College of Medicine across the street from Memorial Hospital. It focuses on the role played by a universal enzyzme, COX-2, in breast cancer. Our hypothesis is that COX-2 is more activated in some kinds of breast cancer and that its inhibition will enable us to better prevent and treat the disease. At present our goal is to complete the development of a very specialized laboratory model of COX-2 deficiency so that we can more clearly study the impact of this enzyme on the development of breast cancer.
Q: Who do you think will benefit from your research? 
A: Our research has broad public health potential. Because aspirin and other COX inhibitors are used by millions of men and women every day, our work could identify how best to leverage this exposure ideally to prevent some specific kinds of breast cancer.
Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field? 
A: We have been funded for 4 years. During that time we have used this funding to do laboratory experiments that would otherwise have been unfunded. As a result, we have been able to obtain larger funding from the National Cancer Institute to conduct a research trial in women about to undergo routine surgery for breast cancer. This experiment provides us with human tissues that correlate with our laboratory experiments. Without the "seed" money provided by BCRF we would have had a much more difficult time convincing reviewers that our science was worthy of this investment.
Q. How close do you think we are to preventing or finding a cure for breast cancer? 
A. It is becoming increasingly clear that breast cancer is truly a collection of related diseases. On a practical level this suggests that we will not be likely to observe a single curative treatment approach. Instead I think it is most likely that we will see significant gains in the prevention and treatment of specific subtypes of the disease.
 
Read more about Dr. Hudis' current research project funded by BCRF. 
 

# data[].attributes.metatag_normalized[].attributes.content
Q&A with Chairman of the Scientific Advisory Board, Dr. Clifford Hudis

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Clifford Hudis to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
Q&A with Chairman of the Scientific Advisory Board, Dr. Clifford Hudis

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Clifford Hudis to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
Q&A with Chairman of the Scientific Advisory Board, Dr. Clifford Hudis

# data[].attributes.body.value
BCRF sat down with Dr. Clifford Hudis to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A:I became interested in breast cancer the same way I became interested in cancer in general: a happy coincidence of scientific curiosity and a motivated and inspiring mentor. As a resident in Internal Medicine I enjoyed a rotation through my hospital's Oncology Division led by a beloved "American Cancer Society Professor" and saw the clearest implementation of the combination of optimism, increasing technology, and hands-on medicine that first drew me to medicine as a career. When I came to Memorial Sloan-Kettering Cancer Center as a research fellow I was assigned to the new clinic of Larry Norton and he, too, was able to show me a clear example of how evolving technology was going to convert a dreaded disease into a more manageable and ultimately curable problem.

Q: Briefly describe your research project.

A: My BCRF funded research is conducted in collaboration with the laboratory of Andrew Dannenberg at Weill College of Medicine across the street from Memorial Hospital. It focuses on the role played by a universal enzyzme, COX-2, in breast cancer. Our hypothesis is that COX-2 is more activated in some kinds of breast cancer and that its inhibition will enable us to better prevent and treat the disease. At present our goal is to complete the development of a very specialized laboratory model of COX-2 deficiency so that we can more clearly study the impact of this enzyme on the development of breast cancer.

Q: Who do you think will benefit from your research?

A: Our research has broad public health potential. Because aspirin and other COX inhibitors are used by millions of men and women every day, our work could identify how best to leverage this exposure ideally to prevent some specific kinds of breast cancer.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: We have been funded for 4 years. During that time we have used this funding to do laboratory experiments that would otherwise have been unfunded. As a result, we have been able to obtain larger funding from the National Cancer Institute to conduct a research trial in women about to undergo routine surgery for breast cancer. This experiment provides us with human tissues that correlate with our laboratory experiments. Without the "seed" money provided by BCRF we would have had a much more difficult time convincing reviewers that our science was worthy of this investment.

Q. How close do you think we are to preventing or finding a cure for breast cancer?

A. It is becoming increasingly clear that breast cancer is truly a collection of related diseases. On a practical level this suggests that we will not be likely to observe a single curative treatment approach. Instead I think it is most likely that we will see significant gains in the prevention and treatment of specific subtypes of the disease.

Read more about Dr. Hudis' current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Clifford Hudis to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A:I became interested in breast cancer the same way I became interested in cancer in general: a happy coincidence of scientific curiosity and a motivated and inspiring mentor. As a resident in Internal Medicine I enjoyed a rotation through my hospital's Oncology Division led by a beloved "American Cancer Society Professor" and saw the clearest implementation of the combination of optimism, increasing technology, and hands-on medicine that first drew me to medicine as a career. When I came to Memorial Sloan-Kettering Cancer Center as a research fellow I was assigned to the new clinic of Larry Norton and he, too, was able to show me a clear example of how evolving technology was going to convert a dreaded disease into a more manageable and ultimately curable problem.

Q: Briefly describe your research project.

A: My BCRF funded research is conducted in collaboration with the laboratory of Andrew Dannenberg at Weill College of Medicine across the street from Memorial Hospital. It focuses on the role played by a universal enzyzme, COX-2, in breast cancer. Our hypothesis is that COX-2 is more activated in some kinds of breast cancer and that its inhibition will enable us to better prevent and treat the disease. At present our goal is to complete the development of a very specialized laboratory model of COX-2 deficiency so that we can more clearly study the impact of this enzyme on the development of breast cancer.

Q: Who do you think will benefit from your research?

A: Our research has broad public health potential. Because aspirin and other COX inhibitors are used by millions of men and women every day, our work could identify how best to leverage this exposure ideally to prevent some specific kinds of breast cancer.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: We have been funded for 4 years. During that time we have used this funding to do laboratory experiments that would otherwise have been unfunded. As a result, we have been able to obtain larger funding from the National Cancer Institute to conduct a research trial in women about to undergo routine surgery for breast cancer. This experiment provides us with human tissues that correlate with our laboratory experiments. Without the "seed" money provided by BCRF we would have had a much more difficult time convincing reviewers that our science was worthy of this investment.

Q. How close do you think we are to preventing or finding a cure for breast cancer?

A. It is becoming increasingly clear that breast cancer is truly a collection of related diseases. On a practical level this suggests that we will not be likely to observe a single curative treatment approach. Instead I think it is most likely that we will see significant gains in the prevention and treatment of specific subtypes of the disease.

Read more about Dr. Hudis' current research project funded by BCRF.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Mary-Claire King to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Mary-Claire King to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Mary-Claire King to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Mary-Claire King to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: As a girl, I enjoyed math and majored in math as an undergraduate at Carleton College in Minnesota. In 1966, I went to Berkeley as a graduate student, took one genetics course and promptly fell in love with this way of thinking. I finished my PhD in Berkeley in 1972, studying a problem of human molecular evolution. As soon as I filed my dissertation, I went to Santiago, Chile to teach on a University of California-Univ de Chile exchange program.

I returned to Berkeley sooner and more abruptly than I'd anticipated, shortly after the Chilean coup of Sept 11, 1973. I was jobless, frightened for my students (with reason), and thoroughly discouraged. I considered dropping out of science. Dr Nick Petrakis at UCSF suggested I come work with him until I got my feet on the ground. He said he had a problem so important and so complex it would absorb all my attention. The problem was: why are some families so severely affected with breast cancer? I began working on the problem on Jan 1, 1974 and have never looked back.

Q: Briefly describe your research project.

A: To determine the genes responsible for inherited predisposition to breast and ovarian cancer, and to identify the non-genetic factors that modify the effects of those genes.

Q: What are your primary goals for this research?

A. Find and characterize all the genes responsible for inherited predisposition to breast cancer and determine the consequences for women who carry mutant forms of these genes.

Q. Who do you think will benefit from your research?

A. At present, the primary beneficiaries are women in families with inherited mutations in BRCA1 and BRCA2. These women can now learn if they carry a cancer-predisposing BRCA1 or BRCA2 mutation or if, by the luck of genetics, they do not carry the cancer-predisposing mutation in their family. Young women who carry such mutations but have not yet been diagnosed with breast or ovarian cancer can undertake interventions that reduce their cancer risk dramatically. These interventions are surgical and invasive but are life saving.

Q. How close do you think we are to preventing or finding a cure for breast cancer?

A. I believe there will be many preventions and many cures. Breast cancer is highly variable genetically and different breast cancers will be prevented and cured by different means. Breast cancers in women with BRCA1 or BRCA2 mutations are prevented by invasive, but successful, surgical intervention. Preventing both these and other breast cancers may eventually be medically tractable.

Q. How has The Breast Cancer Research Foundation been helpful to you?

A. BCRF support enabled Joan Marks and me to undertake The New York Breast Cancer Study, which has provided the definitive determination of risks associated with inherited mutations in BRCA1 and BRCA2. The NYBCS was carried out entirely among women of Ashkenazi Jewish ancestry, but the results are applicable to women of all ancestries. The BCRF now supports the effort of the New York Breast Study to identify genes responsible for inherited predisposition to breast cancer in severely affected Ashkenazi Jewish families who have no mutations of any kind in BRCA1 or BRCA2 or any other known breast cancer gene. As previously, we anticipate that results first obtained for Jewish families will be generalizable to women of all ancestries. Absent the BCRF, The New York Breast Cancer Study could not have been undertaken. My research would be far narrower and less meaningful in consequence. I am eternally grateful to BCRF and I am not alone in this gratitude.

Read more about Dr. King's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Mary-Claire King to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: As a girl, I enjoyed math and majored in math as an undergraduate at Carleton College in Minnesota. In 1966, I went to Berkeley as a graduate student, took one genetics course and promptly fell in love with this way of thinking. I finished my PhD in Berkeley in 1972, studying a problem of human molecular evolution. As soon as I filed my dissertation, I went to Santiago, Chile to teach on a University of California-Univ de Chile exchange program.

I returned to Berkeley sooner and more abruptly than I'd anticipated, shortly after the Chilean coup of Sept 11, 1973. I was jobless, frightened for my students (with reason), and thoroughly discouraged. I considered dropping out of science. Dr Nick Petrakis at UCSF suggested I come work with him until I got my feet on the ground. He said he had a problem so important and so complex it would absorb all my attention. The problem was: why are some families so severely affected with breast cancer? I began working on the problem on Jan 1, 1974 and have never looked back.

Q: Briefly describe your research project.

A: To determine the genes responsible for inherited predisposition to breast and ovarian cancer, and to identify the non-genetic factors that modify the effects of those genes.

Q: What are your primary goals for this research?

A. Find and characterize all the genes responsible for inherited predisposition to breast cancer and determine the consequences for women who carry mutant forms of these genes.

Q. Who do you think will benefit from your research?

A. At present, the primary beneficiaries are women in families with inherited mutations in BRCA1 and BRCA2. These women can now learn if they carry a cancer-predisposing BRCA1 or BRCA2 mutation or if, by the luck of genetics, they do not carry the cancer-predisposing mutation in their family. Young women who carry such mutations but have not yet been diagnosed with breast or ovarian cancer can undertake interventions that reduce their cancer risk dramatically. These interventions are surgical and invasive but are life saving.

Q. How close do you think we are to preventing or finding a cure for breast cancer?

A. I believe there will be many preventions and many cures. Breast cancer is highly variable genetically and different breast cancers will be prevented and cured by different means. Breast cancers in women with BRCA1 or BRCA2 mutations are prevented by invasive, but successful, surgical intervention. Preventing both these and other breast cancers may eventually be medically tractable.

Q. How has The Breast Cancer Research Foundation been helpful to you?

A. BCRF support enabled Joan Marks and me to undertake The New York Breast Cancer Study, which has provided the definitive determination of risks associated with inherited mutations in BRCA1 and BRCA2. The NYBCS was carried out entirely among women of Ashkenazi Jewish ancestry, but the results are applicable to women of all ancestries. The BCRF now supports the effort of the New York Breast Study to identify genes responsible for inherited predisposition to breast cancer in severely affected Ashkenazi Jewish families who have no mutations of any kind in BRCA1 or BRCA2 or any other known breast cancer gene. As previously, we anticipate that results first obtained for Jewish families will be generalizable to women of all ancestries. Absent the BCRF, The New York Breast Cancer Study could not have been undertaken. My research would be far narrower and less meaningful in consequence. I am eternally grateful to BCRF and I am not alone in this gratitude.

Read more about Dr. King's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Mary-Claire King to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Titia de Lange to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: How did you become interested in breast cancer research? 
A: During my graduate training at the Dutch Cancer Institute and post-doctoral training in Harold Varmus's laboratory at UCSF, I was always working side by side with cancer biologists; I had a lot of exposure to cancer research early on. My own interest is in fundamental questions about how our cells reproduce, stabilize, and repair their DNA. This is an issue relevant to cancer because cancer is a disease caused by changes in our DNA. For instance, the breast cancer genes BRCA1 and BRCA2 are involved in homologous recombination, a kind of DNA repair during copying. We know that breast and ovarian cancers can get their start when either of these two mutated genes fail in their intended job. Later on in my own research, several projects that relate to breast cancer arose out of fundamental biological questions I was asking. For instance, one of our BCRF-funded projects allowed us to study the Rif1 gene, which, like BRCA1 and BRCA2 is involved in homologous recombination. We were able to create a detailed analysis of what this gene does in a cell during this process. If we understand the activities of the genes involved at these vulnerable moments of DNA-copying, we may contribute to new treatments for cells' predictable deficiencies.
Q: Could you describe your recent discovery that may have a positive impact on breast cancer? 
A: Our current BCRF-funded project grew out of an interest in the Tel2 gene, which sits at the crossroads of the most important signaling pathways in cells. Now, we are testing whether we can use the Tel2 gene as an additional target to sensitize cancer cells to chemotherapy. We published our research results in the journal Cell in December 2007.
Q: You are known for your discovery and ongoing research on telomeres, the tips of chromosomes that protect our DNA. How is this discovery relevant to cancer? 
A: Cancer cells have a way to prevent their telomeres from withering away, as they do in our normal cells. This provides cancer cells with their immortal growth properties and has raised the possibility that we can stop cancer growth by blocking their telomere synthesis. So, our work on telomeres provides a way of understanding how cancer cells survive and reproduce themselves.
Q: How close do you think we are to preventing or finding a cure for breast cancers? 
A: I am more optimistic now than I was in the past because of the development of tools to get a full inventory of every genetic change in a cancerous tumor and the efforts to create screening modalities that can reveal the Achilles heel of each type of breast cancer. My hope is that the new information will identify the molecular pathways where interventions will be effective and cancer-specific so that better and less toxic treatments can be developed.
Q: How has BCRF been helpful to you? 
A: The BCRF was key for our work on Tel2. Our research on Tel2 began as part of a project funded by a National Institutes of Health grant. We knew that Tel2 to be an important gene but our hypothesis about its functions turned out to be wrong (which is not unusual in my experience). Luckily, we learned something unexpected and important in the process: Tel2 affects a critical nutrient-sensing pathway called mTOR. mTOR is already being explored in the clinic as an important breast cancer target. But our NIH funding did not support this type of research and we would have stopped working on it if it hadn't been for the BCRF funding. 
Q: What are the biggest challenges in cancer research today? 
A: To mine the avalanche of new genetic information coming our way and use the new insights to make sense of the cancer cell and intervene in ways that help real people in their struggles withdisease.
Q: Did you ever consider another kind of career than that of the sciences? 
A: I am not good at anything else, so I don't really have a choice. I don't recall ever choosing science as a "career." For me, science is not a career or work; it is a (well-paid!) hobby which I enjoy, every day. I consider myself extremely lucky because I don't have to work.
Q: What advice would you give to young researchers? 
A:Do what you think is fun and interesting in science. Don't follow the herd. Focus on research that excites you and put the fundability concerns second.
Read more about Dr. de Lange's current research project funded by BCRF. 

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Titia de Lange to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: How did you become interested in breast cancer research?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Titia de Lange to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: How did you become interested in breast cancer research?

# data[].attributes.body.value
BCRF sat down with Dr. Titia de Lange to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: How did you become interested in breast cancer research?

A: During my graduate training at the Dutch Cancer Institute and post-doctoral training in Harold Varmus's laboratory at UCSF, I was always working side by side with cancer biologists; I had a lot of exposure to cancer research early on. My own interest is in fundamental questions about how our cells reproduce, stabilize, and repair their DNA. This is an issue relevant to cancer because cancer is a disease caused by changes in our DNA. For instance, the breast cancer genes BRCA1 and BRCA2 are involved in homologous recombination, a kind of DNA repair during copying. We know that breast and ovarian cancers can get their start when either of these two mutated genes fail in their intended job. Later on in my own research, several projects that relate to breast cancer arose out of fundamental biological questions I was asking. For instance, one of our BCRF-funded projects allowed us to study the Rif1 gene, which, like BRCA1 and BRCA2 is involved in homologous recombination. We were able to create a detailed analysis of what this gene does in a cell during this process. If we understand the activities of the genes involved at these vulnerable moments of DNA-copying, we may contribute to new treatments for cells' predictable deficiencies.

Q: Could you describe your recent discovery that may have a positive impact on breast cancer?

A: Our current BCRF-funded project grew out of an interest in the Tel2 gene, which sits at the crossroads of the most important signaling pathways in cells. Now, we are testing whether we can use the Tel2 gene as an additional target to sensitize cancer cells to chemotherapy. We published our research results in the journal Cell in December 2007.

Q: You are known for your discovery and ongoing research on telomeres, the tips of chromosomes that protect our DNA. How is this discovery relevant to cancer?

A: Cancer cells have a way to prevent their telomeres from withering away, as they do in our normal cells. This provides cancer cells with their immortal growth properties and has raised the possibility that we can stop cancer growth by blocking their telomere synthesis. So, our work on telomeres provides a way of understanding how cancer cells survive and reproduce themselves.

Q: How close do you think we are to preventing or finding a cure for breast cancers?

A: I am more optimistic now than I was in the past because of the development of tools to get a full inventory of every genetic change in a cancerous tumor and the efforts to create screening modalities that can reveal the Achilles heel of each type of breast cancer. My hope is that the new information will identify the molecular pathways where interventions will be effective and cancer-specific so that better and less toxic treatments can be developed.

Q: How has BCRF been helpful to you?

A: The BCRF was key for our work on Tel2. Our research on Tel2 began as part of a project funded by a National Institutes of Health grant. We knew that Tel2 to be an important gene but our hypothesis about its functions turned out to be wrong (which is not unusual in my experience). Luckily, we learned something unexpected and important in the process: Tel2 affects a critical nutrient-sensing pathway called mTOR. mTOR is already being explored in the clinic as an important breast cancer target. But our NIH funding did not support this type of research and we would have stopped working on it if it hadn't been for the BCRF funding.

Q: What are the biggest challenges in cancer research today?

A: To mine the avalanche of new genetic information coming our way and use the new insights to make sense of the cancer cell and intervene in ways that help real people in their struggles withdisease.

Q: Did you ever consider another kind of career than that of the sciences?

A: I am not good at anything else, so I don't really have a choice. I don't recall ever choosing science as a "career." For me, science is not a career or work; it is a (well-paid!) hobby which I enjoy, every day. I consider myself extremely lucky because I don't have to work.

Q: What advice would you give to young researchers?

A:Do what you think is fun and interesting in science. Don't follow the herd. Focus on research that excites you and put the fundability concerns second.

Read more about Dr. de Lange's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Titia de Lange to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: How did you become interested in breast cancer research?

A: During my graduate training at the Dutch Cancer Institute and post-doctoral training in Harold Varmus's laboratory at UCSF, I was always working side by side with cancer biologists; I had a lot of exposure to cancer research early on. My own interest is in fundamental questions about how our cells reproduce, stabilize, and repair their DNA. This is an issue relevant to cancer because cancer is a disease caused by changes in our DNA. For instance, the breast cancer genes BRCA1 and BRCA2 are involved in homologous recombination, a kind of DNA repair during copying. We know that breast and ovarian cancers can get their start when either of these two mutated genes fail in their intended job. Later on in my own research, several projects that relate to breast cancer arose out of fundamental biological questions I was asking. For instance, one of our BCRF-funded projects allowed us to study the Rif1 gene, which, like BRCA1 and BRCA2 is involved in homologous recombination. We were able to create a detailed analysis of what this gene does in a cell during this process. If we understand the activities of the genes involved at these vulnerable moments of DNA-copying, we may contribute to new treatments for cells' predictable deficiencies.

Q: Could you describe your recent discovery that may have a positive impact on breast cancer?

A: Our current BCRF-funded project grew out of an interest in the Tel2 gene, which sits at the crossroads of the most important signaling pathways in cells. Now, we are testing whether we can use the Tel2 gene as an additional target to sensitize cancer cells to chemotherapy. We published our research results in the journal Cell in December 2007.

Q: You are known for your discovery and ongoing research on telomeres, the tips of chromosomes that protect our DNA. How is this discovery relevant to cancer?

A: Cancer cells have a way to prevent their telomeres from withering away, as they do in our normal cells. This provides cancer cells with their immortal growth properties and has raised the possibility that we can stop cancer growth by blocking their telomere synthesis. So, our work on telomeres provides a way of understanding how cancer cells survive and reproduce themselves.

Q: How close do you think we are to preventing or finding a cure for breast cancers?

A: I am more optimistic now than I was in the past because of the development of tools to get a full inventory of every genetic change in a cancerous tumor and the efforts to create screening modalities that can reveal the Achilles heel of each type of breast cancer. My hope is that the new information will identify the molecular pathways where interventions will be effective and cancer-specific so that better and less toxic treatments can be developed.

Q: How has BCRF been helpful to you?

A: The BCRF was key for our work on Tel2. Our research on Tel2 began as part of a project funded by a National Institutes of Health grant. We knew that Tel2 to be an important gene but our hypothesis about its functions turned out to be wrong (which is not unusual in my experience). Luckily, we learned something unexpected and important in the process: Tel2 affects a critical nutrient-sensing pathway called mTOR. mTOR is already being explored in the clinic as an important breast cancer target. But our NIH funding did not support this type of research and we would have stopped working on it if it hadn't been for the BCRF funding.

Q: What are the biggest challenges in cancer research today?

A: To mine the avalanche of new genetic information coming our way and use the new insights to make sense of the cancer cell and intervene in ways that help real people in their struggles withdisease.

Q: Did you ever consider another kind of career than that of the sciences?

A: I am not good at anything else, so I don't really have a choice. I don't recall ever choosing science as a "career." For me, science is not a career or work; it is a (well-paid!) hobby which I enjoy, every day. I consider myself extremely lucky because I don't have to work.

Q: What advice would you give to young researchers?

A:Do what you think is fun and interesting in science. Don't follow the herd. Focus on research that excites you and put the fundability concerns second.

Read more about Dr. de Lange's current research project funded by BCRF.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Ephrat Levy-Lahad to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Ephrat Levy-Lahad to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Ephrat Levy-Lahad to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Ephrat Levy-Lahad to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I am a medical geneticist. My interest in breast cancer started fortuitously. I began my career as an internist with primary interest in adult diseases like Alzheimer's. At the time (the early 1990s), geneticists were mostly pediatricians. The idea that adult disease could also be related to genetics was new. Coincidentally, when I was doing a Medical Genetics fellowship at the University of Washington in Seattle, Mary-Claire King, PhD, the discoverer of BRCA1 (breast cancer susceptibility gene 1), just moved from University of California, Berkeley, to University of Washington. So I met with her, and we really hit it off.

After my training, I returned to Israel to set up a cancer genetics clinic, one of world's first, at Shaare Zedek Medical Center. There are genetic issues particularly relevant to Jewish women. For instance, mutations in the BRCA genes, which indicate predisposition to both breast and ovarian cancers, are found in a higher proportion of Ashkenazi Jewish women than any other group. Through the clinic, many basic science questions emerged. For example, why do women with genetic mutations get cancer? Also, when you look at women with the same genetic mutation, why do some get breast cancer in their 20s, while others in their 60s? Why do some develop ovarian cancer, while others will never get any cancer at all?

My colleagues and I also started thinking about prevention. We began to screen women systematically to identify ones at elevated risk so we could intervene clinically to prevent the development of cancer. Combining clinical practice with basic research has been very important. When I started my career, I did not think I would be doing much research but I really love it!

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: I currently participate in two BCRF-funded projects, one of which is a collaboration with fellow grantees Mary-Claire King, PhD (University of Washington) and Moien Kanaan, PhD (Bethlehem University). My main focus is using what is known about breast cancer genetics to improve prevention strategies.

In our Israel Breast Cancer Study, we evaluate BRCA1 and BRCA2 mutations in the Ashkenazi Jewish population of Israel. We tested over 8,000 healthy men and among them found 175 who were carriers of mutations. These men were the key to their families, because through them we could observe the cancer risk in their female relatives. We found that even when we identify a BRCA1 or BRCA2 family through a healthy male, women in the family who are carriers are still at elevated risk for breast and ovarian cancers compared to women without the mutation. We aim for how best to identify mutation carriers at the earliest point possible when prevention interventions are most effective. The patients we encounter in the clinic "inspired" this project. A normal 32 year-old woman would not think of herself as being at risk for breast cancer. But if you are a BRCA carrier, then your risk increases, and monitoring can mean a world of difference.

Our second project is a collaboration with Drs. Kanaan and King looking at breast cancer genetics in the Arab population. This project has two components. One is providing genetics services for the Palestinian population. Also, the Arab-Israeli population has not been studied extensively at all, so we are looking for new breast cancer genes.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: Newly developed gene sequencing technology, allowing us to look at many genes at one time, helps us examine the interactions between genes, called epistasis. We are now entering the stage where we can look at 20,000 or 30, 000 genes at a time. The question that now arises is how to integrate all of this information, or data, to find a combination that tells us whether an individual is at increased risk and for what type of cancer.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: From the genetics angle, the trend of better prediction of who is at risk will emerge so we will be able to do better genetic profiles. The other advance is the genetic profiling of the tumors themselves. Scientifically, for many years now, we know that breast cancer is not one disease but many diseases. At the molecular level, when you compare individual tumors and the genes are expressed in them, we can put them in subgroups or subtypes. We already know that tumors are different in their biological behaviors and responses to treatment; this subtyping will become very sophisticated in the near future. This is also a component of what is called "personalized medicine." When you look at cancer, it has two prongs - one is your own genetic background or make-up and the other is that of the tumor, and the interaction between these two, which extends to response to treatment. The hope is that if you understand so much more about the genetic biology of the tumor, you'll have many more specific drugs that will combat it.

Q: What other projects are you currently working on?

A: Most of my other work is not related to cancer but does come out of the collaboration with Dr. Kanaan. In the Middle East, pediatric hereditary diseases are prevalent because of consanguinity and because families tend to be large. We are very interested in finding the genetic basis of diseases such as microcephaly, mental retardation, and endocrine disorders, with our topmost goal being prevention. Building on the work started with BCRF, we just received a large grant from Middle East Regional Cooperation (MERC) Program through USAID to do this research.

Q: How close are we to preventing and curing all forms of breast cancer?

A: I think we're closer than we think. In terms of prevention, genetics holds huge promise in this regard. I can envision a not too distant future where we can understand most of the genetic predispositions to cancer. Even though I am a geneticist, I know that not everything is genetic. So there will be other risk factors, but understanding what's genetic will allow you to weed out what is genetic and what is not. Even now when you look at treatment of breast cancer, there has been tremendous progress. I think it will happen at a much faster pace again because we'll understand more of the biology. I think it's a combination of prevention, early detection, and treatment. All of that comes together.

Q: In your opinion, how has BCRF impacted breast cancer research?

A:I don't think I could have done breast cancer research without BCRF. I work in a part of the world where the funding for research does not come close to what's available in the US or Europe. Technically, all of the work that we've done would have been impossible without BCRF. BCRF has been the difference between being able to do research and not being able to do it.

Also, BCRF gives researchers the freedom to think about what they'd really like to do, try out new ideas. When we started our study on healthy people and checking them for BRCA1 and BRCA2, I would say that many of my colleagues thought we were "really pushing the envelope."

Finally, as a person, I think medicine and science are areas where the "human good" and the common goals are so obvious that it becomes easier to overcome some of the obstacles often associated with political conflict, like the Israeli/Palestinian situation. Our projects funded by BCRF give people the opportunity to work and spend time together whereas otherwise they never would have had the chance. For example, BCRF supports a Palestinian PhD student, who works both in Bethlehem University and at Shaare Zedek. We have common goals, and this collaboration transcends borders that are not often crossed. We are very proud of sustaining this joint effort and are thankful to BCRF for inspiring it. That has had a big impact.

Read more about Dr. Levy-Lahad's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Ephrat Levy-Lahad to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I am a medical geneticist. My interest in breast cancer started fortuitously. I began my career as an internist with primary interest in adult diseases like Alzheimer's. At the time (the early 1990s), geneticists were mostly pediatricians. The idea that adult disease could also be related to genetics was new. Coincidentally, when I was doing a Medical Genetics fellowship at the University of Washington in Seattle, Mary-Claire King, PhD, the discoverer of BRCA1 (breast cancer susceptibility gene 1), just moved from University of California, Berkeley, to University of Washington. So I met with her, and we really hit it off.

After my training, I returned to Israel to set up a cancer genetics clinic, one of world's first, at Shaare Zedek Medical Center. There are genetic issues particularly relevant to Jewish women. For instance, mutations in the BRCA genes, which indicate predisposition to both breast and ovarian cancers, are found in a higher proportion of Ashkenazi Jewish women than any other group. Through the clinic, many basic science questions emerged. For example, why do women with genetic mutations get cancer? Also, when you look at women with the same genetic mutation, why do some get breast cancer in their 20s, while others in their 60s? Why do some develop ovarian cancer, while others will never get any cancer at all?

My colleagues and I also started thinking about prevention. We began to screen women systematically to identify ones at elevated risk so we could intervene clinically to prevent the development of cancer. Combining clinical practice with basic research has been very important. When I started my career, I did not think I would be doing much research but I really love it!

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: I currently participate in two BCRF-funded projects, one of which is a collaboration with fellow grantees Mary-Claire King, PhD (University of Washington) and Moien Kanaan, PhD (Bethlehem University). My main focus is using what is known about breast cancer genetics to improve prevention strategies.

In our Israel Breast Cancer Study, we evaluate BRCA1 and BRCA2 mutations in the Ashkenazi Jewish population of Israel. We tested over 8,000 healthy men and among them found 175 who were carriers of mutations. These men were the key to their families, because through them we could observe the cancer risk in their female relatives. We found that even when we identify a BRCA1 or BRCA2 family through a healthy male, women in the family who are carriers are still at elevated risk for breast and ovarian cancers compared to women without the mutation. We aim for how best to identify mutation carriers at the earliest point possible when prevention interventions are most effective. The patients we encounter in the clinic "inspired" this project. A normal 32 year-old woman would not think of herself as being at risk for breast cancer. But if you are a BRCA carrier, then your risk increases, and monitoring can mean a world of difference.

Our second project is a collaboration with Drs. Kanaan and King looking at breast cancer genetics in the Arab population. This project has two components. One is providing genetics services for the Palestinian population. Also, the Arab-Israeli population has not been studied extensively at all, so we are looking for new breast cancer genes.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: Newly developed gene sequencing technology, allowing us to look at many genes at one time, helps us examine the interactions between genes, called epistasis. We are now entering the stage where we can look at 20,000 or 30, 000 genes at a time. The question that now arises is how to integrate all of this information, or data, to find a combination that tells us whether an individual is at increased risk and for what type of cancer.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: From the genetics angle, the trend of better prediction of who is at risk will emerge so we will be able to do better genetic profiles. The other advance is the genetic profiling of the tumors themselves. Scientifically, for many years now, we know that breast cancer is not one disease but many diseases. At the molecular level, when you compare individual tumors and the genes are expressed in them, we can put them in subgroups or subtypes. We already know that tumors are different in their biological behaviors and responses to treatment; this subtyping will become very sophisticated in the near future. This is also a component of what is called "personalized medicine." When you look at cancer, it has two prongs - one is your own genetic background or make-up and the other is that of the tumor, and the interaction between these two, which extends to response to treatment. The hope is that if you understand so much more about the genetic biology of the tumor, you'll have many more specific drugs that will combat it.

Q: What other projects are you currently working on?

A: Most of my other work is not related to cancer but does come out of the collaboration with Dr. Kanaan. In the Middle East, pediatric hereditary diseases are prevalent because of consanguinity and because families tend to be large. We are very interested in finding the genetic basis of diseases such as microcephaly, mental retardation, and endocrine disorders, with our topmost goal being prevention. Building on the work started with BCRF, we just received a large grant from Middle East Regional Cooperation (MERC) Program through USAID to do this research.

Q: How close are we to preventing and curing all forms of breast cancer?

A: I think we're closer than we think. In terms of prevention, genetics holds huge promise in this regard. I can envision a not too distant future where we can understand most of the genetic predispositions to cancer. Even though I am a geneticist, I know that not everything is genetic. So there will be other risk factors, but understanding what's genetic will allow you to weed out what is genetic and what is not. Even now when you look at treatment of breast cancer, there has been tremendous progress. I think it will happen at a much faster pace again because we'll understand more of the biology. I think it's a combination of prevention, early detection, and treatment. All of that comes together.

Q: In your opinion, how has BCRF impacted breast cancer research?

A:I don't think I could have done breast cancer research without BCRF. I work in a part of the world where the funding for research does not come close to what's available in the US or Europe. Technically, all of the work that we've done would have been impossible without BCRF. BCRF has been the difference between being able to do research and not being able to do it.

Also, BCRF gives researchers the freedom to think about what they'd really like to do, try out new ideas. When we started our study on healthy people and checking them for BRCA1 and BRCA2, I would say that many of my colleagues thought we were "really pushing the envelope."

Finally, as a person, I think medicine and science are areas where the "human good" and the common goals are so obvious that it becomes easier to overcome some of the obstacles often associated with political conflict, like the Israeli/Palestinian situation. Our projects funded by BCRF give people the opportunity to work and spend time together whereas otherwise they never would have had the chance. For example, BCRF supports a Palestinian PhD student, who works both in Bethlehem University and at Shaare Zedek. We have common goals, and this collaboration transcends borders that are not often crossed. We are very proud of sustaining this joint effort and are thankful to BCRF for inspiring it. That has had a big impact.

Read more about Dr. Levy-Lahad's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Ephrat Levy-Lahad to discuss her current work and interest in breast cancer research. Read on to learn more. 

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Richard R. Love to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Richard R. Love to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in global breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Richard R. Love to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in global breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Richard R. Love to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in global breast cancer research.

A: We're all a product of our pasts. When I was a teenager, my family moved around internationally as my father's career grew. Because of this experience, I saw parts of the world that most do not. The poverty in places like India deeply moved me from the age of 15, when I visited Calcutta. As a college student, I returned to the US. This was the 1960s, during the war in Vietnam. Being a student during that war left strong conflicts in me. I continued on to medical school and cancer medicine. Years later, in 1991, The International Union Against Cancer, an organization that I had joined and worked with for more than a decade, became interested in initiating a project in Vietnam. I joined this effort. It was in some ways an opportunity to get the monkey off my back in terms of my considerably mixed feelings about the war, and try to do something positive.

At first in Vietnam it seemed that the challenges were educational, working with local doctors, nurses and cancer patients alike. But soon I came to the realization that we also needed to develop clinical research. With increased awareness of the disease comes the need for treatments that are affordable and effective. My first affiliation with an international cancer clinical trial was in Vietnam. That's what got me on the way to being involved in global clinical research.

Q: Did you ever consider another kind of career than that of the medical science?

A: No. I love what I do at all kinds of levels. It's difficult, but also very rewarding. For example, I spend about 20 percent of my time in Bangladesh. When I'm there, at least once a day, I find myself thinking, "Oh, dear, they didn't teach me how to do this in school." I'm confronted with the reality that in order to achieve results, namely, helping women with breast cancer in a population-dense but largely poor place, I've got to be more eclectic in my thinking and problem-solving. I can't fall in to what William Easterly described in his book "White man's burden," or overlooking real possibilities for improvement because of excessive and often unhelpful planning.

In Bangladesh and other developing countries, the chronic disease transition is becoming more of a problem. With improved water, immunizations and nutrition, people are living longer. They reach the age when increasing malignancies occur. There's also more obesity, diabetes and heart disease, which complicates if not contributes to breast cancers. With Mohammad Yunus, the Bangledeshi Nobel Peace Prize laureate, I've been developing a population-based approach to breast cancer. The program involves educational, service and research projects in partnership with a non-governmental agency in a rural area called Khulna, where 7 million women live. Yunus' methods create sustainable social businesses, and we are working with him as part of the larger effort to create better health care systems in the country. I think we can be a good model for developing standards and practices that can go country-wide. If we can figure out how to do this in Bangladesh, with such population density and other challenges, then I think we can apply that knowledge in other, similar populations. I've learned that there are all kinds of ways of making things worse. I'm focused on making things better.

Q: You've mentioned your efforts in Bangladesh, Vietnam. You also have projects in The Philippines, China, Indonesia, Malaysia. Why so much focus on Asia?

A: Because that's where the greatest burden of breast cancer cases is. The number of new cases of breast cancer that occur globally per year is now estimated at 1.5 million. Over half of this total, or 800,000 cases, occurs in women in Asia, mostly in poor women.

Q: You are a public advocate as well as a clinician-researcher who describes global breast cancer research and clinical trials as a "win-win." What do you mean by this?

A: The prevalence of breast cancer in Asia is an opportunity to do some good in those countries and to understand breast cancer in ways we can't in the United States. The genetics of Asian women are different than those of Caucasian women and women of other ethnicities. That and factors like poverty, how it affects a women's health through her nutritional status, for example, reveal how known treatments work in different ways. There are many Asian women living in the United States and they also get breast cancer. We can bring new insights to their treatment here through the analysis of genetics in the Asian women we treat and study globally. In the United States, it costs approximately $5000 per patient to conduct a clinical trial. Our studies in Bangladesh, The Philippines and Vietnam cost about 18 percent of what I would need to run a study here. That even includes the lab technicians and researchers we employ here in Indiana and Ohio who handle our hundreds of flash frozen tumor samples for analysis!

Q: You have studied hormonal therapies-especially tamoxifen-in global populations. What have you learned?

A: Tamoxifen is the most widely used hormonal therapy in breast cancer. But it must be metabolized in certain way in order to be effective. In the body, this drug becomes endoxifen and that is what provides the therapeutic effect. There is increasing data that suggest that small differences in a gene called CYP2D6 determine whether a woman can metabolize tamoxifen properly. In Western populations of women of Europe and North America, we think that about six percent of women do not metabolize tamoxifen because of this genetic difference. We've been studying these genetic differences in Asian women for several years. We see CYP2D6 polymorphisms (different forms of the gene), responsible for the reduced metabolizing capacity, in 40-50 percent of women there. That's very significant and suggests that tamoxifen may be ineffective in that percentage of our Asian patients. Our studies in Vietnam and in the Philippines are now looking at blood levels of endoxifen for every single patient. This level of endoxifen in the blood after giving tamoxifen seems to be the real issue of importance.

Q: Another hypothesis you are testing in an international study is the timing of oophorectomy, or surgical removal of ovaries, as a treatment for metastatic, hormone-receptor positive breast cancer. What is the status of this investigation?

A: Breast cancer has been a neglected disease in many of the countries where I work. That is starting to change, but the reality is that the breast cancers we see in Asia are more advanced, and often metastatic. We're always trying to figure out practical, low cost, non-toxic and easily replicable treatments. They're the best kind of "public health oncology," and offer poor women in poor countries a better chance of surviving. Based on a lot of initial data, we've now got two studies running in seven Asian and two African countries. We think we can extend survival by about a year for advanced, metastatic breast cancer if we time the removal of ovaries to the second half of the menstrual cycle.

We've already seen very positive remissions of locally advanced disease in the patients involved in our study. The likely reason for this is because levels of progesterone drop off at this late stage of the menstrual cycle. Progesterone is thought to control certain proteins that are angiogenic. Cancers rely on these proteins to build a blood supply and fuel tumor growth. When progesterone is high, cancers do better. Removing ovaries at a time when progesterone has dropped off may create a more difficult environment for a hormone receptor positive breast cancer. This is the first time there's been a major pre-menopausal study in this subgroup of patients. We'll have our goal of 350 women in the study in 2011 or 12. If this timing issue is a real factor that will improve outcomes, these women with little hope will certainly benefit. And we can take this kind of knowledge back to our own context in the United States and put it to very good use as well.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: It's an exciting time. Targeted therapy is not only about the tumor. The data on host biology is going to prove equally important. We're learning more and more about in whom breast cancer occurs, which will guide us to select better controls. If we're right in our hypothesis about the optimal time to remove ovaries, it helps us understand better how signaling control works in breast cancer. We can begin putting that kind of information in a bottle, in a way that's important to non-hormone receptor positive breast cancers, too. By thinking about more than the tumor in the conventional sense, we are going to develop some clever and simple ways of dealing with cancer.

Q: How has BCRF been helpful to you?

A: It has given me the freedom to focus on the kinds of questions that will truly personalize the nature of existing treatments, and within short periods of time. For example, you'd like to give a woman the drug that works best and that is associated with the minimum of side effects for her breast cancer. Yet here in the United States, it is hard to determine those who will and those who won't do well on a certain drug with a specific cancer. Why? Because once we know it works, we start using a new drug in every woman who might be helped by it. It then takes decades of prospective studies to figure out who isn't helped by it. I'll be retired by the time we have those results.

Look at tamoxifen in Asia. It's just coming into widespread availability and use. We can test a woman's endoxifen levels in Asia because there's overwhelming genetic evidence that it is a useful thing to check. We can ethically decide not to use tamoxifen if endoxifen levels are not high enough. If we're right about it correlating to a woman's response rate, then we'll have proof that taking a blood sample that measures a woman's endoxifen levels would improve decisions about treatment. In the Philippines, we'll know the answer to this question within three years.

Q: What are the biggest challenges in cancer research today?

A: Not letting cancer, a significantly complex illness, stand in the way of simple solutions that we can bring to bear on the situation and improve outcomes. I've seen what other global health practitioners have done with improving outcomes with communicable diseases, like diarrheal disease among children. They work with local populations to circulate valuable information and creatively apply solutions. Watching others make progress with seemingly impossible problems encourage me. Cancers are significantly complicated, but we can do better.

Q: What advice would you give to young researchers?

A: Think creatively in terms of the whole world. You'll be surprised at what it returns to you where you live. I just took a young Canadian researcher to Bangladesh, and introduced her to a genetic study there. Now, I receive an average of five or six e-mails a day from her about next steps on this project. She's absolutely taken by this study. She recognizes opportunities to answer questions in Bangladesh that she can't answer in Canada, or that we can't answer in North America in general. Five or ten years ago people didn't think about global cancer research as much. Was it arrogance? I think it was more a lack of realization of what tremendous opportunities are out there. We're realizing that particularly through partnerships with people, we can move the whole breast cancer agenda forward. Our new Administration is calling it "medical diplomacy," but the reality is that the whole world has to be part of the solution, whether it is ending wars or ending cancer.

Read more about Dr. Love's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Richard R. Love to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in global breast cancer research.

A: We're all a product of our pasts. When I was a teenager, my family moved around internationally as my father's career grew. Because of this experience, I saw parts of the world that most do not. The poverty in places like India deeply moved me from the age of 15, when I visited Calcutta. As a college student, I returned to the US. This was the 1960s, during the war in Vietnam. Being a student during that war left strong conflicts in me. I continued on to medical school and cancer medicine. Years later, in 1991, The International Union Against Cancer, an organization that I had joined and worked with for more than a decade, became interested in initiating a project in Vietnam. I joined this effort. It was in some ways an opportunity to get the monkey off my back in terms of my considerably mixed feelings about the war, and try to do something positive.

At first in Vietnam it seemed that the challenges were educational, working with local doctors, nurses and cancer patients alike. But soon I came to the realization that we also needed to develop clinical research. With increased awareness of the disease comes the need for treatments that are affordable and effective. My first affiliation with an international cancer clinical trial was in Vietnam. That's what got me on the way to being involved in global clinical research.

Q: Did you ever consider another kind of career than that of the medical science?

A: No. I love what I do at all kinds of levels. It's difficult, but also very rewarding. For example, I spend about 20 percent of my time in Bangladesh. When I'm there, at least once a day, I find myself thinking, "Oh, dear, they didn't teach me how to do this in school." I'm confronted with the reality that in order to achieve results, namely, helping women with breast cancer in a population-dense but largely poor place, I've got to be more eclectic in my thinking and problem-solving. I can't fall in to what William Easterly described in his book "White man's burden," or overlooking real possibilities for improvement because of excessive and often unhelpful planning.

In Bangladesh and other developing countries, the chronic disease transition is becoming more of a problem. With improved water, immunizations and nutrition, people are living longer. They reach the age when increasing malignancies occur. There's also more obesity, diabetes and heart disease, which complicates if not contributes to breast cancers. With Mohammad Yunus, the Bangledeshi Nobel Peace Prize laureate, I've been developing a population-based approach to breast cancer. The program involves educational, service and research projects in partnership with a non-governmental agency in a rural area called Khulna, where 7 million women live. Yunus' methods create sustainable social businesses, and we are working with him as part of the larger effort to create better health care systems in the country. I think we can be a good model for developing standards and practices that can go country-wide. If we can figure out how to do this in Bangladesh, with such population density and other challenges, then I think we can apply that knowledge in other, similar populations. I've learned that there are all kinds of ways of making things worse. I'm focused on making things better.

Q: You've mentioned your efforts in Bangladesh, Vietnam. You also have projects in The Philippines, China, Indonesia, Malaysia. Why so much focus on Asia?

A: Because that's where the greatest burden of breast cancer cases is. The number of new cases of breast cancer that occur globally per year is now estimated at 1.5 million. Over half of this total, or 800,000 cases, occurs in women in Asia, mostly in poor women.

Q: You are a public advocate as well as a clinician-researcher who describes global breast cancer research and clinical trials as a "win-win." What do you mean by this?

A: The prevalence of breast cancer in Asia is an opportunity to do some good in those countries and to understand breast cancer in ways we can't in the United States. The genetics of Asian women are different than those of Caucasian women and women of other ethnicities. That and factors like poverty, how it affects a women's health through her nutritional status, for example, reveal how known treatments work in different ways. There are many Asian women living in the United States and they also get breast cancer. We can bring new insights to their treatment here through the analysis of genetics in the Asian women we treat and study globally. In the United States, it costs approximately $5000 per patient to conduct a clinical trial. Our studies in Bangladesh, The Philippines and Vietnam cost about 18 percent of what I would need to run a study here. That even includes the lab technicians and researchers we employ here in Indiana and Ohio who handle our hundreds of flash frozen tumor samples for analysis!

Q: You have studied hormonal therapies-especially tamoxifen-in global populations. What have you learned?

A: Tamoxifen is the most widely used hormonal therapy in breast cancer. But it must be metabolized in certain way in order to be effective. In the body, this drug becomes endoxifen and that is what provides the therapeutic effect. There is increasing data that suggest that small differences in a gene called CYP2D6 determine whether a woman can metabolize tamoxifen properly. In Western populations of women of Europe and North America, we think that about six percent of women do not metabolize tamoxifen because of this genetic difference. We've been studying these genetic differences in Asian women for several years. We see CYP2D6 polymorphisms (different forms of the gene), responsible for the reduced metabolizing capacity, in 40-50 percent of women there. That's very significant and suggests that tamoxifen may be ineffective in that percentage of our Asian patients. Our studies in Vietnam and in the Philippines are now looking at blood levels of endoxifen for every single patient. This level of endoxifen in the blood after giving tamoxifen seems to be the real issue of importance.

Q: Another hypothesis you are testing in an international study is the timing of oophorectomy, or surgical removal of ovaries, as a treatment for metastatic, hormone-receptor positive breast cancer. What is the status of this investigation?

A: Breast cancer has been a neglected disease in many of the countries where I work. That is starting to change, but the reality is that the breast cancers we see in Asia are more advanced, and often metastatic. We're always trying to figure out practical, low cost, non-toxic and easily replicable treatments. They're the best kind of "public health oncology," and offer poor women in poor countries a better chance of surviving. Based on a lot of initial data, we've now got two studies running in seven Asian and two African countries. We think we can extend survival by about a year for advanced, metastatic breast cancer if we time the removal of ovaries to the second half of the menstrual cycle.

We've already seen very positive remissions of locally advanced disease in the patients involved in our study. The likely reason for this is because levels of progesterone drop off at this late stage of the menstrual cycle. Progesterone is thought to control certain proteins that are angiogenic. Cancers rely on these proteins to build a blood supply and fuel tumor growth. When progesterone is high, cancers do better. Removing ovaries at a time when progesterone has dropped off may create a more difficult environment for a hormone receptor positive breast cancer. This is the first time there's been a major pre-menopausal study in this subgroup of patients. We'll have our goal of 350 women in the study in 2011 or 12. If this timing issue is a real factor that will improve outcomes, these women with little hope will certainly benefit. And we can take this kind of knowledge back to our own context in the United States and put it to very good use as well.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: It's an exciting time. Targeted therapy is not only about the tumor. The data on host biology is going to prove equally important. We're learning more and more about in whom breast cancer occurs, which will guide us to select better controls. If we're right in our hypothesis about the optimal time to remove ovaries, it helps us understand better how signaling control works in breast cancer. We can begin putting that kind of information in a bottle, in a way that's important to non-hormone receptor positive breast cancers, too. By thinking about more than the tumor in the conventional sense, we are going to develop some clever and simple ways of dealing with cancer.

Q: How has BCRF been helpful to you?

A: It has given me the freedom to focus on the kinds of questions that will truly personalize the nature of existing treatments, and within short periods of time. For example, you'd like to give a woman the drug that works best and that is associated with the minimum of side effects for her breast cancer. Yet here in the United States, it is hard to determine those who will and those who won't do well on a certain drug with a specific cancer. Why? Because once we know it works, we start using a new drug in every woman who might be helped by it. It then takes decades of prospective studies to figure out who isn't helped by it. I'll be retired by the time we have those results.

Look at tamoxifen in Asia. It's just coming into widespread availability and use. We can test a woman's endoxifen levels in Asia because there's overwhelming genetic evidence that it is a useful thing to check. We can ethically decide not to use tamoxifen if endoxifen levels are not high enough. If we're right about it correlating to a woman's response rate, then we'll have proof that taking a blood sample that measures a woman's endoxifen levels would improve decisions about treatment. In the Philippines, we'll know the answer to this question within three years.

Q: What are the biggest challenges in cancer research today?

A: Not letting cancer, a significantly complex illness, stand in the way of simple solutions that we can bring to bear on the situation and improve outcomes. I've seen what other global health practitioners have done with improving outcomes with communicable diseases, like diarrheal disease among children. They work with local populations to circulate valuable information and creatively apply solutions. Watching others make progress with seemingly impossible problems encourage me. Cancers are significantly complicated, but we can do better.

Q: What advice would you give to young researchers?

A: Think creatively in terms of the whole world. You'll be surprised at what it returns to you where you live. I just took a young Canadian researcher to Bangladesh, and introduced her to a genetic study there. Now, I receive an average of five or six e-mails a day from her about next steps on this project. She's absolutely taken by this study. She recognizes opportunities to answer questions in Bangladesh that she can't answer in Canada, or that we can't answer in North America in general. Five or ten years ago people didn't think about global cancer research as much. Was it arrogance? I think it was more a lack of realization of what tremendous opportunities are out there. We're realizing that particularly through partnerships with people, we can move the whole breast cancer agenda forward. Our new Administration is calling it "medical diplomacy," but the reality is that the whole world has to be part of the solution, whether it is ending wars or ending cancer.

Read more about Dr. Love's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Richard R. Love to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Sofia Merajver to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Sofia Merajver to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Sofia Merajver to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Sofia Merajver to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: I decided to be a scientist at the age of 5. I had asked my mother what I should be when I grow up and she told me to become a researcher. Mom was very wise in general, so I basically planned my whole life around becoming a scientist. Since a very early age, science has been my craft. Discovery is what I do.

My involvement in breast cancer is a bit of an accident. At the University of Michigan, I was completing my medical training and Dr. Barbara Weber [coincidentally a BCRF grantee for several years] was taking over as head of the breast cancer program. She called me while I was in the middle of a surgical procedure and asked me to come work with her as the junior clinician on the breast cancer unit. That's how it started; it was a good opportunity and I fell in love with every aspect of it, from the humanistic and therapeutic, to the scientific and global public health aspects. I'm very privileged to work with patients as well as pursue meaningful research.

Q: Did you ever seriously consider another kind of career than that of the sciences? If so, what?

A: Well, I've had more than one scientific career so far! Does that count? My beginnings were in physics. Again, this is attributable to my mother. I was raised in Argentina in a modest home with a vast library. When I asked my mother what kind of researcher I should become, she pulled the biography of Marie Curie off the shelf and gave it to me. From that time, I was convinced that physics would be useful for anything I would do in life. I grew up and got my Ph.D. in physics. I became head of a lab here in the United States and was very successful with grants and research. At a certain point, however, I realized that I wanted to work on scientific problems that would impact humanity in my lifetime. I had seen very clearly how the future of physics could be applied in medicine, but quantitative methods were only rarely applied in biology then. I made a radical decision to get another set of scientific credentials. I spent the next 12 years getting my medical training and specialization. It was worth it.

Q: You are known for your ongoing research on inflammatory breast cancer (IBC), both in the United States and in Africa and the Middle East. What have you and your colleagues learned about this hard-to-detect, aggressive disease?

A: The proportion of IBC relative to the total number of breast cancers is eight to ten times greater in some parts of the world, such as Egypt, for example, than it is for women in the United States. With the help of funding from BCRF, we are trying to understand the reasons that make it so much more abundant in these places. Are there inherited factors among certain ethnic populations? Is it environmental? Studying IBC now in Tunisia, Egypt, Algeria, Morocco, Tanzania, Uganda, Ghana and Zambia helps us to better understand it in American women. And just as important, having the means to study IBC in Africa and the Middle East gives us the ability to change the oftentimes meager infrastructure of treatment where women so desperately need improved care. Cancer is a painful disease to endure without treatment; in the past, I used to see too many women in Africa and the Middle East die of IBC with little to no medical intervention. We are committed to doing the work that improves outcomes in all the locations where we study the disease.

I will never forget my first trip to Egypt in 2004. My flight arrived at 2 a.m. and they took me straight to the clinic. To my complete surprise, there were 20 patients sitting on the floor drinking tea, waiting to be seen. They all had IBC, yet they were gracious and seemed happy. I was determined to help them in any way that I could. When the doctors in the clinic showed me the first slide of a very aggressive case, I realized that I had not been thinking about IBC correctly. The features of this Egyptian case sparked in my mind, for the first time, the concept that large clusters of cancer cells in the vessels of the skin (which are celled emboli) are the ones spreading to distant organs as well; they are the very culprits of why IBC moves about the body not in individual cells the way most tumors do, but in loosely bound clusters. I couldn't wait to call my lab and tell them what to work on next, while I was in Egypt.

Q: How has this discovery shaped your research goals with IBC?

A: We very quickly zeroed in on the Rho genes, genes that in 1999 were determined to be responsible for motility, or movement of cells, both normal and abnormal. Rho genes are very important in embryonic development, but afterward, they are largely turned down, probably because in our adult life tissues don't move around so much. For IBC, it will be enormously helpful to have a system of drugs that suppresses this motion. Right now, we have reached the point where we have three compounds as promising candidates. Within two to three years, if all goes well, they should be in clinical trials. We know that in several tumor types, if a lesion has hyperactive Rho genes, they are more likely to have a poorer prognosis. If we are successful with our compounds, it may lead to new interventions not only for IBC and other breast cancers, but also with pancreatic cancer and melanoma, both of which have high motility.

Q: You recently persuaded the journal Cancer Research, where you are an editorial advisor, to add a new section focused on mathematical modeling. What is mathematical modeling and why is it important in breast cancer research?

A: Amazingly, the best tools we have to study the intricate vicissitudes of biological phenomena require mathematics. Beyond accumulating a series of descriptions of phenomena, powerful as they may be, mathematics permits us to explore the patterns and principles underlying a biological phenomenon and to make predictions. We need to make these prediction tools available to clinicians and the tools themselves more widely available to cancer researchers. To succeed in this goal, we must publish understandable articles about mathematics in the journals that cancer researchers and doctors read.

With my research, for example, I realized that we must study, in real time, the dynamics of the IBC clusters. What I wanted to know about them is how they communicate, or signal, both internally and to the cells lining vessels. Learning this teaches us how to intervene and prevent the aggressive changes these cells are capable of. Based on modeling intracellular signaling pathways, we have learned something remarkable. Not only does a chemical signal move forward and backward along a pathway; in addition, when there is crosstalk among neighboring pathways, the signal crosses over the gap and transmits bidirectionally as well in the neighboring pathway. This often means, for example, that if one pathway fails or is inhibited, another pathway can pick up speed or efficiency and the biological results are the same. If you are trying to suppress certain signaling pathways, like those telling cells to move in clusters, it is vitally important to know how the pathways that direct motion are interconnected. It dictates a change in strategy!

Q: How can laypeople better understand the significance of mathematical modeling for breast cancer outcomes?

A: Easy. If we have the ability to map the real-time activity of cancer cells taken from a patient, and aided by accurate mathematical models, we can make better decisions about a patient's treatment. Based on real time testing of a patient's live cells, you may decide to give drugs in a particular sequence in time based on a combination of actual observations and modeling: for example, while you know you can inhibit the protein causing a problem, if by a few hours later you've seen that another protein will take its place, then a different drug would be needed at that point. We have discovered that quite often crosstalk allows pathways to compensate for one another. The cells obtained from a standard breast tumor biopsy are dead, so they cannot tell us these things.

Herein lies, in my opinion, the future of personalized medicine-dynamic analyses, taking into account the major complexities of a patient's cancer. We've come very far already with targeted therapies, but we're going to go much further. Right now we have the precursor technology to look at a patient's living cancer cell that works in a few laboratories, but we need to bring this technology to the clinic, in real time, from bench top to desktop. I have seen so-called insurmountable problems in my life in physics and in medicine yield to creativity and resources: building this technology, by combining time-resolved measurements in living cells with mathematical modeling is not insurmountable!

Q: How close do you think we are to preventing or finding a cure for breast cancers?

A: An absolute cure and prevention of cancer - true eradication - is still in the future. But we are very close to turning most breast cancer into a chronic illness that affects only lightly our quality and length of life. We will do this in two ways: first, by preventing metastasis. We are close to limiting the opportunities for metastasis with breast cancer. This control will be what turns breast cancer into a more manageable, long term illness rather than a life-threatening disease; this is already occurring for many patients and we need to increase the numbers of survivors with metastatic cancer, who live well with cancer kept at bay. Second, we will become better at reducing incidence in general. We've learned so much about nutrition and lifestyle that contributes to cancer; we are on the verge better public education to greatly limit cancer occurrence. And we can and should be exporting this knowledge around the globe.

Q: How has BCRF been helpful to you?

A: The Breast Cancer Research Foundation has helped me be the kind of scientist I dreamed of being as a child. It allows me to consider all of my creative ideas in science as potential. In other words, I'm not forced to discard any potentially good ideas. I do not have to prove to BCRF that I already achieved the result in question before they fund my ideas. I can help people faster because of BCRF. This model of funding is the bridge between the safe approach to science versus the breakthrough approach to science. It allows me to mentor people and build teams. It's catalyzing. The annual meetings of BCRF grantees have often influenced what I do for the rest of the year. I learn from these colleagues and have opportunities to reach across disciplines for answers.

Q: What are the biggest challenges in cancer research today?

A: The biggest challenge in research today is how to build that bridge - the one that spans the safe approach to doing science, which is the way most funds are allocated, to the breakthrough approach to doing science, which is the way BCRF funds are allocated. We need to find ways to have more of our creativity as scientists take the lead throughout cancer research in general. The bridge has to span disciplines and teams of people and countries; the disease of cancer has no political boundaries, but cancer care and research do, and we must change that. BCRF is helping me and many others accomplish this.

Q: What advice would you give to young researchers?

A: I tell young people to dream big - to think about and find the answerable questions-and to build teams. It is unfortunate that we are discouraging a lot of young talent today based on how our funding in science works. Young people must not be afraid about not knowing enough mathematics, epidemiology, cell biology, clinical medicine. Have your colleagues teach you the languages you need to learn to formulate the exact question you want to answer. At the college level, pursue a broad education; take that extra math, statistics or physics course. Those are the tools of biology now.

Read more about Dr. Merajver's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Sofia Merajver to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: I decided to be a scientist at the age of 5. I had asked my mother what I should be when I grow up and she told me to become a researcher. Mom was very wise in general, so I basically planned my whole life around becoming a scientist. Since a very early age, science has been my craft. Discovery is what I do.

My involvement in breast cancer is a bit of an accident. At the University of Michigan, I was completing my medical training and Dr. Barbara Weber [coincidentally a BCRF grantee for several years] was taking over as head of the breast cancer program. She called me while I was in the middle of a surgical procedure and asked me to come work with her as the junior clinician on the breast cancer unit. That's how it started; it was a good opportunity and I fell in love with every aspect of it, from the humanistic and therapeutic, to the scientific and global public health aspects. I'm very privileged to work with patients as well as pursue meaningful research.

Q: Did you ever seriously consider another kind of career than that of the sciences? If so, what?

A: Well, I've had more than one scientific career so far! Does that count? My beginnings were in physics. Again, this is attributable to my mother. I was raised in Argentina in a modest home with a vast library. When I asked my mother what kind of researcher I should become, she pulled the biography of Marie Curie off the shelf and gave it to me. From that time, I was convinced that physics would be useful for anything I would do in life. I grew up and got my Ph.D. in physics. I became head of a lab here in the United States and was very successful with grants and research. At a certain point, however, I realized that I wanted to work on scientific problems that would impact humanity in my lifetime. I had seen very clearly how the future of physics could be applied in medicine, but quantitative methods were only rarely applied in biology then. I made a radical decision to get another set of scientific credentials. I spent the next 12 years getting my medical training and specialization. It was worth it.

Q: You are known for your ongoing research on inflammatory breast cancer (IBC), both in the United States and in Africa and the Middle East. What have you and your colleagues learned about this hard-to-detect, aggressive disease?

A: The proportion of IBC relative to the total number of breast cancers is eight to ten times greater in some parts of the world, such as Egypt, for example, than it is for women in the United States. With the help of funding from BCRF, we are trying to understand the reasons that make it so much more abundant in these places. Are there inherited factors among certain ethnic populations? Is it environmental? Studying IBC now in Tunisia, Egypt, Algeria, Morocco, Tanzania, Uganda, Ghana and Zambia helps us to better understand it in American women. And just as important, having the means to study IBC in Africa and the Middle East gives us the ability to change the oftentimes meager infrastructure of treatment where women so desperately need improved care. Cancer is a painful disease to endure without treatment; in the past, I used to see too many women in Africa and the Middle East die of IBC with little to no medical intervention. We are committed to doing the work that improves outcomes in all the locations where we study the disease.

I will never forget my first trip to Egypt in 2004. My flight arrived at 2 a.m. and they took me straight to the clinic. To my complete surprise, there were 20 patients sitting on the floor drinking tea, waiting to be seen. They all had IBC, yet they were gracious and seemed happy. I was determined to help them in any way that I could. When the doctors in the clinic showed me the first slide of a very aggressive case, I realized that I had not been thinking about IBC correctly. The features of this Egyptian case sparked in my mind, for the first time, the concept that large clusters of cancer cells in the vessels of the skin (which are celled emboli) are the ones spreading to distant organs as well; they are the very culprits of why IBC moves about the body not in individual cells the way most tumors do, but in loosely bound clusters. I couldn't wait to call my lab and tell them what to work on next, while I was in Egypt.

Q: How has this discovery shaped your research goals with IBC?

A: We very quickly zeroed in on the Rho genes, genes that in 1999 were determined to be responsible for motility, or movement of cells, both normal and abnormal. Rho genes are very important in embryonic development, but afterward, they are largely turned down, probably because in our adult life tissues don't move around so much. For IBC, it will be enormously helpful to have a system of drugs that suppresses this motion. Right now, we have reached the point where we have three compounds as promising candidates. Within two to three years, if all goes well, they should be in clinical trials. We know that in several tumor types, if a lesion has hyperactive Rho genes, they are more likely to have a poorer prognosis. If we are successful with our compounds, it may lead to new interventions not only for IBC and other breast cancers, but also with pancreatic cancer and melanoma, both of which have high motility.

Q: You recently persuaded the journal Cancer Research, where you are an editorial advisor, to add a new section focused on mathematical modeling. What is mathematical modeling and why is it important in breast cancer research?

A: Amazingly, the best tools we have to study the intricate vicissitudes of biological phenomena require mathematics. Beyond accumulating a series of descriptions of phenomena, powerful as they may be, mathematics permits us to explore the patterns and principles underlying a biological phenomenon and to make predictions. We need to make these prediction tools available to clinicians and the tools themselves more widely available to cancer researchers. To succeed in this goal, we must publish understandable articles about mathematics in the journals that cancer researchers and doctors read.

With my research, for example, I realized that we must study, in real time, the dynamics of the IBC clusters. What I wanted to know about them is how they communicate, or signal, both internally and to the cells lining vessels. Learning this teaches us how to intervene and prevent the aggressive changes these cells are capable of. Based on modeling intracellular signaling pathways, we have learned something remarkable. Not only does a chemical signal move forward and backward along a pathway; in addition, when there is crosstalk among neighboring pathways, the signal crosses over the gap and transmits bidirectionally as well in the neighboring pathway. This often means, for example, that if one pathway fails or is inhibited, another pathway can pick up speed or efficiency and the biological results are the same. If you are trying to suppress certain signaling pathways, like those telling cells to move in clusters, it is vitally important to know how the pathways that direct motion are interconnected. It dictates a change in strategy!

Q: How can laypeople better understand the significance of mathematical modeling for breast cancer outcomes?

A: Easy. If we have the ability to map the real-time activity of cancer cells taken from a patient, and aided by accurate mathematical models, we can make better decisions about a patient's treatment. Based on real time testing of a patient's live cells, you may decide to give drugs in a particular sequence in time based on a combination of actual observations and modeling: for example, while you know you can inhibit the protein causing a problem, if by a few hours later you've seen that another protein will take its place, then a different drug would be needed at that point. We have discovered that quite often crosstalk allows pathways to compensate for one another. The cells obtained from a standard breast tumor biopsy are dead, so they cannot tell us these things.

Herein lies, in my opinion, the future of personalized medicine-dynamic analyses, taking into account the major complexities of a patient's cancer. We've come very far already with targeted therapies, but we're going to go much further. Right now we have the precursor technology to look at a patient's living cancer cell that works in a few laboratories, but we need to bring this technology to the clinic, in real time, from bench top to desktop. I have seen so-called insurmountable problems in my life in physics and in medicine yield to creativity and resources: building this technology, by combining time-resolved measurements in living cells with mathematical modeling is not insurmountable!

Q: How close do you think we are to preventing or finding a cure for breast cancers?

A: An absolute cure and prevention of cancer - true eradication - is still in the future. But we are very close to turning most breast cancer into a chronic illness that affects only lightly our quality and length of life. We will do this in two ways: first, by preventing metastasis. We are close to limiting the opportunities for metastasis with breast cancer. This control will be what turns breast cancer into a more manageable, long term illness rather than a life-threatening disease; this is already occurring for many patients and we need to increase the numbers of survivors with metastatic cancer, who live well with cancer kept at bay. Second, we will become better at reducing incidence in general. We've learned so much about nutrition and lifestyle that contributes to cancer; we are on the verge better public education to greatly limit cancer occurrence. And we can and should be exporting this knowledge around the globe.

Q: How has BCRF been helpful to you?

A: The Breast Cancer Research Foundation has helped me be the kind of scientist I dreamed of being as a child. It allows me to consider all of my creative ideas in science as potential. In other words, I'm not forced to discard any potentially good ideas. I do not have to prove to BCRF that I already achieved the result in question before they fund my ideas. I can help people faster because of BCRF. This model of funding is the bridge between the safe approach to science versus the breakthrough approach to science. It allows me to mentor people and build teams. It's catalyzing. The annual meetings of BCRF grantees have often influenced what I do for the rest of the year. I learn from these colleagues and have opportunities to reach across disciplines for answers.

Q: What are the biggest challenges in cancer research today?

A: The biggest challenge in research today is how to build that bridge - the one that spans the safe approach to doing science, which is the way most funds are allocated, to the breakthrough approach to doing science, which is the way BCRF funds are allocated. We need to find ways to have more of our creativity as scientists take the lead throughout cancer research in general. The bridge has to span disciplines and teams of people and countries; the disease of cancer has no political boundaries, but cancer care and research do, and we must change that. BCRF is helping me and many others accomplish this.

Q: What advice would you give to young researchers?

A: I tell young people to dream big - to think about and find the answerable questions-and to build teams. It is unfortunate that we are discouraging a lot of young talent today based on how our funding in science works. Young people must not be afraid about not knowing enough mathematics, epidemiology, cell biology, clinical medicine. Have your colleagues teach you the languages you need to learn to formulate the exact question you want to answer. At the college level, pursue a broad education; take that extra math, statistics or physics course. Those are the tools of biology now.

Read more about Dr. Merajver's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Sofia Merajver to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Kathy D. Miller to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research. 
A: I first became interested in cancer as a second-year medical student. I was fascinated by the biology and power of cancer; imagine a single cell that escapes the normal control of growth and aging to become lethal. I spent that following summer doing basic cancer research. My laboratory mentor took me on rounds and to his clinic. In no time, I was hooked. I was struck by the impact of breast cancer on our patients (and their families) lives. A colleague likens this to the impact of the 9/11 attack; suddenly life changes and it seems like there is no safe place in the world. But I also saw that women are resilient and frequently emerge as stronger versions of their former selves. I discovered that I enjoyed taking care of the women with breast cancer, whether the news called for laughter or tears. And I was determined to focus my research on decreasing the need for tears.
Q: Briefly describe your research project. 
A: BCRF funding has allowed me to pursue several projects that might otherwise not have been possible.1) A monumental change is underway in how we think about and treat breast cancer. In the past we concentrated on anatomic features like the size and location of the tumor masses and the appearance of the cells under the microscope. Now biology and chemistry dominate our thinking because these are the reasons that cancers behave as they do. Anatomy is still important, but our first questions now focus on the 'character' or 'biology' of the tumor. Women have long understood that 'one size NEVER fits all.' That's true in breast cancer therapy as well. My first BCRF project collected blood and tumor samples to determine the gene and protein 'fingerprints.' We compared the fingerprints of patients who benefited from treatment to the fingerprints of those whose tumors were resistant. This work will allow us to individualize therapy for future patients.
2) My interest in angiogenesis has fostered ongoing productive collaborations with members of the Department of Imaging Science, Drs. Gary Hutchins and Qi-Huang Zheng. Our long-range goal is to develop noninvasive imaging techniques that will enhance knowledge of breast cancer biology and guide therapy with antiangiogenic agents. Imagine taking a small 'test dose' of therapy and using special x-rays to determine if your breast cancer will respond to that treatment. BCRF funds development of new imaging techniques and laboratory studies, as well as our first pilot clinical trial.
3) BCRF (through grants to the Eastern Cooperative Oncology Group) has funded studies on the blood, urine and tumor samples collected from patients enrolled in the E2100 trial that I led. E2100 was the first phase III trial to prove the benefit of antiangiogenic therapy in women with advanced breast cancer, reporting the largest improvement in progression free survival to date. The laboratory data that formed the basis for E2100 was partly funded by BCRF. Now we hope these correlative studies will help us predict which patients will benefit most from this treatment.
4) BCRF is currently funding a phase II trial based on laboratory data from Dr. Pat Steeg at NCI. Preliminary data suggest that an old drug, medroxyprogesterone acetate (MPA), inhibits two critical features of cancer - metastasis and angiogenesis - in estrogen (ER) and progesterone (PR) receptor negative breast cancers. The trial includes both clinical and biologic endpoints to maximize the information gained.
Q: What are your primary goals for this research? 
A: Advances in breast cancer treatment require new therapeutic strategies that are firmly rooted in an understanding of biology. As such, the major goal of my research is to evaluate innovative biologically based therapies in translational trials that yield both clinical and laboratory data. To put it more simply, my goal is to be a two-way bridge between the laboratory and clinic ï¿½ bringing basic advances to the clinic and trying to understand our clinical observations in the lab.
The Breast Program at Indiana University has focused on angiogenesis (the growth of new blood vessels into a tumor) and antiangiogenic therapy (how we can stop the growth of those blood vessels) for over a decade. This focus spans departmental boundaries and has taken several forms: laboratory evaluation of the anti-angiogenic activity of new and established drugs, imaging modalities that measure the tumor's blood vessels, clinical trials of anti-angiogenic agents, and studying how inherited differences in the genes that control blood vessel growth might influence the risk of developing breast cancer and likelihood of response to treatment.
Q: Who do you think will benefit from your research? 
A: I treat a large number of patients, many of whom have benefited personally by taking part in BCRF funded research. But good research reaches far beyond the walls of my clinic. Patients elsewhere, both now and in the future, benefit from the 'standard' therapies that were first studied thanks to BCRF.
Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field? 
A: The cornerstone of my research focus - facilitating an interplay between the laboratory and the clinic - has remained constant. As laboratory scientists may advances, our clinical trials follow (and occasionally lead). In some areas BCRF has allowed us to pursue small pilot studies and obtain data crucial to obtaining continued funding. In other projects, BCRF funding has allowed us to expand the knowledge gained from a larger project. For example, the E2100 trial was supported by NCI but we would have had no funding for the important blood and tissue studies without BCRF.
Q: How close do you think we are to preventing or finding a cure for breast cancer? 
A: We already have many cures for breast cancer; surgery (with or without radiation) cures many women. Hormonal therapy, chemotherapy, and now herceptin cure even more. BUT our current therapies don't work for everyone, and can have troubling (at times life-threatening) side effects. Research clearly tells us that breast cancer isn't one disease. We need to find more cures, with fewer side effects. Equally importantly, we need to match the right cure to the right patient to minimize the harm our therapies can cause. The pace of progress has never been quicker and is never quick enough. Read more about Dr. Miller's research projects funded by BCRF.
 
Read more about Dr. Miller's current research project funded by BCRF. 

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Kathy D. Miller to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Kathy D. Miller to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Kathy D. Miller to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I first became interested in cancer as a second-year medical student. I was fascinated by the biology and power of cancer; imagine a single cell that escapes the normal control of growth and aging to become lethal. I spent that following summer doing basic cancer research. My laboratory mentor took me on rounds and to his clinic. In no time, I was hooked. I was struck by the impact of breast cancer on our patients (and their families) lives. A colleague likens this to the impact of the 9/11 attack; suddenly life changes and it seems like there is no safe place in the world. But I also saw that women are resilient and frequently emerge as stronger versions of their former selves. I discovered that I enjoyed taking care of the women with breast cancer, whether the news called for laughter or tears. And I was determined to focus my research on decreasing the need for tears.

Q: Briefly describe your research project.

A: BCRF funding has allowed me to pursue several projects that might otherwise not have been possible.
1) A monumental change is underway in how we think about and treat breast cancer. In the past we concentrated on anatomic features like the size and location of the tumor masses and the appearance of the cells under the microscope. Now biology and chemistry dominate our thinking because these are the reasons that cancers behave as they do. Anatomy is still important, but our first questions now focus on the 'character' or 'biology' of the tumor. Women have long understood that 'one size NEVER fits all.' That's true in breast cancer therapy as well. My first BCRF project collected blood and tumor samples to determine the gene and protein 'fingerprints.' We compared the fingerprints of patients who benefited from treatment to the fingerprints of those whose tumors were resistant. This work will allow us to individualize therapy for future patients.

2) My interest in angiogenesis has fostered ongoing productive collaborations with members of the Department of Imaging Science, Drs. Gary Hutchins and Qi-Huang Zheng. Our long-range goal is to develop noninvasive imaging techniques that will enhance knowledge of breast cancer biology and guide therapy with antiangiogenic agents. Imagine taking a small 'test dose' of therapy and using special x-rays to determine if your breast cancer will respond to that treatment. BCRF funds development of new imaging techniques and laboratory studies, as well as our first pilot clinical trial.

3) BCRF (through grants to the Eastern Cooperative Oncology Group) has funded studies on the blood, urine and tumor samples collected from patients enrolled in the E2100 trial that I led. E2100 was the first phase III trial to prove the benefit of antiangiogenic therapy in women with advanced breast cancer, reporting the largest improvement in progression free survival to date. The laboratory data that formed the basis for E2100 was partly funded by BCRF. Now we hope these correlative studies will help us predict which patients will benefit most from this treatment.

4) BCRF is currently funding a phase II trial based on laboratory data from Dr. Pat Steeg at NCI. Preliminary data suggest that an old drug, medroxyprogesterone acetate (MPA), inhibits two critical features of cancer - metastasis and angiogenesis - in estrogen (ER) and progesterone (PR) receptor negative breast cancers. The trial includes both clinical and biologic endpoints to maximize the information gained.

Q: What are your primary goals for this research?

A: Advances in breast cancer treatment require new therapeutic strategies that are firmly rooted in an understanding of biology. As such, the major goal of my research is to evaluate innovative biologically based therapies in translational trials that yield both clinical and laboratory data. To put it more simply, my goal is to be a two-way bridge between the laboratory and clinic ï¿½ bringing basic advances to the clinic and trying to understand our clinical observations in the lab.

The Breast Program at Indiana University has focused on angiogenesis (the growth of new blood vessels into a tumor) and antiangiogenic therapy (how we can stop the growth of those blood vessels) for over a decade. This focus spans departmental boundaries and has taken several forms: laboratory evaluation of the anti-angiogenic activity of new and established drugs, imaging modalities that measure the tumor's blood vessels, clinical trials of anti-angiogenic agents, and studying how inherited differences in the genes that control blood vessel growth might influence the risk of developing breast cancer and likelihood of response to treatment.

Q: Who do you think will benefit from your research?

A: I treat a large number of patients, many of whom have benefited personally by taking part in BCRF funded research. But good research reaches far beyond the walls of my clinic. Patients elsewhere, both now and in the future, benefit from the 'standard' therapies that were first studied thanks to BCRF.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: The cornerstone of my research focus - facilitating an interplay between the laboratory and the clinic - has remained constant. As laboratory scientists may advances, our clinical trials follow (and occasionally lead). In some areas BCRF has allowed us to pursue small pilot studies and obtain data crucial to obtaining continued funding. In other projects, BCRF funding has allowed us to expand the knowledge gained from a larger project. For example, the E2100 trial was supported by NCI but we would have had no funding for the important blood and tissue studies without BCRF.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: We already have many cures for breast cancer; surgery (with or without radiation) cures many women. Hormonal therapy, chemotherapy, and now herceptin cure even more. BUT our current therapies don't work for everyone, and can have troubling (at times life-threatening) side effects. Research clearly tells us that breast cancer isn't one disease. We need to find more cures, with fewer side effects. Equally importantly, we need to match the right cure to the right patient to minimize the harm our therapies can cause. The pace of progress has never been quicker and is never quick enough. Read more about Dr. Miller's research projects funded by BCRF.

Read more about Dr. Miller's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Kathy D. Miller to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I first became interested in cancer as a second-year medical student. I was fascinated by the biology and power of cancer; imagine a single cell that escapes the normal control of growth and aging to become lethal. I spent that following summer doing basic cancer research. My laboratory mentor took me on rounds and to his clinic. In no time, I was hooked. I was struck by the impact of breast cancer on our patients (and their families) lives. A colleague likens this to the impact of the 9/11 attack; suddenly life changes and it seems like there is no safe place in the world. But I also saw that women are resilient and frequently emerge as stronger versions of their former selves. I discovered that I enjoyed taking care of the women with breast cancer, whether the news called for laughter or tears. And I was determined to focus my research on decreasing the need for tears.

Q: Briefly describe your research project.

A: BCRF funding has allowed me to pursue several projects that might otherwise not have been possible.
1) A monumental change is underway in how we think about and treat breast cancer. In the past we concentrated on anatomic features like the size and location of the tumor masses and the appearance of the cells under the microscope. Now biology and chemistry dominate our thinking because these are the reasons that cancers behave as they do. Anatomy is still important, but our first questions now focus on the 'character' or 'biology' of the tumor. Women have long understood that 'one size NEVER fits all.' That's true in breast cancer therapy as well. My first BCRF project collected blood and tumor samples to determine the gene and protein 'fingerprints.' We compared the fingerprints of patients who benefited from treatment to the fingerprints of those whose tumors were resistant. This work will allow us to individualize therapy for future patients.

2) My interest in angiogenesis has fostered ongoing productive collaborations with members of the Department of Imaging Science, Drs. Gary Hutchins and Qi-Huang Zheng. Our long-range goal is to develop noninvasive imaging techniques that will enhance knowledge of breast cancer biology and guide therapy with antiangiogenic agents. Imagine taking a small 'test dose' of therapy and using special x-rays to determine if your breast cancer will respond to that treatment. BCRF funds development of new imaging techniques and laboratory studies, as well as our first pilot clinical trial.

3) BCRF (through grants to the Eastern Cooperative Oncology Group) has funded studies on the blood, urine and tumor samples collected from patients enrolled in the E2100 trial that I led. E2100 was the first phase III trial to prove the benefit of antiangiogenic therapy in women with advanced breast cancer, reporting the largest improvement in progression free survival to date. The laboratory data that formed the basis for E2100 was partly funded by BCRF. Now we hope these correlative studies will help us predict which patients will benefit most from this treatment.

4) BCRF is currently funding a phase II trial based on laboratory data from Dr. Pat Steeg at NCI. Preliminary data suggest that an old drug, medroxyprogesterone acetate (MPA), inhibits two critical features of cancer - metastasis and angiogenesis - in estrogen (ER) and progesterone (PR) receptor negative breast cancers. The trial includes both clinical and biologic endpoints to maximize the information gained.

Q: What are your primary goals for this research?

A: Advances in breast cancer treatment require new therapeutic strategies that are firmly rooted in an understanding of biology. As such, the major goal of my research is to evaluate innovative biologically based therapies in translational trials that yield both clinical and laboratory data. To put it more simply, my goal is to be a two-way bridge between the laboratory and clinic ï¿½ bringing basic advances to the clinic and trying to understand our clinical observations in the lab.

The Breast Program at Indiana University has focused on angiogenesis (the growth of new blood vessels into a tumor) and antiangiogenic therapy (how we can stop the growth of those blood vessels) for over a decade. This focus spans departmental boundaries and has taken several forms: laboratory evaluation of the anti-angiogenic activity of new and established drugs, imaging modalities that measure the tumor's blood vessels, clinical trials of anti-angiogenic agents, and studying how inherited differences in the genes that control blood vessel growth might influence the risk of developing breast cancer and likelihood of response to treatment.

Q: Who do you think will benefit from your research?

A: I treat a large number of patients, many of whom have benefited personally by taking part in BCRF funded research. But good research reaches far beyond the walls of my clinic. Patients elsewhere, both now and in the future, benefit from the 'standard' therapies that were first studied thanks to BCRF.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: The cornerstone of my research focus - facilitating an interplay between the laboratory and the clinic - has remained constant. As laboratory scientists may advances, our clinical trials follow (and occasionally lead). In some areas BCRF has allowed us to pursue small pilot studies and obtain data crucial to obtaining continued funding. In other projects, BCRF funding has allowed us to expand the knowledge gained from a larger project. For example, the E2100 trial was supported by NCI but we would have had no funding for the important blood and tissue studies without BCRF.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: We already have many cures for breast cancer; surgery (with or without radiation) cures many women. Hormonal therapy, chemotherapy, and now herceptin cure even more. BUT our current therapies don't work for everyone, and can have troubling (at times life-threatening) side effects. Research clearly tells us that breast cancer isn't one disease. We need to find more cures, with fewer side effects. Equally importantly, we need to match the right cure to the right patient to minimize the harm our therapies can cause. The pace of progress has never been quicker and is never quick enough. Read more about Dr. Miller's research projects funded by BCRF.

Read more about Dr. Miller's current research project funded by BCRF.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Hyman B. Muss to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research. 
A: Several of my family have and have had breast cancer and the spectrum of illness and treatments always seemed a great challenge to me. From a research vantage there are opportunities to work in basic biology, prevention, diagnosis, treatment, and supportive care. It is a worldwide problem and what we learn from our research is often applicable to other cancers. Best, I love the patients-all types, all backgrounds-breast cancer is colorblind and has no respect for socioeconomic status-so it affects us all.
Q: Briefly describe your research project. 
A: We have been fortunate to have several funded projects. Initially we explored new tumor markers that could tell us which patients might most benefit from tamoxifen treatment. More recently we looked at the interaction of the "normal" appearing stromal tissue (the normal looking cells that are interspersed with the cancer cells) and the breast cancer cells. We found that these normal appearing cells had different gene patterns than other normal appearing cells in the breast that were not near the cancer. We are following up on this to look for targeted agents that might interfere with this stroma-cancer cell "crosstalk" that would provide novel ways to treat patients.
Right now our major project is related to angiogenesis-the development of blood vessels in the cancer that support its growth. In normal people as well as women with cancer a large percentage of the proteins that stimulate new blood vessel formation (vascular endothelial growth factors or ï¿½VEGFï¿½) are in the blood platelets-small cells in the blood that are essential for blood clotting. We have found that tamoxifen and aromatase inhibitors interact with platelets and affect the release of VEGF. We are currently planning to see if an anti-platelet agent can augment this VEGF release in a clinical trial in patients with early breast cancer. If this is the case then a larger trial will be planned to see if this improves outcome for women receiving hormonal therapy.
Q: What are your primary goals for this research? 
A: To look for new targets for better treatment. 
Q: Who do you think will benefit from your research? 
A: Patients with early breast cancer for the most part but if we can find agents affecting the stromal-breast cancer cell interaction we would plan trials in patients with metastatic disease.
Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field? 
A: The BCRF funds have allowed us to do studies in new and exciting areas. We have a superb cancer-coagulation group at the Vermont Cancer Center and are excited about the leads we have for the role of platelets, VEGF, and hormonal; therapy interactions in women with early breast cancer.
Q: How close do you think we are to preventing or finding a cure for breast cancer? 
A: We have learned that breast cancer is not a single disease-just as cancer is not a singular disease-we need to think about curing "cancers" and not cancer. We have decreased breast cancer mortality rates since the early 1990's by about 30%. This improvement is the result of better screening and newer adjuvant therapies. We have learned that it is unlikely that there will be a single "magic bullet" that will cure breast cancers and that success will be related to small but important incremental increases in treatment benefits. I would say we are getting close to finding cures (a plural) for some breast cancers but have a way to go with others. We are though making slow but sure progress on all fronts and I believe curing most patients is an attainable research goal in the next decade.
Read more about Dr. Muss' current research project funded by BCRF. 

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Hyman B. Muss to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Hyman B. Muss to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Hyman B. Muss to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: Several of my family have and have had breast cancer and the spectrum of illness and treatments always seemed a great challenge to me. From a research vantage there are opportunities to work in basic biology, prevention, diagnosis, treatment, and supportive care. It is a worldwide problem and what we learn from our research is often applicable to other cancers. Best, I love the patients-all types, all backgrounds-breast cancer is colorblind and has no respect for socioeconomic status-so it affects us all.

Q: Briefly describe your research project.

A: We have been fortunate to have several funded projects. Initially we explored new tumor markers that could tell us which patients might most benefit from tamoxifen treatment. More recently we looked at the interaction of the "normal" appearing stromal tissue (the normal looking cells that are interspersed with the cancer cells) and the breast cancer cells. We found that these normal appearing cells had different gene patterns than other normal appearing cells in the breast that were not near the cancer. We are following up on this to look for targeted agents that might interfere with this stroma-cancer cell "crosstalk" that would provide novel ways to treat patients.

Right now our major project is related to angiogenesis-the development of blood vessels in the cancer that support its growth. In normal people as well as women with cancer a large percentage of the proteins that stimulate new blood vessel formation (vascular endothelial growth factors or ï¿½VEGFï¿½) are in the blood platelets-small cells in the blood that are essential for blood clotting. We have found that tamoxifen and aromatase inhibitors interact with platelets and affect the release of VEGF. We are currently planning to see if an anti-platelet agent can augment this VEGF release in a clinical trial in patients with early breast cancer. If this is the case then a larger trial will be planned to see if this improves outcome for women receiving hormonal therapy.

Q: What are your primary goals for this research?

A: To look for new targets for better treatment.

Q: Who do you think will benefit from your research?

A: Patients with early breast cancer for the most part but if we can find agents affecting the stromal-breast cancer cell interaction we would plan trials in patients with metastatic disease.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: The BCRF funds have allowed us to do studies in new and exciting areas. We have a superb cancer-coagulation group at the Vermont Cancer Center and are excited about the leads we have for the role of platelets, VEGF, and hormonal; therapy interactions in women with early breast cancer.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: We have learned that breast cancer is not a single disease-just as cancer is not a singular disease-we need to think about curing "cancers" and not cancer. We have decreased breast cancer mortality rates since the early 1990's by about 30%. This improvement is the result of better screening and newer adjuvant therapies. We have learned that it is unlikely that there will be a single "magic bullet" that will cure breast cancers and that success will be related to small but important incremental increases in treatment benefits. I would say we are getting close to finding cures (a plural) for some breast cancers but have a way to go with others. We are though making slow but sure progress on all fronts and I believe curing most patients is an attainable research goal in the next decade.

Read more about Dr. Muss' current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Hyman B. Muss to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: Several of my family have and have had breast cancer and the spectrum of illness and treatments always seemed a great challenge to me. From a research vantage there are opportunities to work in basic biology, prevention, diagnosis, treatment, and supportive care. It is a worldwide problem and what we learn from our research is often applicable to other cancers. Best, I love the patients-all types, all backgrounds-breast cancer is colorblind and has no respect for socioeconomic status-so it affects us all.

Q: Briefly describe your research project.

A: We have been fortunate to have several funded projects. Initially we explored new tumor markers that could tell us which patients might most benefit from tamoxifen treatment. More recently we looked at the interaction of the "normal" appearing stromal tissue (the normal looking cells that are interspersed with the cancer cells) and the breast cancer cells. We found that these normal appearing cells had different gene patterns than other normal appearing cells in the breast that were not near the cancer. We are following up on this to look for targeted agents that might interfere with this stroma-cancer cell "crosstalk" that would provide novel ways to treat patients.

Right now our major project is related to angiogenesis-the development of blood vessels in the cancer that support its growth. In normal people as well as women with cancer a large percentage of the proteins that stimulate new blood vessel formation (vascular endothelial growth factors or ï¿½VEGFï¿½) are in the blood platelets-small cells in the blood that are essential for blood clotting. We have found that tamoxifen and aromatase inhibitors interact with platelets and affect the release of VEGF. We are currently planning to see if an anti-platelet agent can augment this VEGF release in a clinical trial in patients with early breast cancer. If this is the case then a larger trial will be planned to see if this improves outcome for women receiving hormonal therapy.

Q: What are your primary goals for this research?

A: To look for new targets for better treatment.

Q: Who do you think will benefit from your research?

A: Patients with early breast cancer for the most part but if we can find agents affecting the stromal-breast cancer cell interaction we would plan trials in patients with metastatic disease.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: The BCRF funds have allowed us to do studies in new and exciting areas. We have a superb cancer-coagulation group at the Vermont Cancer Center and are excited about the leads we have for the role of platelets, VEGF, and hormonal; therapy interactions in women with early breast cancer.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: We have learned that breast cancer is not a single disease-just as cancer is not a singular disease-we need to think about curing "cancers" and not cancer. We have decreased breast cancer mortality rates since the early 1990's by about 30%. This improvement is the result of better screening and newer adjuvant therapies. We have learned that it is unlikely that there will be a single "magic bullet" that will cure breast cancers and that success will be related to small but important incremental increases in treatment benefits. I would say we are getting close to finding cures (a plural) for some breast cancers but have a way to go with others. We are though making slow but sure progress on all fronts and I believe curing most patients is an attainable research goal in the next decade.

Read more about Dr. Muss' current research project funded by BCRF.

# data[].attributes.title
Q&A With Scientific Director Dr. Larry Norton

# data[].attributes.metatag_normalized[].attributes.content
Q&A With Scientific Director Dr. Larry Norton | BCRF

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Larry Norton to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
Q&A With Scientific Director Dr. Larry Norton

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Larry Norton to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
Q&A With Scientific Director Dr. Larry Norton

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Larry Norton to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
Q&A With Scientific Director Dr. Larry Norton

# data[].attributes.body.value
BCRF sat down with Dr. Larry Norton to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: What attracted me to science in the first place was that it seemed capable of attacking big problems, the kinds that affected a lot of people. Among these, cancer seemed a good place on which to focus my life and energies. But once I made this decision I had to make another choice: Would I focus on a narrow topic (which the academic reward system favors) or a broad approach, which engenders considerable risk regarding an academic career? I wanted to try to cure cancer any way I could, so I took the riskier path.

Accordingly, for graduate school I chose to earn a medical degree rather than a PhD in science. This was not easy for me because I regarded (and still regard) the accumulation of knowledge through unfettered scientific discovery one of humanity's most commendable goals. But I also felt compelled to try to help people through hands-on medicine. A combined degree, an MD-PhD, would have been optimal, but my local draft board precluded that - they would not have given me a draft exemption during the Vietnam War had I pursued a PhD after I had finished my medical training.

In the 1970s, in the second year of my fellowship in medical oncology at the National Cancer Institute, I had the opportunity to do laboratory work in viruses and cancer, which was then and remains a hot topic. However, with my colleague Richard Simon I had already made some interesting observations about the mathematics of cancer growth, observations with clinical implications that just begged for testing in clinical trials. I knew that to get these ideas tested I would have to earn the trust of the cancer clinical trials community, largely hands-on physicians, which means I would have to pursue that path even though laboratory-based science offered more academic rewards. For example, very few clinical trialists or theoretical biomathematicians get elected to the National Academies! Nevertheless, I was compelled to try to test our ideas in the clinic.

The very first implication of our work was that for cancer-killing drugs to work optimally they should be given often at a "right" moderate dose level rather than at a high "maximum tolerated dosage." This new approach, using moderate dose levels frequently, was later termed "dose density." It is an approach designed mathematically to maximize the killing of cancer cells while minimizing side effects. It took about two decades to get the idea into a clinical trial and another five years thereafter to show that the idea worked! But now it is widely applied, in breast cancer and many other cancer types.

Over the years I have been involved in many research topics, including the identification of inherited genetic abnormalities that predispose people to cancer, the development of new drugs such as monoclonal antibodies that target growth factor receptors, vaccines, and most recently, with my colleague Joan Massague, a self-seeding concept of how tumors grow and spread. This latter work actually explains the mathematical basis for dose-dense anti-cancer therapy and has many other implications for further research and, we hope, clinical applications.

My decision to "cure cancer anyway I could" has guided all of my career decisions. It has led me to become a physician, a mathematical scientist, a research administrator, a teacher, a mentor, a fundraiser, and now the medical director of a wonderful health facility. I wake up every morning and ask the question, "How can I make further progress today?" and pray that some good will come from it.

Q: Did you ever seriously consider another kind of career than that of the sciences?

A: I think that biomedical science was always in picture, even when it was obscured by other loves. For example, I love music and think the making of music with other musicians, especially before a live audience, is one of life's greatest pleasures. Frankly there is no substitute for that experience on an emotional level. But I made the decision early on follow my current path, and I am not sorry (most of the time).

Q: What advice would you give to young physician-researchers?

A: It depends on how young they are. I would say to the youngest students that they should think about studying neuroscience rather than cancer because cancer will be licked by the time they are ready to do their mature work. Neurodegenerative diseases will be the next big problem to solve after infectious diseases and cancer are controlled. And in all of these areas, prevention is the name of the game, although therapeutic advances are a step in that direction. To medical students interested in clinical work I say that they should spend some time doing formal laboratory research to enhance their personal development and professional growth. Still, we need great clinicians and clinical trialists as well as great laboratory-based researchers, and I hope the academic system will learn to reward such career choices.

Q: How close are we to preventing and curing all forms of breast cancer?

A: That is a question that is on every person's mind. We have made massive strides in curing cancer, and have realized many improvements in the areas of diagnostics (such as the use of MRI) and breast conservation surgery. When The Breast Cancer Research Foundation began 16 years ago, we started our sentences with "If we cure cancer..." Today it is not "if" but "When we cure cancer..." Everyone knows breast cancer will be eliminated and our goal is to make it happen as rapidly as possible.

Q: You have directed BCRF's activities since its beginnings. How has the BCRF grant program expanded over the years?

A: I think "directed" is too strong a word. The key concept of BCRF is collaboration, involving leadership, supporters, scientists, physicians... indeed the whole community. We have grown because we are all part of the whole great mission that is greater than the sum of its parts. When, in 1992, Evelyn Lauder initially helped raise funds for the construction of the Evelyn H. Lauder Breast Center at Memorial Sloan- Kettering Cancer Center we knew we were developing an idea, not just a physical space. We wanted to put the patient in the middle of a circle of specialists rather than have the patient shuttle between specialists. This was a novel idea at the time. But what was missing was putting all the specialists together in their academic time - which we have fixed in our new Evelyn H. Lauder Breast Center, by the way. By extension, we realized that to make progress faster we needed to connect many great researchers together in a "virtual" space. That is where the idea for BCRF was born.

Back then, there was some - never enough - money available to support basic science and clinical trials, but very little to support the connection between laboratory science and clinical research. There was no organization dedicated primarily to fostering the development of creative ideas and collaborations that would help translate what we learned in the laboratory into the better management of breast diseases in the clinic.

For these reasons The Breast Cancer Research Foundation began in 1993 with the goal of serving two basic needs: translational science and networking among researchers. What started as Evelyn hosting an intimate dinner in her home to raise money to support these goals has evolved into an organization that not only realizes grants for like-minded investigators all over the country and the world, but one that influences other grant-giving philanthropic organizations to do the same.

Q: How has BCRF impacted breast cancer research?

A: The Breast Cancer Research Foundation has already had a significant impact, in ways specific and more general. Specifically, the research it has supported has improved all aspects of breast cancer management, from prevention to diagnosis to prognostication to therapy to wellness after therapy is completed. These achievements are documented, in part, on the BCRF website. In addition - and in the long run maybe more significant - is the fact that we have reinvented how biomedical research should be supported. We do not solicit competitive grant applications - although we applaud those other institutions that do, since this is a very important part of the mix. Instead, we search out great scientists, relative beginners and established ones as well, who are accomplished and creative and want to help solve the cancer problem. We support people, not projects, although - of course - we assess and monitor progress as these researchers work in imaginative directions. Once preliminary data are accumulated these same researchers are encouraged to attract further financial support from more conventional sources. We have had great success employing this method.

In addition, we encourage collaboration, cooperation, and networking, all aspects of creating a community of scholars interested in making progress faster by working together. Scientists do want to work together, but they need a structure within which to accomplish this most efficiently. To this end we have pioneered a Web portal to encourage the exchange of ideas, materials, and information. We also host a think tank every year with focus groups from which we expect action items to arise. The creativity of this activity has been amazing.

Great science is a creative art. So the most important characteristic of BCRF is the priority it puts on creative thinking and on giving investigators the freedom they need to explore new ideas. One way we accomplish the latter task is by funding cooperative groups and hospital consortia working together to carry out translational research.

For example, in 2005 BCRF founded the Translational Breast Cancer Research Consortium (TBCRC), which is now supported in partnership with other organizations. The TBCRC unites the efforts of fourteen leading breast cancer research centers in the United States. This group designs and conducts high-technology, usually multidisciplinary clinical trials that incorporate sophisticated laboratory investigations. The focus is on making progress against breast cancer, using the tools of modern biological science as its weapon.

BCRF also partners with other organizations such as the American Society for Clinical Oncology (ASCO) Foundation and the American Association of Cancer Research (AACR) to give grants to investigators to conduct promising translational breast cancer research.

Following the core principles of BCRF, we do not limit our support to the borders of the United States. By 2009 the BCRF had expanded its research funding to 28 countries on six continents. Just as breast cancer is a global problem, so must the solution involve global cooperation and collaboration.

Q: What challenges lay ahead for BCRF?

A: I am confident that we are moving in the right direction, but I am never happy with the speed of progress. We have an ethical obligation to move forward faster. One thing we need to do to maximize our rate of progress is to keep identifying the new ideas and new people who offer great promise. This takes a lot of work, a lot of time, a lot of travel, but the rewards are great too. And we have to continue, indeed expand, our ability to support not just the development of the new ideas, but the connections between them. If you want to hear the sound of a ringing bell, you need not just the bell and a hammer, but the means to have the hammer strike the bell: The goal is the interac- tion between the elements.

Q: Much has been accomplished but more needs to be done to eradicate and ultimately prevent breast cancer altogether. What is stopping us from reaching that goal?

A: Most people do not really know how underfunded we are in cancer research and education. We are talking about a set of diseases that will afflict up to a half of all Americans, and affect 100% of us indirectly if not directly. Yet if one puts together all sources of support for making progress - everything spent by government and industry and private donors put together - it accounts for less than 69 cents per American per week. As a nation, this is less than one-sixth of what we spend on soft drinks! Hence, to make progress faster, to save our own lives as well as the lives of our loved ones, what we need is not massive sacrifice but mass commitment. By connecting that commitment with high quality creative research we can eradicate breast cancer and all cancers in real time. We see the light at the end of the tunnel, which means it is a straight shot: Let us get there as fast as our commitment allows.

Read more about Dr. Norton's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Larry Norton to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: What attracted me to science in the first place was that it seemed capable of attacking big problems, the kinds that affected a lot of people. Among these, cancer seemed a good place on which to focus my life and energies. But once I made this decision I had to make another choice: Would I focus on a narrow topic (which the academic reward system favors) or a broad approach, which engenders considerable risk regarding an academic career? I wanted to try to cure cancer any way I could, so I took the riskier path.

Accordingly, for graduate school I chose to earn a medical degree rather than a PhD in science. This was not easy for me because I regarded (and still regard) the accumulation of knowledge through unfettered scientific discovery one of humanity's most commendable goals. But I also felt compelled to try to help people through hands-on medicine. A combined degree, an MD-PhD, would have been optimal, but my local draft board precluded that - they would not have given me a draft exemption during the Vietnam War had I pursued a PhD after I had finished my medical training.

In the 1970s, in the second year of my fellowship in medical oncology at the National Cancer Institute, I had the opportunity to do laboratory work in viruses and cancer, which was then and remains a hot topic. However, with my colleague Richard Simon I had already made some interesting observations about the mathematics of cancer growth, observations with clinical implications that just begged for testing in clinical trials. I knew that to get these ideas tested I would have to earn the trust of the cancer clinical trials community, largely hands-on physicians, which means I would have to pursue that path even though laboratory-based science offered more academic rewards. For example, very few clinical trialists or theoretical biomathematicians get elected to the National Academies! Nevertheless, I was compelled to try to test our ideas in the clinic.

The very first implication of our work was that for cancer-killing drugs to work optimally they should be given often at a "right" moderate dose level rather than at a high "maximum tolerated dosage." This new approach, using moderate dose levels frequently, was later termed "dose density." It is an approach designed mathematically to maximize the killing of cancer cells while minimizing side effects. It took about two decades to get the idea into a clinical trial and another five years thereafter to show that the idea worked! But now it is widely applied, in breast cancer and many other cancer types.

Over the years I have been involved in many research topics, including the identification of inherited genetic abnormalities that predispose people to cancer, the development of new drugs such as monoclonal antibodies that target growth factor receptors, vaccines, and most recently, with my colleague Joan Massague, a self-seeding concept of how tumors grow and spread. This latter work actually explains the mathematical basis for dose-dense anti-cancer therapy and has many other implications for further research and, we hope, clinical applications.

My decision to "cure cancer anyway I could" has guided all of my career decisions. It has led me to become a physician, a mathematical scientist, a research administrator, a teacher, a mentor, a fundraiser, and now the medical director of a wonderful health facility. I wake up every morning and ask the question, "How can I make further progress today?" and pray that some good will come from it.

Q: Did you ever seriously consider another kind of career than that of the sciences?

A: I think that biomedical science was always in picture, even when it was obscured by other loves. For example, I love music and think the making of music with other musicians, especially before a live audience, is one of life's greatest pleasures. Frankly there is no substitute for that experience on an emotional level. But I made the decision early on follow my current path, and I am not sorry (most of the time).

Q: What advice would you give to young physician-researchers?

A: It depends on how young they are. I would say to the youngest students that they should think about studying neuroscience rather than cancer because cancer will be licked by the time they are ready to do their mature work. Neurodegenerative diseases will be the next big problem to solve after infectious diseases and cancer are controlled. And in all of these areas, prevention is the name of the game, although therapeutic advances are a step in that direction. To medical students interested in clinical work I say that they should spend some time doing formal laboratory research to enhance their personal development and professional growth. Still, we need great clinicians and clinical trialists as well as great laboratory-based researchers, and I hope the academic system will learn to reward such career choices.

Q: How close are we to preventing and curing all forms of breast cancer?

A: That is a question that is on every person's mind. We have made massive strides in curing cancer, and have realized many improvements in the areas of diagnostics (such as the use of MRI) and breast conservation surgery. When The Breast Cancer Research Foundation began 16 years ago, we started our sentences with "If we cure cancer..." Today it is not "if" but "When we cure cancer..." Everyone knows breast cancer will be eliminated and our goal is to make it happen as rapidly as possible.

Q: You have directed BCRF's activities since its beginnings. How has the BCRF grant program expanded over the years?

A: I think "directed" is too strong a word. The key concept of BCRF is collaboration, involving leadership, supporters, scientists, physicians... indeed the whole community. We have grown because we are all part of the whole great mission that is greater than the sum of its parts. When, in 1992, Evelyn Lauder initially helped raise funds for the construction of the Evelyn H. Lauder Breast Center at Memorial Sloan- Kettering Cancer Center we knew we were developing an idea, not just a physical space. We wanted to put the patient in the middle of a circle of specialists rather than have the patient shuttle between specialists. This was a novel idea at the time. But what was missing was putting all the specialists together in their academic time - which we have fixed in our new Evelyn H. Lauder Breast Center, by the way. By extension, we realized that to make progress faster we needed to connect many great researchers together in a "virtual" space. That is where the idea for BCRF was born.

Back then, there was some - never enough - money available to support basic science and clinical trials, but very little to support the connection between laboratory science and clinical research. There was no organization dedicated primarily to fostering the development of creative ideas and collaborations that would help translate what we learned in the laboratory into the better management of breast diseases in the clinic.

For these reasons The Breast Cancer Research Foundation began in 1993 with the goal of serving two basic needs: translational science and networking among researchers. What started as Evelyn hosting an intimate dinner in her home to raise money to support these goals has evolved into an organization that not only realizes grants for like-minded investigators all over the country and the world, but one that influences other grant-giving philanthropic organizations to do the same.

Q: How has BCRF impacted breast cancer research?

A: The Breast Cancer Research Foundation has already had a significant impact, in ways specific and more general. Specifically, the research it has supported has improved all aspects of breast cancer management, from prevention to diagnosis to prognostication to therapy to wellness after therapy is completed. These achievements are documented, in part, on the BCRF website. In addition - and in the long run maybe more significant - is the fact that we have reinvented how biomedical research should be supported. We do not solicit competitive grant applications - although we applaud those other institutions that do, since this is a very important part of the mix. Instead, we search out great scientists, relative beginners and established ones as well, who are accomplished and creative and want to help solve the cancer problem. We support people, not projects, although - of course - we assess and monitor progress as these researchers work in imaginative directions. Once preliminary data are accumulated these same researchers are encouraged to attract further financial support from more conventional sources. We have had great success employing this method.

In addition, we encourage collaboration, cooperation, and networking, all aspects of creating a community of scholars interested in making progress faster by working together. Scientists do want to work together, but they need a structure within which to accomplish this most efficiently. To this end we have pioneered a Web portal to encourage the exchange of ideas, materials, and information. We also host a think tank every year with focus groups from which we expect action items to arise. The creativity of this activity has been amazing.

Great science is a creative art. So the most important characteristic of BCRF is the priority it puts on creative thinking and on giving investigators the freedom they need to explore new ideas. One way we accomplish the latter task is by funding cooperative groups and hospital consortia working together to carry out translational research.

For example, in 2005 BCRF founded the Translational Breast Cancer Research Consortium (TBCRC), which is now supported in partnership with other organizations. The TBCRC unites the efforts of fourteen leading breast cancer research centers in the United States. This group designs and conducts high-technology, usually multidisciplinary clinical trials that incorporate sophisticated laboratory investigations. The focus is on making progress against breast cancer, using the tools of modern biological science as its weapon.

BCRF also partners with other organizations such as the American Society for Clinical Oncology (ASCO) Foundation and the American Association of Cancer Research (AACR) to give grants to investigators to conduct promising translational breast cancer research.

Following the core principles of BCRF, we do not limit our support to the borders of the United States. By 2009 the BCRF had expanded its research funding to 28 countries on six continents. Just as breast cancer is a global problem, so must the solution involve global cooperation and collaboration.

Q: What challenges lay ahead for BCRF?

A: I am confident that we are moving in the right direction, but I am never happy with the speed of progress. We have an ethical obligation to move forward faster. One thing we need to do to maximize our rate of progress is to keep identifying the new ideas and new people who offer great promise. This takes a lot of work, a lot of time, a lot of travel, but the rewards are great too. And we have to continue, indeed expand, our ability to support not just the development of the new ideas, but the connections between them. If you want to hear the sound of a ringing bell, you need not just the bell and a hammer, but the means to have the hammer strike the bell: The goal is the interac- tion between the elements.

Q: Much has been accomplished but more needs to be done to eradicate and ultimately prevent breast cancer altogether. What is stopping us from reaching that goal?

A: Most people do not really know how underfunded we are in cancer research and education. We are talking about a set of diseases that will afflict up to a half of all Americans, and affect 100% of us indirectly if not directly. Yet if one puts together all sources of support for making progress - everything spent by government and industry and private donors put together - it accounts for less than 69 cents per American per week. As a nation, this is less than one-sixth of what we spend on soft drinks! Hence, to make progress faster, to save our own lives as well as the lives of our loved ones, what we need is not massive sacrifice but mass commitment. By connecting that commitment with high quality creative research we can eradicate breast cancer and all cancers in real time. We see the light at the end of the tunnel, which means it is a straight shot: Let us get there as fast as our commitment allows.

Read more about Dr. Norton's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Larry Norton to discuss his current work and interest in breast cancer research. Read on to learn more. 

# data[].attributes.metatag_normalized[].attributes.content
Q&A With Dr. Olufunmilayo Olopade | BCRF

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Olufunmilayo Olopade to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research. 
A: I grew up in Nigeria, where I retain close ties with cancer specialists there and return frequently to teach, for research and to visit. I received my M.D. degree in 1980 from the University of Ibadan, Nigeria, and served as a medical officer at the Nigerian Navy Hospital in Lagos. In 1986, I completed an internship and residency at the Cook County Hospital, in Chicago, and trained in hematology and oncology as a postdoctoral fellow (1987-1991) at the University of Chicago, where I have been on the faculty since 1991. As a clinician, my interests include finding and testing improved methods for prediction, prevention and early detection of cancer for moderate- and high-risk populations. In the Cancer Risk Clinic at the University of Chicago, which I started in 1992, we coordinate preventive care and testing for healthy patients and their families who because of genetics or family history are at increased risk for cancer. The clinic also focuses on quality-of-life issues for young breast cancer patients, including concerns related to pregnancy, fertility, and employment. I became interested in breast cancer research shortly after the BRCA1 gene was identified as a breast cancer susceptibility gene. (BCRF note to reader: the research Dr. Olopade refers to in discovering the BRCA1 gene was performed by Dr. Mary-Claire King, a BCRF grantee since 1996.)
Q: Briefly describe your research project. 
A: My interest in bridging the gaps between clinical services, translational research, and basic science investigations in cancer genetics led to the establishment of the Center for Clinical Cancer Genetics at the University of Chicago. By establishing and maintaining a large and growing database of high-risk individuals, I am able to examine the contribution of germline BRCA1 and BRCA2 mutations in diverse populations. Our laboratory was the first to describe recurrent BRCA1 mutations in extended African American families with breast cancer, a study that we have extended to the founder population of African Americans in West Africa. We recently found that breast cancers in African women often produce a pattern of gene expression that is significantly different from that seen in Caucasians. Tumors of African women are more likely to be "basal like" or estrogen receptor negative and originate from a different group of cells within the breast. These tumors are less likely to present the molecular targets that form the basis of many standard therapies. We are interested in understanding the importance of epigenetic regulation of BRCA1 in sporadic breast cancers and have proposed a model for breast cancer progression whereby BRCA1 methylation can substitute as a first event, much like an inherited germ-line mutation, and promote tumor progression down a restricted set of molecular pathways.
Q: What are your primary goals for this research? 
A: Our focus on women of African ancestry who share a disproportionate burden of aggressive young onset "basal-like" breast cancer is expected to reveal previously unmeasured gene environment interactions in disease causation that underlie disparities in health outcomes. We hope to develop novel treatment approaches with fewer side effects for young women.
Q: Who do you think will benefit from your research? 
A: A better understanding of the most aggressive type of breast cancer in young women will lead to improved methods for prevention, early detection and treatment of all breast cancers. Currently we have no good understanding of how to best treat young women with "basal like" breast cancer. These women have a different set of criteria that we must now consider when treating them, such as wanting to have families after diagnosis, etc. Up until now, older Caucasian women have provided the base line information for breast cancer prevention and treatment, and this leaves a large portion of the population out of the equation. Hopefully our study will affect that in a positive way. All women will eventually benefit.
Q: How close do you think we are to preventing or finding a cure for breast cancer? 
A: We have made significant progress. In women whose breast cancer is diagnosed at an early stage and is localized, 98% survive more than 5 years. For all stages of breast cancer, the 5-year survival rate is 88%. Currently, we believe there are 2 million women, at minimum, living in the U.S. who have survived breast cancer.
Q: How has The Breast Cancer Research Foundation been helpful to you? 
A: BCRF has been instrumental in sustaining our research in young women at high genetic risk for breast cancer. Nigeria, a country of 150 million people, had no pathology services that could reliably perform immunohistochemistry for breast cancer until BCRF came to the rescue. Now, with support from BCRF, a state of the art immunohistochemistry laboratory has been established in Nigeria to support the 1st multi-center breast cancer treatment trial in Africa.
 
Read more about Dr. Olopade's current research project funded by BCRF. 

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Olufunmilayo Olopade to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Olufunmilayo Olopade to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Olufunmilayo Olopade to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I grew up in Nigeria, where I retain close ties with cancer specialists there and return frequently to teach, for research and to visit. I received my M.D. degree in 1980 from the University of Ibadan, Nigeria, and served as a medical officer at the Nigerian Navy Hospital in Lagos. In 1986, I completed an internship and residency at the Cook County Hospital, in Chicago, and trained in hematology and oncology as a postdoctoral fellow (1987-1991) at the University of Chicago, where I have been on the faculty since 1991. As a clinician, my interests include finding and testing improved methods for prediction, prevention and early detection of cancer for moderate- and high-risk populations. In the Cancer Risk Clinic at the University of Chicago, which I started in 1992, we coordinate preventive care and testing for healthy patients and their families who because of genetics or family history are at increased risk for cancer. The clinic also focuses on quality-of-life issues for young breast cancer patients, including concerns related to pregnancy, fertility, and employment. I became interested in breast cancer research shortly after the BRCA1 gene was identified as a breast cancer susceptibility gene. (BCRF note to reader: the research Dr. Olopade refers to in discovering the BRCA1 gene was performed by Dr. Mary-Claire King, a BCRF grantee since 1996.)

Q: Briefly describe your research project.

A: My interest in bridging the gaps between clinical services, translational research, and basic science investigations in cancer genetics led to the establishment of the Center for Clinical Cancer Genetics at the University of Chicago. By establishing and maintaining a large and growing database of high-risk individuals, I am able to examine the contribution of germline BRCA1 and BRCA2 mutations in diverse populations. Our laboratory was the first to describe recurrent BRCA1 mutations in extended African American families with breast cancer, a study that we have extended to the founder population of African Americans in West Africa. We recently found that breast cancers in African women often produce a pattern of gene expression that is significantly different from that seen in Caucasians. Tumors of African women are more likely to be "basal like" or estrogen receptor negative and originate from a different group of cells within the breast. These tumors are less likely to present the molecular targets that form the basis of many standard therapies. We are interested in understanding the importance of epigenetic regulation of BRCA1 in sporadic breast cancers and have proposed a model for breast cancer progression whereby BRCA1 methylation can substitute as a first event, much like an inherited germ-line mutation, and promote tumor progression down a restricted set of molecular pathways.

Q: What are your primary goals for this research?

A: Our focus on women of African ancestry who share a disproportionate burden of aggressive young onset "basal-like" breast cancer is expected to reveal previously unmeasured gene environment interactions in disease causation that underlie disparities in health outcomes. We hope to develop novel treatment approaches with fewer side effects for young women.

Q: Who do you think will benefit from your research?

A: A better understanding of the most aggressive type of breast cancer in young women will lead to improved methods for prevention, early detection and treatment of all breast cancers. Currently we have no good understanding of how to best treat young women with "basal like" breast cancer. These women have a different set of criteria that we must now consider when treating them, such as wanting to have families after diagnosis, etc. Up until now, older Caucasian women have provided the base line information for breast cancer prevention and treatment, and this leaves a large portion of the population out of the equation. Hopefully our study will affect that in a positive way. All women will eventually benefit.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: We have made significant progress. In women whose breast cancer is diagnosed at an early stage and is localized, 98% survive more than 5 years. For all stages of breast cancer, the 5-year survival rate is 88%. Currently, we believe there are 2 million women, at minimum, living in the U.S. who have survived breast cancer.

Q: How has The Breast Cancer Research Foundation been helpful to you?

A: BCRF has been instrumental in sustaining our research in young women at high genetic risk for breast cancer. Nigeria, a country of 150 million people, had no pathology services that could reliably perform immunohistochemistry for breast cancer until BCRF came to the rescue. Now, with support from BCRF, a state of the art immunohistochemistry laboratory has been established in Nigeria to support the 1st multi-center breast cancer treatment trial in Africa.

Read more about Dr. Olopade's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Olufunmilayo Olopade to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I grew up in Nigeria, where I retain close ties with cancer specialists there and return frequently to teach, for research and to visit. I received my M.D. degree in 1980 from the University of Ibadan, Nigeria, and served as a medical officer at the Nigerian Navy Hospital in Lagos. In 1986, I completed an internship and residency at the Cook County Hospital, in Chicago, and trained in hematology and oncology as a postdoctoral fellow (1987-1991) at the University of Chicago, where I have been on the faculty since 1991. As a clinician, my interests include finding and testing improved methods for prediction, prevention and early detection of cancer for moderate- and high-risk populations. In the Cancer Risk Clinic at the University of Chicago, which I started in 1992, we coordinate preventive care and testing for healthy patients and their families who because of genetics or family history are at increased risk for cancer. The clinic also focuses on quality-of-life issues for young breast cancer patients, including concerns related to pregnancy, fertility, and employment. I became interested in breast cancer research shortly after the BRCA1 gene was identified as a breast cancer susceptibility gene. (BCRF note to reader: the research Dr. Olopade refers to in discovering the BRCA1 gene was performed by Dr. Mary-Claire King, a BCRF grantee since 1996.)

Q: Briefly describe your research project.

A: My interest in bridging the gaps between clinical services, translational research, and basic science investigations in cancer genetics led to the establishment of the Center for Clinical Cancer Genetics at the University of Chicago. By establishing and maintaining a large and growing database of high-risk individuals, I am able to examine the contribution of germline BRCA1 and BRCA2 mutations in diverse populations. Our laboratory was the first to describe recurrent BRCA1 mutations in extended African American families with breast cancer, a study that we have extended to the founder population of African Americans in West Africa. We recently found that breast cancers in African women often produce a pattern of gene expression that is significantly different from that seen in Caucasians. Tumors of African women are more likely to be "basal like" or estrogen receptor negative and originate from a different group of cells within the breast. These tumors are less likely to present the molecular targets that form the basis of many standard therapies. We are interested in understanding the importance of epigenetic regulation of BRCA1 in sporadic breast cancers and have proposed a model for breast cancer progression whereby BRCA1 methylation can substitute as a first event, much like an inherited germ-line mutation, and promote tumor progression down a restricted set of molecular pathways.

Q: What are your primary goals for this research?

A: Our focus on women of African ancestry who share a disproportionate burden of aggressive young onset "basal-like" breast cancer is expected to reveal previously unmeasured gene environment interactions in disease causation that underlie disparities in health outcomes. We hope to develop novel treatment approaches with fewer side effects for young women.

Q: Who do you think will benefit from your research?

A: A better understanding of the most aggressive type of breast cancer in young women will lead to improved methods for prevention, early detection and treatment of all breast cancers. Currently we have no good understanding of how to best treat young women with "basal like" breast cancer. These women have a different set of criteria that we must now consider when treating them, such as wanting to have families after diagnosis, etc. Up until now, older Caucasian women have provided the base line information for breast cancer prevention and treatment, and this leaves a large portion of the population out of the equation. Hopefully our study will affect that in a positive way. All women will eventually benefit.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: We have made significant progress. In women whose breast cancer is diagnosed at an early stage and is localized, 98% survive more than 5 years. For all stages of breast cancer, the 5-year survival rate is 88%. Currently, we believe there are 2 million women, at minimum, living in the U.S. who have survived breast cancer.

Q: How has The Breast Cancer Research Foundation been helpful to you?

A: BCRF has been instrumental in sustaining our research in young women at high genetic risk for breast cancer. Nigeria, a country of 150 million people, had no pathology services that could reliably perform immunohistochemistry for breast cancer until BCRF came to the rescue. Now, with support from BCRF, a state of the art immunohistochemistry laboratory has been established in Nigeria to support the 1st multi-center breast cancer treatment trial in Africa.

Read more about Dr. Olopade's current research project funded by BCRF.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Edith Perez to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Edith Perez to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Please tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Edith Perez to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Please tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Edith Perez to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Please tell us about yourself as a scientist and how you became interested in breast cancer research.

A: I consider myself honored to be a clinical and translational investigator in the field of breast cancer research. From the start of my career, I knew that working in something innovative and impactful was important, although I didn’t know exactly what area that would be. I wanted to be part of a field where there was a need for someone to be a thinker — a positive thinker — about the possibilities. I learned about the impact of breast cancer during my first year after medical school, and the path was set. I then read about the global challenges with breast cancer–the development of the disease as well as its management--that affected the lives of millions of people. I saw the need to incorporate scientific principles in the context of personalized approaches to help tackle the problem.

Q: Have you considered another kind of career?

A: When I started college at age 16, my field was mathematics. I was really adept at understanding mathematical problems and solving them. However, there were two reasons why I changed course in college: one, my grandmother died suddenly and I thought “wow, if I had been a physician, I could have helped her”. Two, I wanted a career that would involve more interaction with people than mathematics could offer. So I began to focus on biology and medicine, completed my undergraduate degree at the University of P.R. in three years (while also playing in the varsity tennis team), and then continued on to medical school, which I found to be truly engaging and energizing.

Q: If you could briefly describe your BCRF-funded research project, what are some laboratory and/or clinical experiences that inspired your work, and what are your primary goals?

A: BCRF has been instrumental in allowing me to develop in the global academic arena, as well as collaborate with amazing individuals who are smart and committed to helping others. I remember the first time I learned about BCRF funding, meeting Evelyn and Leonard Lauder for dinner at their home, back in 1998. I felt deeply honored to be one of the few individuals at that time who were selected to receive this opportunity to develop my research. The vision that Evelyn Lauder and the BCRF board had from the very beginning was to identify people who had both commitment and intellect; lucky for me that they found me to be worthy of such consideration.

It has been fantastic to connect with others and work to advance breast cancer diagnosis, prevention, and care. So to me it’s been heartwarming to be part of the BCRF family over the years. Certainly the association with Play for Pink has also been fabulous because these women are so committed to their belief in the mission of BCRF that they devote a lot of their own time to do this work. Moreover, they are delightful human beings.

Q: In terms of the scientific portion of your research, what are some experiences that inspired your work and what are your primary goals?

A: My ultimate goal in research is to improve people’s lives. That’s really the driver for it all. I realized the best way to do this was to identify the areas that needed more research, focus on some of those areas, and assemble a team of like-minded individuals to try and answer the questions relevant for patient care. At the very beginning of my career, I concentrated on research that would identify new drugs, and better drug schedules to optimize benefits for patients by shrinking breast tumors and diminishing toxicity. I am very fortunate to work here at Mayo Clinic. I have established relationships with many people and have access to critical resources. We have been able to help develop clinical trials that changed the scope of how we manage patients locally, nationally, and globally. This research naturally evolved to then thinking, “Ok, in addition to finding drugs or agents that target specific abnormalities of cancers, what can we do to better understand the targets that can be affected by therapies, in terms of understanding protein expression and gene expression so that then we can optimize new treatment strategies?” The research that we have collectively done over the years has helped identify tumor abnormalities that are important drivers of growth and in its ability to metastasize. Our current research includes identifying novel treatments that can best block those abnormalities, as well as evaluation of gene and protein interactions that impact tumor behavior and ultimately patients’ lives.

BCRF has allowed me time to think of innovative questions that are relevant to patients, has provided much-needed funds to attract other scientists to join in collaboration, and has helped with financial support to get reagents needed for our experiments. But most importantly, BCRF has offered an avenue to do the best research possible to utilize science to help optimize patient care.

Q:Are there specific developments or technologies that have made your work possible? What additional advances can help enhance your progress?

A: In addition to conducting effective clinical trials, we have focused on the collection and storage of biospecimens from patients in many parts of the United States and abroad. This is essential so that we can find the biomarkers that are integral for the development of better treatments. I am very proud that BCRF partially helped support that initiative.

We’ve taken advantage of developing technologies, helped with the definition of standards for protein and gene testing in the setting of breast cancer, specifically HER2 testing. Additionally, we’ve been concentrating on what we call next generation gene sequencing, which not only identifies different gene expressions in tumors, but also looks at the interactions of genes that may impact a tumor’s behavior. I think this is the future, to look not only at specific genes or proteins, but also at their interactions, so we can develop new treatments for our patients.

Q: What direction or trends do you see emerging in breast cancer research in the next 10 years?

A: There certainly will be advances in science, along with a growing emphasis on global collaboration. This will require travel to many parts of the world, to help update physicians and medical personnel, as well as to foster their participation in clinical and translational research with us. Breast cancer is a global problem, and we need to be inclusive in our educational and research strategies.

Q: What are some of the countries that you’ve had collaborations in?

A: I’ve had many. I’ve had collaborations with physicians from China, Spain, Japan, Malaysia, France, Italy, the Netherlands, Great Britain, South Africa, Argentina, Peru, and certainly Puerto Rico, which is where I was born. I’m very fortunate to have met amazing people all over the world and helped to bring them into our research team. These are also nice places to visit!

Q: What other projects are you currently working on? I know you’re the vice chair of the Alliance.

A: I am involved in many global clinical trials to identify new agents for treatment. I am also a very big believer in the importance of clinical research in the United States, and that is why being the vice chair of the Alliance for Clinical Trials in Oncology suits me extremely well. Our group has hundreds of investigators throughout the US and other parts of the world. The structure of the Alliance is very important so that investigators feel welcome and able to foster their professional development. I’m very honored to be a member of this organization.

Q: How close do you think we are to preventing and curing different forms of breast cancer?

A: Every day our work is helping to prevent some breast cancers, and every day, is helping someone to be cured. The advances that have been made over the years allow me to be confident about that statement. The issue is: how can we increase the number of people who are cured? How can we increase the patients who will NOT develop cancer through prevention strategies? I think this is something that we’re progressing toward every day. We are helping more and more people as we continue our research, as well as our education. The hope is that an increasing number of people will understand that there are things they can do to decrease the risk of disease, and improve the cure rate by adhering to the therapies that have been proven to help.

Q: How has BCRF impacted breast cancer research in your opinion?

A: BCRF is a group that nationally and internationally has brought about a renaissance in terms of evolved understanding of science and applicability to patients. I associate the word “renaissance” very closely with Evelyn Lauder. I think she was a renaissance woman in terms of her ability to bring her friends and colleagues to be part of a group to raise funds so that physician scientists like me can devote a major portion of our lives to improve the lives of others. So I think BCRF should get a gold star, the gold star.

Read more about Dr. Perez's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Edith Perez to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Please tell us about yourself as a scientist and how you became interested in breast cancer research.

A: I consider myself honored to be a clinical and translational investigator in the field of breast cancer research. From the start of my career, I knew that working in something innovative and impactful was important, although I didn’t know exactly what area that would be. I wanted to be part of a field where there was a need for someone to be a thinker — a positive thinker — about the possibilities. I learned about the impact of breast cancer during my first year after medical school, and the path was set. I then read about the global challenges with breast cancer–the development of the disease as well as its management--that affected the lives of millions of people. I saw the need to incorporate scientific principles in the context of personalized approaches to help tackle the problem.

Q: Have you considered another kind of career?

A: When I started college at age 16, my field was mathematics. I was really adept at understanding mathematical problems and solving them. However, there were two reasons why I changed course in college: one, my grandmother died suddenly and I thought “wow, if I had been a physician, I could have helped her”. Two, I wanted a career that would involve more interaction with people than mathematics could offer. So I began to focus on biology and medicine, completed my undergraduate degree at the University of P.R. in three years (while also playing in the varsity tennis team), and then continued on to medical school, which I found to be truly engaging and energizing.

Q: If you could briefly describe your BCRF-funded research project, what are some laboratory and/or clinical experiences that inspired your work, and what are your primary goals?

A: BCRF has been instrumental in allowing me to develop in the global academic arena, as well as collaborate with amazing individuals who are smart and committed to helping others. I remember the first time I learned about BCRF funding, meeting Evelyn and Leonard Lauder for dinner at their home, back in 1998. I felt deeply honored to be one of the few individuals at that time who were selected to receive this opportunity to develop my research. The vision that Evelyn Lauder and the BCRF board had from the very beginning was to identify people who had both commitment and intellect; lucky for me that they found me to be worthy of such consideration.

It has been fantastic to connect with others and work to advance breast cancer diagnosis, prevention, and care. So to me it’s been heartwarming to be part of the BCRF family over the years. Certainly the association with Play for Pink has also been fabulous because these women are so committed to their belief in the mission of BCRF that they devote a lot of their own time to do this work. Moreover, they are delightful human beings.

Q: In terms of the scientific portion of your research, what are some experiences that inspired your work and what are your primary goals?

A: My ultimate goal in research is to improve people’s lives. That’s really the driver for it all. I realized the best way to do this was to identify the areas that needed more research, focus on some of those areas, and assemble a team of like-minded individuals to try and answer the questions relevant for patient care. At the very beginning of my career, I concentrated on research that would identify new drugs, and better drug schedules to optimize benefits for patients by shrinking breast tumors and diminishing toxicity. I am very fortunate to work here at Mayo Clinic. I have established relationships with many people and have access to critical resources. We have been able to help develop clinical trials that changed the scope of how we manage patients locally, nationally, and globally. This research naturally evolved to then thinking, “Ok, in addition to finding drugs or agents that target specific abnormalities of cancers, what can we do to better understand the targets that can be affected by therapies, in terms of understanding protein expression and gene expression so that then we can optimize new treatment strategies?” The research that we have collectively done over the years has helped identify tumor abnormalities that are important drivers of growth and in its ability to metastasize. Our current research includes identifying novel treatments that can best block those abnormalities, as well as evaluation of gene and protein interactions that impact tumor behavior and ultimately patients’ lives.

BCRF has allowed me time to think of innovative questions that are relevant to patients, has provided much-needed funds to attract other scientists to join in collaboration, and has helped with financial support to get reagents needed for our experiments. But most importantly, BCRF has offered an avenue to do the best research possible to utilize science to help optimize patient care.

Q:Are there specific developments or technologies that have made your work possible? What additional advances can help enhance your progress?

A: In addition to conducting effective clinical trials, we have focused on the collection and storage of biospecimens from patients in many parts of the United States and abroad. This is essential so that we can find the biomarkers that are integral for the development of better treatments. I am very proud that BCRF partially helped support that initiative.

We’ve taken advantage of developing technologies, helped with the definition of standards for protein and gene testing in the setting of breast cancer, specifically HER2 testing. Additionally, we’ve been concentrating on what we call next generation gene sequencing, which not only identifies different gene expressions in tumors, but also looks at the interactions of genes that may impact a tumor’s behavior. I think this is the future, to look not only at specific genes or proteins, but also at their interactions, so we can develop new treatments for our patients.

Q: What direction or trends do you see emerging in breast cancer research in the next 10 years?

A: There certainly will be advances in science, along with a growing emphasis on global collaboration. This will require travel to many parts of the world, to help update physicians and medical personnel, as well as to foster their participation in clinical and translational research with us. Breast cancer is a global problem, and we need to be inclusive in our educational and research strategies.

Q: What are some of the countries that you’ve had collaborations in?

A: I’ve had many. I’ve had collaborations with physicians from China, Spain, Japan, Malaysia, France, Italy, the Netherlands, Great Britain, South Africa, Argentina, Peru, and certainly Puerto Rico, which is where I was born. I’m very fortunate to have met amazing people all over the world and helped to bring them into our research team. These are also nice places to visit!

Q: What other projects are you currently working on? I know you’re the vice chair of the Alliance.

A: I am involved in many global clinical trials to identify new agents for treatment. I am also a very big believer in the importance of clinical research in the United States, and that is why being the vice chair of the Alliance for Clinical Trials in Oncology suits me extremely well. Our group has hundreds of investigators throughout the US and other parts of the world. The structure of the Alliance is very important so that investigators feel welcome and able to foster their professional development. I’m very honored to be a member of this organization.

Q: How close do you think we are to preventing and curing different forms of breast cancer?

A: Every day our work is helping to prevent some breast cancers, and every day, is helping someone to be cured. The advances that have been made over the years allow me to be confident about that statement. The issue is: how can we increase the number of people who are cured? How can we increase the patients who will NOT develop cancer through prevention strategies? I think this is something that we’re progressing toward every day. We are helping more and more people as we continue our research, as well as our education. The hope is that an increasing number of people will understand that there are things they can do to decrease the risk of disease, and improve the cure rate by adhering to the therapies that have been proven to help.

Q: How has BCRF impacted breast cancer research in your opinion?

A: BCRF is a group that nationally and internationally has brought about a renaissance in terms of evolved understanding of science and applicability to patients. I associate the word “renaissance” very closely with Evelyn Lauder. I think she was a renaissance woman in terms of her ability to bring her friends and colleagues to be part of a group to raise funds so that physician scientists like me can devote a major portion of our lives to improve the lives of others. So I think BCRF should get a gold star, the gold star.

Read more about Dr. Perez's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Edith Perez to discuss her current work and interest in breast cancer research. Read on to learn more. 

# data[].attributes.metatag_normalized[].attributes.content
Q&A With Dr. Martine Piccart-Gebhart | BCRF

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Martine Piccart-Gebhart to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. 
A: My father, whom I admired very much, was a gynecologist, so I became interested in medicine very early. Then, when I was a teenager, my uncle developed colon cancer. I visited him at Jules Bordet Institute, where I now work, and an inexplicable feeling came over me when I walked into the hospital. Later on, I made these same trips to visit my mother, who developed breast cancer during the second year of my training in oncology. Her illness was a great motivation for me to become more interested in breast cancer.
Q: Describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research? 
A: I have devoted a lot of time and effort into the founding and activities of the Breast International Group (BIG), an international consortium of research groups outside the US. The genesis of the group was the huge problem faced by European researchers, a problem which did not exist in the US until very recently. That is, there is virtually no government funding for clinical trials, making us European researchers highly dependent on the pharmaceutical industry.
In addition, we researchers want to answer questions that are of high interest to patients and clinicians, but not to drug companies. For instance, we wanted to launch a trial called MINDACT, studying chemotherapy over-treatment, because there are patients who could gain the same level of therapeutic benefits from endocrine therapy alone without adding chemotherapy. It was very difficult to get funding for this study. Although we did get a significant grant from the European Union, it was not enough to cover the entire trial. Fortunately, Dr. Larry Norton was familiar with BIG and the frustrations that our research community faced. BCRF support helped to set up the biobanking facility for the MINDACT trial, which is testing the clinical utility of the Mammaprint 70-gene signature. Since then, BCRF has become a recurrent funding source for academic BIG projects that would not otherwise be able to proceed.
The availability of BCRF funding made me think about enhancing collaboration between BIG and the US research network through the North American Breast Cancer Group (NABCG, formerly known as The Breast Cancer Intergroup). When I was training in the US, I saw how US researchers work together and the "power" they achieved together. While European organizations, like the EORTC, were doing excellent clinical research, the US groups took collaboration to another level.
At the beginning, the BIG and NABCG collaboration was quite modest. BIG and NABCG researchers met for an hour at the annual ASCO meeting to exchange ideas. Then, collaborations increased. BCRF, again, made this possible because no one wanted industry to fund these high-level strategy meetings.
Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress? 
A: It's an incredibly exciting time in breast cancer research. Our basic (laboratory) scientists have done a superb job in dissecting the mechanisms behind cancer cell survival, proliferation, and invasion/metastasis. Also, we are witnessing the development of powerful high-throughput technologies, which can give us the entire genome information of an individual and his/her tumor.
However, if we want all these advances and knowledge to benefit our patients, we will need to fundamentally revolutionize the way we conduct research. Personalized medicine is our goal, but it is one that I believe is still in the future. One of the reasons is that our translational research programs - bringing insights and progress made in the laboratory to the patient's bedside - have lacked ambition and are inefficient. For example, in the current process, we look at the possible significance of one gene in tumor behavior, but a tumor relies on a complex signaling network! Also, the publication process is extremely slow.
The next step is for us is to make the best of the precious tumor samples that our patients generously give us. We need to start sharing these samples and data much sooner, especially now that the technology can give so much data on a single tumor.
The human genome was sequenced quickly because of the fantastic collaboration among all the scientists. This kind of teamwork is the only way for us to move away from the very empirical way we practice today towards something that can be really called personalized oncology.
Q: What direction(s)/trends do you see emerging in breast cancer research in the next ten years?
A: Wider and stronger collaboration will become even more important in the future than in the last three decades. New technologies are helping us better understand the complexity of breast cancer. We now know that "breast cancer" is five or six different diseases. As a result, we should no longer design studies for all breast cancer patients but for subpopulations of them. Because these studies will apply to small percentages of women sharing certain common profiles in their tumors, joining forces will be even more critical to progress.
The second thing is that we will need to do a much better job in designing studies. We need to be more ambitious in terms of what we want to achieve: not just look at the particular characteristics of each tumor, but also analyze the blood of our patients, look at their circulating tumor cells and analyze their genetic background. Translational research programs will become more complex and more ambitious. Again, this means more collaboration because ambitious translational research is expensive, so all of us will need to share expertise.
Q: What other projects are you currently working on? 
A: Currently, BIG has two important initiatives. We continue running large clinical trials that are going to make important new drugs available to patients. We completed two large trials for the Human Epidermal growth factor Receptor 2 positive (HER2+) breast cancer subtype. Now, we are busy working on a third study, also on new anti-HER2 agent. These large trials aim to improve patient outcome and to help determine who would benefit the most from the new intervention, so we spend a lot of efforts in designing good translational research programs.
Q: How close are we to preventing and curing all forms of breast cancer? 
A: I wish I could say that we are close. The form of breast cancer that we are not too far from "curing" is the HER2+ subtype, for which we have witnessed the development of six or seven new drugs, two or three of which are very advanced. The first results of the use of two anti-HER2 drugs given in combination, which were reported at the December 2010 San Antonio conference, are very, very promising because in some patients the tumor disappeared after receiving the two anti-HER2 drugs even before chemotherapy.
This is fascinating! So, I think that if we do the right things, design the right trials, and collaborate together, it may be possible over the next decade to cure 99% of the HER2+ cases. For the other subtypes, we still have major challenges ahead, so I'm a bit less optimistic.
Q: In your opinion, how has BCRF impacted breast cancer research? 
A: What I like about BCRF is its desire to support innovation. BCRF does not do just what others do. This openness encourages innovation and "new thinking," which is so important to progress. Also, BCRF's reporting requirements, unlike other organizations', are extremely reasonable. Some organizations require us to produce a 150-page document, which is counterproductive since you have to stop research for one month just to write a report! On top of that, the way we are treated is unique to BCRF. We have a gathering once a year where we get to interact on many levels and meet the donors who support our work. It's something I've never experienced anywhere else.
 
Read more about Dr. Piccart-Gebhart's current research project funded by BCRF. 
 

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Martine Piccart-Gebhart to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Martine Piccart-Gebhart to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. Martine Piccart-Gebhart to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: My father, whom I admired very much, was a gynecologist, so I became interested in medicine very early. Then, when I was a teenager, my uncle developed colon cancer. I visited him at Jules Bordet Institute, where I now work, and an inexplicable feeling came over me when I walked into the hospital. Later on, I made these same trips to visit my mother, who developed breast cancer during the second year of my training in oncology. Her illness was a great motivation for me to become more interested in breast cancer.

Q: Describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: I have devoted a lot of time and effort into the founding and activities of the Breast International Group (BIG), an international consortium of research groups outside the US. The genesis of the group was the huge problem faced by European researchers, a problem which did not exist in the US until very recently. That is, there is virtually no government funding for clinical trials, making us European researchers highly dependent on the pharmaceutical industry.

In addition, we researchers want to answer questions that are of high interest to patients and clinicians, but not to drug companies. For instance, we wanted to launch a trial called MINDACT, studying chemotherapy over-treatment, because there are patients who could gain the same level of therapeutic benefits from endocrine therapy alone without adding chemotherapy. It was very difficult to get funding for this study. Although we did get a significant grant from the European Union, it was not enough to cover the entire trial. Fortunately, Dr. Larry Norton was familiar with BIG and the frustrations that our research community faced. BCRF support helped to set up the biobanking facility for the MINDACT trial, which is testing the clinical utility of the Mammaprint 70-gene signature. Since then, BCRF has become a recurrent funding source for academic BIG projects that would not otherwise be able to proceed.

The availability of BCRF funding made me think about enhancing collaboration between BIG and the US research network through the North American Breast Cancer Group (NABCG, formerly known as The Breast Cancer Intergroup). When I was training in the US, I saw how US researchers work together and the "power" they achieved together. While European organizations, like the EORTC, were doing excellent clinical research, the US groups took collaboration to another level.

At the beginning, the BIG and NABCG collaboration was quite modest. BIG and NABCG researchers met for an hour at the annual ASCO meeting to exchange ideas. Then, collaborations increased. BCRF, again, made this possible because no one wanted industry to fund these high-level strategy meetings.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: It's an incredibly exciting time in breast cancer research. Our basic (laboratory) scientists have done a superb job in dissecting the mechanisms behind cancer cell survival, proliferation, and invasion/metastasis. Also, we are witnessing the development of powerful high-throughput technologies, which can give us the entire genome information of an individual and his/her tumor.

However, if we want all these advances and knowledge to benefit our patients, we will need to fundamentally revolutionize the way we conduct research. Personalized medicine is our goal, but it is one that I believe is still in the future. One of the reasons is that our translational research programs - bringing insights and progress made in the laboratory to the patient's bedside - have lacked ambition and are inefficient. For example, in the current process, we look at the possible significance of one gene in tumor behavior, but a tumor relies on a complex signaling network! Also, the publication process is extremely slow.

The next step is for us is to make the best of the precious tumor samples that our patients generously give us. We need to start sharing these samples and data much sooner, especially now that the technology can give so much data on a single tumor.

The human genome was sequenced quickly because of the fantastic collaboration among all the scientists. This kind of teamwork is the only way for us to move away from the very empirical way we practice today towards something that can be really called personalized oncology.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next ten years?

A: Wider and stronger collaboration will become even more important in the future than in the last three decades. New technologies are helping us better understand the complexity of breast cancer. We now know that "breast cancer" is five or six different diseases. As a result, we should no longer design studies for all breast cancer patients but for subpopulations of them. Because these studies will apply to small percentages of women sharing certain common profiles in their tumors, joining forces will be even more critical to progress.

The second thing is that we will need to do a much better job in designing studies. We need to be more ambitious in terms of what we want to achieve: not just look at the particular characteristics of each tumor, but also analyze the blood of our patients, look at their circulating tumor cells and analyze their genetic background. Translational research programs will become more complex and more ambitious. Again, this means more collaboration because ambitious translational research is expensive, so all of us will need to share expertise.

Q: What other projects are you currently working on?

A: Currently, BIG has two important initiatives. We continue running large clinical trials that are going to make important new drugs available to patients. We completed two large trials for the Human Epidermal growth factor Receptor 2 positive (HER2+) breast cancer subtype. Now, we are busy working on a third study, also on new anti-HER2 agent. These large trials aim to improve patient outcome and to help determine who would benefit the most from the new intervention, so we spend a lot of efforts in designing good translational research programs.

Q: How close are we to preventing and curing all forms of breast cancer?

A: I wish I could say that we are close. The form of breast cancer that we are not too far from "curing" is the HER2+ subtype, for which we have witnessed the development of six or seven new drugs, two or three of which are very advanced. The first results of the use of two anti-HER2 drugs given in combination, which were reported at the December 2010 San Antonio conference, are very, very promising because in some patients the tumor disappeared after receiving the two anti-HER2 drugs even before chemotherapy.

This is fascinating! So, I think that if we do the right things, design the right trials, and collaborate together, it may be possible over the next decade to cure 99% of the HER2+ cases. For the other subtypes, we still have major challenges ahead, so I'm a bit less optimistic.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: What I like about BCRF is its desire to support innovation. BCRF does not do just what others do. This openness encourages innovation and "new thinking," which is so important to progress. Also, BCRF's reporting requirements, unlike other organizations', are extremely reasonable. Some organizations require us to produce a 150-page document, which is counterproductive since you have to stop research for one month just to write a report! On top of that, the way we are treated is unique to BCRF. We have a gathering once a year where we get to interact on many levels and meet the donors who support our work. It's something I've never experienced anywhere else.

Read more about Dr. Piccart-Gebhart's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Martine Piccart-Gebhart to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research.

A: My father, whom I admired very much, was a gynecologist, so I became interested in medicine very early. Then, when I was a teenager, my uncle developed colon cancer. I visited him at Jules Bordet Institute, where I now work, and an inexplicable feeling came over me when I walked into the hospital. Later on, I made these same trips to visit my mother, who developed breast cancer during the second year of my training in oncology. Her illness was a great motivation for me to become more interested in breast cancer.

Q: Describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: I have devoted a lot of time and effort into the founding and activities of the Breast International Group (BIG), an international consortium of research groups outside the US. The genesis of the group was the huge problem faced by European researchers, a problem which did not exist in the US until very recently. That is, there is virtually no government funding for clinical trials, making us European researchers highly dependent on the pharmaceutical industry.

In addition, we researchers want to answer questions that are of high interest to patients and clinicians, but not to drug companies. For instance, we wanted to launch a trial called MINDACT, studying chemotherapy over-treatment, because there are patients who could gain the same level of therapeutic benefits from endocrine therapy alone without adding chemotherapy. It was very difficult to get funding for this study. Although we did get a significant grant from the European Union, it was not enough to cover the entire trial. Fortunately, Dr. Larry Norton was familiar with BIG and the frustrations that our research community faced. BCRF support helped to set up the biobanking facility for the MINDACT trial, which is testing the clinical utility of the Mammaprint 70-gene signature. Since then, BCRF has become a recurrent funding source for academic BIG projects that would not otherwise be able to proceed.

The availability of BCRF funding made me think about enhancing collaboration between BIG and the US research network through the North American Breast Cancer Group (NABCG, formerly known as The Breast Cancer Intergroup). When I was training in the US, I saw how US researchers work together and the "power" they achieved together. While European organizations, like the EORTC, were doing excellent clinical research, the US groups took collaboration to another level.

At the beginning, the BIG and NABCG collaboration was quite modest. BIG and NABCG researchers met for an hour at the annual ASCO meeting to exchange ideas. Then, collaborations increased. BCRF, again, made this possible because no one wanted industry to fund these high-level strategy meetings.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: It's an incredibly exciting time in breast cancer research. Our basic (laboratory) scientists have done a superb job in dissecting the mechanisms behind cancer cell survival, proliferation, and invasion/metastasis. Also, we are witnessing the development of powerful high-throughput technologies, which can give us the entire genome information of an individual and his/her tumor.

However, if we want all these advances and knowledge to benefit our patients, we will need to fundamentally revolutionize the way we conduct research. Personalized medicine is our goal, but it is one that I believe is still in the future. One of the reasons is that our translational research programs - bringing insights and progress made in the laboratory to the patient's bedside - have lacked ambition and are inefficient. For example, in the current process, we look at the possible significance of one gene in tumor behavior, but a tumor relies on a complex signaling network! Also, the publication process is extremely slow.

The next step is for us is to make the best of the precious tumor samples that our patients generously give us. We need to start sharing these samples and data much sooner, especially now that the technology can give so much data on a single tumor.

The human genome was sequenced quickly because of the fantastic collaboration among all the scientists. This kind of teamwork is the only way for us to move away from the very empirical way we practice today towards something that can be really called personalized oncology.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next ten years?

A: Wider and stronger collaboration will become even more important in the future than in the last three decades. New technologies are helping us better understand the complexity of breast cancer. We now know that "breast cancer" is five or six different diseases. As a result, we should no longer design studies for all breast cancer patients but for subpopulations of them. Because these studies will apply to small percentages of women sharing certain common profiles in their tumors, joining forces will be even more critical to progress.

The second thing is that we will need to do a much better job in designing studies. We need to be more ambitious in terms of what we want to achieve: not just look at the particular characteristics of each tumor, but also analyze the blood of our patients, look at their circulating tumor cells and analyze their genetic background. Translational research programs will become more complex and more ambitious. Again, this means more collaboration because ambitious translational research is expensive, so all of us will need to share expertise.

Q: What other projects are you currently working on?

A: Currently, BIG has two important initiatives. We continue running large clinical trials that are going to make important new drugs available to patients. We completed two large trials for the Human Epidermal growth factor Receptor 2 positive (HER2+) breast cancer subtype. Now, we are busy working on a third study, also on new anti-HER2 agent. These large trials aim to improve patient outcome and to help determine who would benefit the most from the new intervention, so we spend a lot of efforts in designing good translational research programs.

Q: How close are we to preventing and curing all forms of breast cancer?

A: I wish I could say that we are close. The form of breast cancer that we are not too far from "curing" is the HER2+ subtype, for which we have witnessed the development of six or seven new drugs, two or three of which are very advanced. The first results of the use of two anti-HER2 drugs given in combination, which were reported at the December 2010 San Antonio conference, are very, very promising because in some patients the tumor disappeared after receiving the two anti-HER2 drugs even before chemotherapy.

This is fascinating! So, I think that if we do the right things, design the right trials, and collaborate together, it may be possible over the next decade to cure 99% of the HER2+ cases. For the other subtypes, we still have major challenges ahead, so I'm a bit less optimistic.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: What I like about BCRF is its desire to support innovation. BCRF does not do just what others do. This openness encourages innovation and "new thinking," which is so important to progress. Also, BCRF's reporting requirements, unlike other organizations', are extremely reasonable. Some organizations require us to produce a 150-page document, which is counterproductive since you have to stop research for one month just to write a report! On top of that, the way we are treated is unique to BCRF. We have a gathering once a year where we get to interact on many levels and meet the donors who support our work. It's something I've never experienced anywhere else.

Read more about Dr. Piccart-Gebhart's current research project funded by BCRF.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Kornelia Polyak to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Kornelia Polyak to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Kornelia Polyak to discuss her current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Kornelia Polyak to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I have always loved science. As a child in Hungary, I always wanted to do experiments, so from very early on I was hooked on science and medicine. I was fortunate to have wonderful teachers who encouraged this, and by high school I pretty much knew I wanted to do cancer research. I was really good in math and science but I wanted to do something applied and I was also I really wanted to be a doctor. But when I went to medical school, I felt frustrated with many things-sometimes you cannot help people because you don't have enough knowledge or you don't have good medicines that can cure your patients. That's why I decided that I wanted to do medical research: to find better ways to treat people. I feel like I could help more people this way. And I decided to focus on breast cancer in particular after completing my post-doctoral training at Johns Hopkins.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: Our BCRF-funded research focuses on understanding heterogeneity (in other words, differences) in breast cancer, specifically heterogeneity within a tumor. We know a tumor is not composed of one type of cancer cell with the same features but of many different types of cells. And the problem is that the more different types of cancer cells there are within a tumor, the more likely this cancer will progress and be able to resist treatments. Current drugs are capable of targeting only some types of cancer cells at a time, but not yet multiple ones. We are studying tumor heterogeneity in patient samples collected during the course of these individuals' treatments.

We are trying to understand how tumors "evolve" in response to treatment and how we may be able to predict which cancer cells will be the resistant ones, so that we can design better treatment strategies based on this knowledge. For example, if you apply a tumor with drug A, the cancer cells that are resistant to the drug will survive and continue to grow. So, the tumor evolves. If at the time of diagnosis, we know all the types of cancer cells that are within a tumor and can predict which cells may not respond to treatment, we could potentially prevent therapy resistance by prescribing a different or an additional drug. Evolution in the tumor also includes turning from localized disease to metastatic disease.

At the same time, we are also experimenting with breast cancer models to try to understand the functional relevance of heterogeneity. Why is there a particular combination of cancer cells in a tumor? Is it because cancer cells talk to each other and particular combinations of cells prefer to grow together, and so on? We are also trying to understand why that is and how we could again exploit this knowledge to better treat cancers. Maybe if we understand the communication among the cancer cells within a tumor, then we can interrupt this communication in addition to killing the particularly bad type of cancer cells. So that is our goal-- basically to develop better ways to predict the evolution of the tumor and also to prevent this evolution, particularly treatment resistance and metastatic progression.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advances can help to enhance your progress?

A: Improvements in technologies that have advanced tremendously over the past two years are now allowing us to assess many characteristics of the tumor, even in individual cancer cells in situ. The older technologies allow us to look sections of cells. We would grind up a tumor, let's say even a small tumor of 1 cm size, and we would be able to get only the average of what is in the tumor. The technologies now allow us to sequence the whole genome of a single cancer cell or determine the genes expressed in a particular cell. That certainly seems extremely useful because we can get really in-depth understanding of the tumor's composition. So, instead of just looking at the average, we now are looking at what are those individual cancer cells that give rise to the tumor. These single cell studies could enhance our understanding of heterogeneity.

Another thing we do is integrating different types of science in our work. For example, we conduct molecular studies but we collaborate with mathematicians and even physicists on looking at the evolution of the tumor. We use mathematical models to predict the evolution and use the same kind of equations used in ecology to look at evolution of an ecosystem. We integrate these disciplines to help us better understand cancers.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: On the positive side, more and more, we are trying to individualize therapy for everyone. I have a somewhat science fiction point of view, which hopefully will not be science fiction much longer. What I picture is this: when a patient is diagnosed with cancer, we would be able to assess her tumor in-depth, at the single cell level. Then, we could put the tumor's characteristics into a computer. Next, based on the computational models we have built and are building, we would be able to simulate what happens to the tumor using various treatment options. These simulations would help us determine the best option for this particular patient. It may sound like science fiction, but there are already computer programs that do this in a much less sophisticated way, and I think if we develop this potential, then individualizing therapy will advance even more. As we know more about the behaviors of the tumors and the probable behaviors of the tumors in response to therapies, while simultaneously continue to develop more and more effective treatments, then we can truly individualize and tailor treatment for patients. I think this will be happening more and more in the next five to ten years.

An issue that worries me and others in the science community is the future of research. We need to make sure that we do not lose the next generation of researchers. The situation with significantly reduced federal funding is scaring many young trainees from an academic research career. Even our lab, arguably one of the best in breast cancer research, has received rejections in the last two years from the National Institutes of Health (NIH) because it has reduced funding to only 5% of the research projects submitted for review. This trend is not sustainable. Most labs cannot survive this lack of funding. If young trainees are seeing that even the more senior, established labs have difficulties getting funding, then they question how could they even go into this field.

Also, training for a scientific research career takes 10 to 15 years. So if you are discouraging college and graduate students from staying in academic medicine, you cannot quickly reverse this loss of human capital. This "brain drain" is not going to be good for academic research or for the country in general. The lack of funding is also pushing many agencies now to plan very formulaic research, or "safer" projects, that appeals to conventional funding mechanisms. This trend is worrisome because "playing safe" may impede, rather than enhance, progress. This situation is happening not only in laboratory science but also in clinical research. There is a huge demand for physician-scientists, and there needs to be additional support mechanisms to ensure that the young, best and brightest, and most enthusiastic people do not get discouraged. This is a situation that is unfortunately not getting enough attention.

Q: What other projects are you currently working on?

A: Our lab is working on two other major areas. One is to understand why women get breast cancer and how we can prevent it. While I want to treat breast cancer, ideally I would prefer to prevent it. To do this, we are studying the normal breast tissue of women who have high risk of breast cancer, for example BRCA1 and BRCA2 mutation carriers or women who have not had children. We are trying to understand the difference between the normal breast tissues of someone at low risk of breast cancer versus that of someone at high risk and how we could change this risk. We are very excited about what we have found in our studies so far. It appears that some cell types seem to be more frequent in women at higher risk of breast cancer, and these cells divide and act kind of like progenitor cells (or stem cells) in the breast. The reason why we are excited about these findings is because we also have ways to eliminate these cells. So theoretically, if you could eliminate these cells, then you could also reduce the risk of breast cancer and maybe even prevent it.

Another area our lab focuses on is epigenetics, in particular focusing on triple negative disease. Many tumors have very few genetic changes. The recent whole genome sequencing of tumors showed that particularly in some bad types of breast cancer, like triple negative disease, there are not too many mutations that we could target with therapies. Epigenetics is looking not just at the genetic alterations in the tumors but also other changes. Epigenetic regulations are basically what determines the function of a cell and whether it becomes a differentiated cell or not, and these regulations frequently to go wrong in cancer. Cancer cells seem to lose their "identity" in a way and become whatever they want. We are trying to understand what is supposed to go on in a cell during its normal development and then what are the abnormalities, such as particular proteins breaking or not doing their specific function, which take place instead and turn normal cells into cancer. We are also trying to see if these epigenetic changes can be targeted through drugs.

Q: How close are we to preventing and curing all forms of breast cancer?

A: We are very excited about the project on normal breast tissue in high risk women, because if we are correct about these cells-of-origin of breast cancer and if we have ways to eliminate these cells, then we could potentially prevent breast cancer. And this prevention would not involve continuous and highly toxic treatments, but possibly doing a type of treatment that mimics pregnancy. We are doing additional studies along these lines on larger cohorts of women. While prevention studies are always difficult to prove, I am optimistic that an approach like this could be done in the next decade or so.

In terms of cure, I do not know if we can ever cure all forms of breast cancer. However, I do think that many cases of breast cancer are curable now. I am optimistic that with the new knowledge we have and will continue to accumulate on heterogeneity and epigenetic targets, we will have major advances in five to ten years, even for the hard-to-treat types of breast cancer, such as triple negative disease and inflammatory breast cancer. I tend to be optimistic and I really want to believe that we will have major advances soon.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has been a major supporter of many researchers who focus on breast cancer and has been really helping the field tremendously. BCRF funding enables us to take on risky projects for which it would be very difficult to obtain conventional government grants, especially now. And BCRF allows us to test ideas, really exciting new ideas. I think it is kind of ironic that while the goal of research should always be to test new ideas, it is difficult to find funding sources for this.

BCRF has been really great, also because it supports individuals who have a proven track record of solving problems in research and are committed to breast cancer, instead of very specific projects. I think this is the way that research in general should be funded, but it is not. I know everybody who is part of the BCRF family is truly thankful to be part of it.

Read more about Dr. Polyak's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Kornelia Polyak to discuss her current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I have always loved science. As a child in Hungary, I always wanted to do experiments, so from very early on I was hooked on science and medicine. I was fortunate to have wonderful teachers who encouraged this, and by high school I pretty much knew I wanted to do cancer research. I was really good in math and science but I wanted to do something applied and I was also I really wanted to be a doctor. But when I went to medical school, I felt frustrated with many things-sometimes you cannot help people because you don't have enough knowledge or you don't have good medicines that can cure your patients. That's why I decided that I wanted to do medical research: to find better ways to treat people. I feel like I could help more people this way. And I decided to focus on breast cancer in particular after completing my post-doctoral training at Johns Hopkins.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: Our BCRF-funded research focuses on understanding heterogeneity (in other words, differences) in breast cancer, specifically heterogeneity within a tumor. We know a tumor is not composed of one type of cancer cell with the same features but of many different types of cells. And the problem is that the more different types of cancer cells there are within a tumor, the more likely this cancer will progress and be able to resist treatments. Current drugs are capable of targeting only some types of cancer cells at a time, but not yet multiple ones. We are studying tumor heterogeneity in patient samples collected during the course of these individuals' treatments.

We are trying to understand how tumors "evolve" in response to treatment and how we may be able to predict which cancer cells will be the resistant ones, so that we can design better treatment strategies based on this knowledge. For example, if you apply a tumor with drug A, the cancer cells that are resistant to the drug will survive and continue to grow. So, the tumor evolves. If at the time of diagnosis, we know all the types of cancer cells that are within a tumor and can predict which cells may not respond to treatment, we could potentially prevent therapy resistance by prescribing a different or an additional drug. Evolution in the tumor also includes turning from localized disease to metastatic disease.

At the same time, we are also experimenting with breast cancer models to try to understand the functional relevance of heterogeneity. Why is there a particular combination of cancer cells in a tumor? Is it because cancer cells talk to each other and particular combinations of cells prefer to grow together, and so on? We are also trying to understand why that is and how we could again exploit this knowledge to better treat cancers. Maybe if we understand the communication among the cancer cells within a tumor, then we can interrupt this communication in addition to killing the particularly bad type of cancer cells. So that is our goal-- basically to develop better ways to predict the evolution of the tumor and also to prevent this evolution, particularly treatment resistance and metastatic progression.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advances can help to enhance your progress?

A: Improvements in technologies that have advanced tremendously over the past two years are now allowing us to assess many characteristics of the tumor, even in individual cancer cells in situ. The older technologies allow us to look sections of cells. We would grind up a tumor, let's say even a small tumor of 1 cm size, and we would be able to get only the average of what is in the tumor. The technologies now allow us to sequence the whole genome of a single cancer cell or determine the genes expressed in a particular cell. That certainly seems extremely useful because we can get really in-depth understanding of the tumor's composition. So, instead of just looking at the average, we now are looking at what are those individual cancer cells that give rise to the tumor. These single cell studies could enhance our understanding of heterogeneity.

Another thing we do is integrating different types of science in our work. For example, we conduct molecular studies but we collaborate with mathematicians and even physicists on looking at the evolution of the tumor. We use mathematical models to predict the evolution and use the same kind of equations used in ecology to look at evolution of an ecosystem. We integrate these disciplines to help us better understand cancers.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: On the positive side, more and more, we are trying to individualize therapy for everyone. I have a somewhat science fiction point of view, which hopefully will not be science fiction much longer. What I picture is this: when a patient is diagnosed with cancer, we would be able to assess her tumor in-depth, at the single cell level. Then, we could put the tumor's characteristics into a computer. Next, based on the computational models we have built and are building, we would be able to simulate what happens to the tumor using various treatment options. These simulations would help us determine the best option for this particular patient. It may sound like science fiction, but there are already computer programs that do this in a much less sophisticated way, and I think if we develop this potential, then individualizing therapy will advance even more. As we know more about the behaviors of the tumors and the probable behaviors of the tumors in response to therapies, while simultaneously continue to develop more and more effective treatments, then we can truly individualize and tailor treatment for patients. I think this will be happening more and more in the next five to ten years.

An issue that worries me and others in the science community is the future of research. We need to make sure that we do not lose the next generation of researchers. The situation with significantly reduced federal funding is scaring many young trainees from an academic research career. Even our lab, arguably one of the best in breast cancer research, has received rejections in the last two years from the National Institutes of Health (NIH) because it has reduced funding to only 5% of the research projects submitted for review. This trend is not sustainable. Most labs cannot survive this lack of funding. If young trainees are seeing that even the more senior, established labs have difficulties getting funding, then they question how could they even go into this field.

Also, training for a scientific research career takes 10 to 15 years. So if you are discouraging college and graduate students from staying in academic medicine, you cannot quickly reverse this loss of human capital. This "brain drain" is not going to be good for academic research or for the country in general. The lack of funding is also pushing many agencies now to plan very formulaic research, or "safer" projects, that appeals to conventional funding mechanisms. This trend is worrisome because "playing safe" may impede, rather than enhance, progress. This situation is happening not only in laboratory science but also in clinical research. There is a huge demand for physician-scientists, and there needs to be additional support mechanisms to ensure that the young, best and brightest, and most enthusiastic people do not get discouraged. This is a situation that is unfortunately not getting enough attention.

Q: What other projects are you currently working on?

A: Our lab is working on two other major areas. One is to understand why women get breast cancer and how we can prevent it. While I want to treat breast cancer, ideally I would prefer to prevent it. To do this, we are studying the normal breast tissue of women who have high risk of breast cancer, for example BRCA1 and BRCA2 mutation carriers or women who have not had children. We are trying to understand the difference between the normal breast tissues of someone at low risk of breast cancer versus that of someone at high risk and how we could change this risk. We are very excited about what we have found in our studies so far. It appears that some cell types seem to be more frequent in women at higher risk of breast cancer, and these cells divide and act kind of like progenitor cells (or stem cells) in the breast. The reason why we are excited about these findings is because we also have ways to eliminate these cells. So theoretically, if you could eliminate these cells, then you could also reduce the risk of breast cancer and maybe even prevent it.

Another area our lab focuses on is epigenetics, in particular focusing on triple negative disease. Many tumors have very few genetic changes. The recent whole genome sequencing of tumors showed that particularly in some bad types of breast cancer, like triple negative disease, there are not too many mutations that we could target with therapies. Epigenetics is looking not just at the genetic alterations in the tumors but also other changes. Epigenetic regulations are basically what determines the function of a cell and whether it becomes a differentiated cell or not, and these regulations frequently to go wrong in cancer. Cancer cells seem to lose their "identity" in a way and become whatever they want. We are trying to understand what is supposed to go on in a cell during its normal development and then what are the abnormalities, such as particular proteins breaking or not doing their specific function, which take place instead and turn normal cells into cancer. We are also trying to see if these epigenetic changes can be targeted through drugs.

Q: How close are we to preventing and curing all forms of breast cancer?

A: We are very excited about the project on normal breast tissue in high risk women, because if we are correct about these cells-of-origin of breast cancer and if we have ways to eliminate these cells, then we could potentially prevent breast cancer. And this prevention would not involve continuous and highly toxic treatments, but possibly doing a type of treatment that mimics pregnancy. We are doing additional studies along these lines on larger cohorts of women. While prevention studies are always difficult to prove, I am optimistic that an approach like this could be done in the next decade or so.

In terms of cure, I do not know if we can ever cure all forms of breast cancer. However, I do think that many cases of breast cancer are curable now. I am optimistic that with the new knowledge we have and will continue to accumulate on heterogeneity and epigenetic targets, we will have major advances in five to ten years, even for the hard-to-treat types of breast cancer, such as triple negative disease and inflammatory breast cancer. I tend to be optimistic and I really want to believe that we will have major advances soon.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has been a major supporter of many researchers who focus on breast cancer and has been really helping the field tremendously. BCRF funding enables us to take on risky projects for which it would be very difficult to obtain conventional government grants, especially now. And BCRF allows us to test ideas, really exciting new ideas. I think it is kind of ironic that while the goal of research should always be to test new ideas, it is difficult to find funding sources for this.

BCRF has been really great, also because it supports individuals who have a proven track record of solving problems in research and are committed to breast cancer, instead of very specific projects. I think this is the way that research in general should be funded, but it is not. I know everybody who is part of the BCRF family is truly thankful to be part of it.

Read more about Dr. Polyak's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Kornelia Polyak to discuss her current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. George W. Sledge to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. George W. Sledge to discuss his current work and interest in breast cancer research. Read on to learn more.
 
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. George W. Sledge to discuss his current work and interest in breast cancer research. Read on to learn more.
 
 
Q: Tell us a little about yourself and how you became interested in breast cancer research.

# data[].attributes.body.value
BCRF sat down with Dr. George W. Sledge to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I became interested in breast cancer research by training with a breast cancer researcher, Dr. Bill McGuire, during my oncology fellowship at the University of Texas at San Antonio. Dr. McGuire was a giant in early research involving both steroid receptors and the development of prognostic factors. He taught me, at an early point in my career, that biology should drive therapy in breast cancer. It was a lesson that has been extremely valuable to me in my work.

Q: Briefly describe your research project.

A: My BCRF funded research has focused on the general area of angiogenesis and anti-angiogenic therapy. We have known for many years, largely through the work of BCRF-funded investigator Dr. Judah Folkman, that new blood vessel formation was a crucial element in the growth and metastasis of breast cancer. In the past decade our group has used this crucial observation as the basis for studying anti-angiogenic therapy as a new therapy for patients with breast cancer. In the laboratory, we investigated combinations of anti-angiogenic agents with standard therapies. We applied the lessons we learned in the laboratory to the clinic in a series of clinical trials culminating in ECOG trial E2100, which demonstrated that anti-angiogenic therapy significantly affected treatment outcome for patients with advanced breast cancer. We have subsequently built on this study by using BCRF funding to examine which patients benefit from anti-angiogenic therapy, as well as to develop new strategies to overcome the cancer's resistance to these therapies.

Q: What are your primary goals for this research?

A: Our primary goals are a) to develop effective treatments for women with breast cancer using agents that target blood vessels; b) to determine who benefits from these agents; and c) to develop new strategies that overcome resistance to anti-angiogenic agents.

Q: Who do you think will benefit from your research?

A: Because new blood vessel formation (angiogenesis) is a central hallmark of the biology of breast cancer, and because the target (host blood vessel cells) are found in all breast tumors, we predict that all women with invasive breast cancers might potentially benefit from anti-angiogenic therapies.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: Our work has changed significantly over the years. When we first began, we did not know whether anti-angiogenic therapy would work in the clinic. There were no proof-of-concept clinical trials available, and widespread skepticism regarding the potential benefits of anti-angiogenic therapy. These initial hurdles have been overcome through the successful completion of trials such as E2100. It is important to emphasize that the crucial step forward in breast cancer, the E2100 trial, was based on research performed in the laboratory with BCRF funding-a perfect example of how the flexibility provided to BCRF investigators can have important results. We have now moved on to face other important challenges. We want to make anti-angiogenic therapy targeted therapy. Because all agents have winners and losers from a therapeutic standpoint, and because these agents are expensive and not without toxicity, we want to find ways of focusing our best efforts on those most likely to benefit. Similarly, we want to discover why therapy fails and how we might reverse these therapeutic failures.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: We will find multiple cures for breast cancer, because there are multiple types of breast cancer.

Read more about Dr. Sledge's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. George W. Sledge to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us a little about yourself and how you became interested in breast cancer research.

A: I became interested in breast cancer research by training with a breast cancer researcher, Dr. Bill McGuire, during my oncology fellowship at the University of Texas at San Antonio. Dr. McGuire was a giant in early research involving both steroid receptors and the development of prognostic factors. He taught me, at an early point in my career, that biology should drive therapy in breast cancer. It was a lesson that has been extremely valuable to me in my work.

Q: Briefly describe your research project.

A: My BCRF funded research has focused on the general area of angiogenesis and anti-angiogenic therapy. We have known for many years, largely through the work of BCRF-funded investigator Dr. Judah Folkman, that new blood vessel formation was a crucial element in the growth and metastasis of breast cancer. In the past decade our group has used this crucial observation as the basis for studying anti-angiogenic therapy as a new therapy for patients with breast cancer. In the laboratory, we investigated combinations of anti-angiogenic agents with standard therapies. We applied the lessons we learned in the laboratory to the clinic in a series of clinical trials culminating in ECOG trial E2100, which demonstrated that anti-angiogenic therapy significantly affected treatment outcome for patients with advanced breast cancer. We have subsequently built on this study by using BCRF funding to examine which patients benefit from anti-angiogenic therapy, as well as to develop new strategies to overcome the cancer's resistance to these therapies.

Q: What are your primary goals for this research?

A: Our primary goals are a) to develop effective treatments for women with breast cancer using agents that target blood vessels; b) to determine who benefits from these agents; and c) to develop new strategies that overcome resistance to anti-angiogenic agents.

Q: Who do you think will benefit from your research?

A: Because new blood vessel formation (angiogenesis) is a central hallmark of the biology of breast cancer, and because the target (host blood vessel cells) are found in all breast tumors, we predict that all women with invasive breast cancers might potentially benefit from anti-angiogenic therapies.

Q: How has your research focus changed since your first BCRF grant, and how would you say that our grants have had an impact on your work and the field?

A: Our work has changed significantly over the years. When we first began, we did not know whether anti-angiogenic therapy would work in the clinic. There were no proof-of-concept clinical trials available, and widespread skepticism regarding the potential benefits of anti-angiogenic therapy. These initial hurdles have been overcome through the successful completion of trials such as E2100. It is important to emphasize that the crucial step forward in breast cancer, the E2100 trial, was based on research performed in the laboratory with BCRF funding-a perfect example of how the flexibility provided to BCRF investigators can have important results. We have now moved on to face other important challenges. We want to make anti-angiogenic therapy targeted therapy. Because all agents have winners and losers from a therapeutic standpoint, and because these agents are expensive and not without toxicity, we want to find ways of focusing our best efforts on those most likely to benefit. Similarly, we want to discover why therapy fails and how we might reverse these therapeutic failures.

Q: How close do you think we are to preventing or finding a cure for breast cancer?

A: We will find multiple cures for breast cancer, because there are multiple types of breast cancer.

Read more about Dr. Sledge's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. George W. Sledge to discuss his current work and interest in breast cancer research. Read on to learn more. 

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Ian E. Smith to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Ian E. Smith to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Ian E. Smith to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Ian E. Smith to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I decided at a fairly early age that I wanted to go into medicine. I trained at the University of Edinburgh, where I sometimes had to look after patients with leukemias or lymphomas. Cancer became an absolutely fascinating challenge to me. From that experience, I decided to go to the Royal Marsden Hospital in London, which is the main and one of the very few stand-alone cancer hospitals in the UK. For me, as a young doctor, the Royal Marsden was an extraordinary stimulus, because there I found clinicians not only treating cancer but also working alongside scientists in laboratories on the same campus. I remember we used to sit together in the evenings and talk about the challenges of cancer treatment and the underlying biology. That was when I decided that I wanted to be a cancer specialist and to take a scientific approach working with scientists to tackle what were very challenging problems.

Now, did I consider any another profession? The answer is "Not really." I had considered studying English literature, which I enjoy very much, but I did not have a very good answer for what I would want to do after graduation. And that was why I went into medicine, because then my path was much clearer.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: My interest in my current BCRF work really began more than 20 years ago, long before the Foundation was formed, when we started doing what is called "neoadjuvant" chemotherapy, or chemotherapy before surgery, for large breast cancers. We use that approach to try to shrink tumors so that mastectomy can be avoided. We did pioneering work on neoadjuvant chemotherapy at the Royal Marsden and then began applying the same approach with endocrine therapy, using tamoxifen and subsequently aromatase inhibitors including in particular letrozole. And we saw some excellent clinical results with good tumor regressions. But what really began to interest me was how we could predict in advance which patients were going to benefit from treatment in the long term. Clinical measurement, we discovered, was a rather crude, inaccurate tool. So, working with my laboratory colleagues, we began to look at molecular markers, also called biomarkers, and particularly Ki67, which measures proliferation. A molecular marker is a biochemical test on a tumor that helps to characterize some aspect of its behavior. There are prognostic and predictive molecular markers. A prognostic marker helps to define a cancer's characteristics and its outlook, whether it is likely to behave in an aggressive or an indolent fashion. But what I think is more interesting and more important clinically are predictive markers, which tell you whether a cancer is going to respond to a treatment or not. The best example of a predictive marker is the estrogen receptor. It has been known for many years that if a breast cancer is estrogen receptor-positive, as most of them are, then there is a good chance that they will respond to endocrine therapy but if they are estrogen receptor-negative, then they will not. In our work, we discovered that when you treat breast cancers with drugs, and in particular with endocrine therapy, the cells in many of these cancers stop proliferating within two weeks of starting treatment and "switch off." Therefore, we thought that measuring the change in the proliferation marker Ki67 might then give us a more accurate way of predicting which cancers were going to respond well to treatment. This has been one of the central tenets of our research and an area of research that BCRF has supported very strongly over the years.

Now, another component of my research that excites me is changing the traditional way of using these molecular markers. Standard practice dictates that you look at the molecular markers before you treat a cancer, use them to predict effectiveness of therapy, and then the surgeon removes the tumor prior to starting adjuvant medical therapy. But what we have been doing, based on our original experience with neoadjuvant treatments, is that instead of immediately removing the cancer, we start with a short course of preoperative medical endocrine treatment with tamoxifen or an aromatase inhibitor, and then remove the cancer two weeks later and look at how these molecular markers are behaving. It is our hypothesis that measuring changes in markers after treatment will predict the likelihood of the therapy working more accurately than if this test was done before beginning treatment. In other words, applying the marker test after treatment has started and after surgery gives us a measure of not just the biology of the cancer but of the sensitivity to the treatment we are using. Now if we can do that, it means that for each individual patient, you can tell very early on whether it is worth giving someone five years of an aromatase inhibitor, five years of tamoxifen, and such. Hopefully, although we are not quite so far ahead in this, we can also tell after one course of chemotherapy whether six or eight courses are going to beneficial or not, because if it is not going to work, the sooner you stop that treatment, the better. Conversely if the chemotherapy is going to be beneficial, it is so much better to be able to say to the patient, "Look, this treatment is unpleasant but we know from the molecular markers after your first course that it's going to work and we know it's got a high chance of cure." At the present, despite all the developments in cancer research, a lot of the medical treatment of early breast cancer is still guesswork. Our research is to overcome that guesswork.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: There certainly have been developments in laboratory technology and my colleagues who work in the labs are the ones to elaborate on these. But for me, what is just as important is changing the mindset on clinical strategy. We spent many years thinking that everyone with breast cancer should have a mastectomy, but it turns out that was completely wrong, and we have changed that mindset. Now we need to change the mindset again, and to have surgeons, and indeed all the team looking after patients with breast cancer, thinking of using medical treatments first rather than rushing to surgery so that we can do these predictive molecular tests. To test our hypothesis, we set up a very large trial, in fact involving the whole of the UK, called POETIC. In POETIC, we aimed to recruit 4,000 patients who would be randomized to two weeks of preoperative endocrine therapy versus going straight to surgery.

Many of our colleagues initially had said that we would not be able to do the POETIC study on a large scale. They said that you could do this at a specialist cancer center but to make this trial work on a larger scale, you have to change the mindset of nearly all the surgeons in the land. And the really exciting thing is that trial has worked extremely well. We have now reached our targeted recruitment of 4,000 patients. In the UK, we have caused a change in the whole mindset, a change in the attitude to approaching breast cancer, so that surgeons and other professionals agree to this concept of using medical treatments first as a means to determining for the individual patient in from molecular tests which is going to be the best treatment. And although that does not sound as clever as developing some new technology, nevertheless, I think it is really very fundamental to further progress in clinical breast cancer research.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: The most dramatic change in breast cancer over the last 10 or 15 years has undoubtedly been the appreciation that breast cancer is not just one disease. We know from gene expression studies and from many different areas of biological research that breast cancer is a series of different disease subtypes, each of which require very different treatment strategies. For example the most dramatic development in recent years has been the discovery of the HER2 biomarker on the cell surface of some breast cancers. Around 20% of breast cancers are of the HER2 subtype, and these respond very well to an antibody against HER2, called trastuzumab (brand name, Herceptin®), which has revolutionized the management of that particular subtype. HER2 has also made us aware of another subtype, called triple negative breast cancer, which is negative for three receptors: HER2, ER, and progesterone (PgR). And we know that for triple negative cancer we need to develop other treatment strategies. There are other subtypes as well and the trend of defining breast cancer on the basis of smaller and smaller subtypes, which all need more and more specific treatments, is going to continue. The fancy word for this is "personalized medicine," and we are well on our way towards that goal.

But there is another really important thing as well--the molecular markers that differentiate different types of breast cancer may also be targets, targets which differentiate normal from cancer cells and which may therefore be targets for new drugs. These might kill off the breast cancer but not damage surrounding normal cells, and trastuzumab is an excellent example. Chemotherapy also has made a major impact in breast cancer but it is a toxic, unpleasant treatment. As time goes on, we will gradually develop more and more of these targeted therapies for different breast cancer subtypes, and it is going to be so much better than the kind of blockbuster "one-size-fits-all" approach that we have had in the past.

Q: What other projects are you currently working on?

A: I have always been in interested in new drug development, which will continue to be a very important part of breast cancer. These new drugs are much more interesting than in the past, as drug development in the past largely was almost serendipitous stumbling on things that work. Now we are basing them on the molecular targets as I have described above.

I also have great interest in breast cancer in young women. For young women, breast cancer can be a particularly devastating disease. We have very good treatments, and patients can often be cured, but the cure comes with a price. Some of our treatments cause long-term infertility, which is a terrible thing for a young woman. Many of our treatments also cause suppression of ovarian function, so young women have very unpleasant side effects due to this highly unnatural state of premature menopause. This is an area that we have not really worked out properly, not so much in terms of research and treatment, but in terms of support, in terms of appreciating the particular problems, the psychological as well as the physical, problems. And it is an area that we have a lot of interest in at the Royal Marsden because young women tend to gravitate here since we are a specialized cancer center.

Q: How close are we to preventing and curing all forms of breast cancer?

A: In terms of preventing breast cancer, we may well be able to prevent some cases through drugs like tamoxifen, and possibly through lifestyle changes. But, I certainly do not think that we are going to be able to prevent all breast cancer in the foreseeable future and it will continue to be a major and very important disease in our society.

But in terms of increasing cure rates I am very optimistic, I think the last 15 years have been very exciting. Even though breast cancer incidence is rising, deaths from breast cancer are falling at a steady rate. A major reason for this has been the use of so-called adjuvant medical therapies given after surgery. Now, as I have described, there are new therapies and new concepts (neoadjuvant therapy being one of the most important) emerging, which are being applied across the board. As new drugs continue to emerge, there is every reason to believe that deaths from breast cancer will continue to fall. We are already in an era where only a minority of patients die of this disease, and I predict that in the next 10 years deaths from breast cancer will become very uncommon.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has had a dramatic and stimulating impact on breast cancer research. The funding itself is not just crucial but quickly accessible. This is important--it is very difficult nowadays to get large amounts of research money quickly through the more traditional sources. That is not to say that governments are unsupportive of research, quite the opposite, but they have limited budgets, and it is increasingly difficult to be able to obtain all the funds you need and quickly.

Another marvelous thing about BCRF is the community spirit that it engenders. BCRF brings all the top people involved in breast cancer research together, physically once a year and in spirit over the rest of the year. That leads to better exchange of ideas, and that is the way progress is made--not by people sitting and working in isolation, but by bringing large groups of people together. This is what makes BCRF so important and so valuable.

Read more about Dr. Smith's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Ian E. Smith to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I decided at a fairly early age that I wanted to go into medicine. I trained at the University of Edinburgh, where I sometimes had to look after patients with leukemias or lymphomas. Cancer became an absolutely fascinating challenge to me. From that experience, I decided to go to the Royal Marsden Hospital in London, which is the main and one of the very few stand-alone cancer hospitals in the UK. For me, as a young doctor, the Royal Marsden was an extraordinary stimulus, because there I found clinicians not only treating cancer but also working alongside scientists in laboratories on the same campus. I remember we used to sit together in the evenings and talk about the challenges of cancer treatment and the underlying biology. That was when I decided that I wanted to be a cancer specialist and to take a scientific approach working with scientists to tackle what were very challenging problems.

Now, did I consider any another profession? The answer is "Not really." I had considered studying English literature, which I enjoy very much, but I did not have a very good answer for what I would want to do after graduation. And that was why I went into medicine, because then my path was much clearer.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: My interest in my current BCRF work really began more than 20 years ago, long before the Foundation was formed, when we started doing what is called "neoadjuvant" chemotherapy, or chemotherapy before surgery, for large breast cancers. We use that approach to try to shrink tumors so that mastectomy can be avoided. We did pioneering work on neoadjuvant chemotherapy at the Royal Marsden and then began applying the same approach with endocrine therapy, using tamoxifen and subsequently aromatase inhibitors including in particular letrozole. And we saw some excellent clinical results with good tumor regressions. But what really began to interest me was how we could predict in advance which patients were going to benefit from treatment in the long term. Clinical measurement, we discovered, was a rather crude, inaccurate tool. So, working with my laboratory colleagues, we began to look at molecular markers, also called biomarkers, and particularly Ki67, which measures proliferation. A molecular marker is a biochemical test on a tumor that helps to characterize some aspect of its behavior. There are prognostic and predictive molecular markers. A prognostic marker helps to define a cancer's characteristics and its outlook, whether it is likely to behave in an aggressive or an indolent fashion. But what I think is more interesting and more important clinically are predictive markers, which tell you whether a cancer is going to respond to a treatment or not. The best example of a predictive marker is the estrogen receptor. It has been known for many years that if a breast cancer is estrogen receptor-positive, as most of them are, then there is a good chance that they will respond to endocrine therapy but if they are estrogen receptor-negative, then they will not. In our work, we discovered that when you treat breast cancers with drugs, and in particular with endocrine therapy, the cells in many of these cancers stop proliferating within two weeks of starting treatment and "switch off." Therefore, we thought that measuring the change in the proliferation marker Ki67 might then give us a more accurate way of predicting which cancers were going to respond well to treatment. This has been one of the central tenets of our research and an area of research that BCRF has supported very strongly over the years.

Now, another component of my research that excites me is changing the traditional way of using these molecular markers. Standard practice dictates that you look at the molecular markers before you treat a cancer, use them to predict effectiveness of therapy, and then the surgeon removes the tumor prior to starting adjuvant medical therapy. But what we have been doing, based on our original experience with neoadjuvant treatments, is that instead of immediately removing the cancer, we start with a short course of preoperative medical endocrine treatment with tamoxifen or an aromatase inhibitor, and then remove the cancer two weeks later and look at how these molecular markers are behaving. It is our hypothesis that measuring changes in markers after treatment will predict the likelihood of the therapy working more accurately than if this test was done before beginning treatment. In other words, applying the marker test after treatment has started and after surgery gives us a measure of not just the biology of the cancer but of the sensitivity to the treatment we are using. Now if we can do that, it means that for each individual patient, you can tell very early on whether it is worth giving someone five years of an aromatase inhibitor, five years of tamoxifen, and such. Hopefully, although we are not quite so far ahead in this, we can also tell after one course of chemotherapy whether six or eight courses are going to beneficial or not, because if it is not going to work, the sooner you stop that treatment, the better. Conversely if the chemotherapy is going to be beneficial, it is so much better to be able to say to the patient, "Look, this treatment is unpleasant but we know from the molecular markers after your first course that it's going to work and we know it's got a high chance of cure." At the present, despite all the developments in cancer research, a lot of the medical treatment of early breast cancer is still guesswork. Our research is to overcome that guesswork.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: There certainly have been developments in laboratory technology and my colleagues who work in the labs are the ones to elaborate on these. But for me, what is just as important is changing the mindset on clinical strategy. We spent many years thinking that everyone with breast cancer should have a mastectomy, but it turns out that was completely wrong, and we have changed that mindset. Now we need to change the mindset again, and to have surgeons, and indeed all the team looking after patients with breast cancer, thinking of using medical treatments first rather than rushing to surgery so that we can do these predictive molecular tests. To test our hypothesis, we set up a very large trial, in fact involving the whole of the UK, called POETIC. In POETIC, we aimed to recruit 4,000 patients who would be randomized to two weeks of preoperative endocrine therapy versus going straight to surgery.

Many of our colleagues initially had said that we would not be able to do the POETIC study on a large scale. They said that you could do this at a specialist cancer center but to make this trial work on a larger scale, you have to change the mindset of nearly all the surgeons in the land. And the really exciting thing is that trial has worked extremely well. We have now reached our targeted recruitment of 4,000 patients. In the UK, we have caused a change in the whole mindset, a change in the attitude to approaching breast cancer, so that surgeons and other professionals agree to this concept of using medical treatments first as a means to determining for the individual patient in from molecular tests which is going to be the best treatment. And although that does not sound as clever as developing some new technology, nevertheless, I think it is really very fundamental to further progress in clinical breast cancer research.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: The most dramatic change in breast cancer over the last 10 or 15 years has undoubtedly been the appreciation that breast cancer is not just one disease. We know from gene expression studies and from many different areas of biological research that breast cancer is a series of different disease subtypes, each of which require very different treatment strategies. For example the most dramatic development in recent years has been the discovery of the HER2 biomarker on the cell surface of some breast cancers. Around 20% of breast cancers are of the HER2 subtype, and these respond very well to an antibody against HER2, called trastuzumab (brand name, Herceptin®), which has revolutionized the management of that particular subtype. HER2 has also made us aware of another subtype, called triple negative breast cancer, which is negative for three receptors: HER2, ER, and progesterone (PgR). And we know that for triple negative cancer we need to develop other treatment strategies. There are other subtypes as well and the trend of defining breast cancer on the basis of smaller and smaller subtypes, which all need more and more specific treatments, is going to continue. The fancy word for this is "personalized medicine," and we are well on our way towards that goal.

But there is another really important thing as well--the molecular markers that differentiate different types of breast cancer may also be targets, targets which differentiate normal from cancer cells and which may therefore be targets for new drugs. These might kill off the breast cancer but not damage surrounding normal cells, and trastuzumab is an excellent example. Chemotherapy also has made a major impact in breast cancer but it is a toxic, unpleasant treatment. As time goes on, we will gradually develop more and more of these targeted therapies for different breast cancer subtypes, and it is going to be so much better than the kind of blockbuster "one-size-fits-all" approach that we have had in the past.

Q: What other projects are you currently working on?

A: I have always been in interested in new drug development, which will continue to be a very important part of breast cancer. These new drugs are much more interesting than in the past, as drug development in the past largely was almost serendipitous stumbling on things that work. Now we are basing them on the molecular targets as I have described above.

I also have great interest in breast cancer in young women. For young women, breast cancer can be a particularly devastating disease. We have very good treatments, and patients can often be cured, but the cure comes with a price. Some of our treatments cause long-term infertility, which is a terrible thing for a young woman. Many of our treatments also cause suppression of ovarian function, so young women have very unpleasant side effects due to this highly unnatural state of premature menopause. This is an area that we have not really worked out properly, not so much in terms of research and treatment, but in terms of support, in terms of appreciating the particular problems, the psychological as well as the physical, problems. And it is an area that we have a lot of interest in at the Royal Marsden because young women tend to gravitate here since we are a specialized cancer center.

Q: How close are we to preventing and curing all forms of breast cancer?

A: In terms of preventing breast cancer, we may well be able to prevent some cases through drugs like tamoxifen, and possibly through lifestyle changes. But, I certainly do not think that we are going to be able to prevent all breast cancer in the foreseeable future and it will continue to be a major and very important disease in our society.

But in terms of increasing cure rates I am very optimistic, I think the last 15 years have been very exciting. Even though breast cancer incidence is rising, deaths from breast cancer are falling at a steady rate. A major reason for this has been the use of so-called adjuvant medical therapies given after surgery. Now, as I have described, there are new therapies and new concepts (neoadjuvant therapy being one of the most important) emerging, which are being applied across the board. As new drugs continue to emerge, there is every reason to believe that deaths from breast cancer will continue to fall. We are already in an era where only a minority of patients die of this disease, and I predict that in the next 10 years deaths from breast cancer will become very uncommon.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has had a dramatic and stimulating impact on breast cancer research. The funding itself is not just crucial but quickly accessible. This is important--it is very difficult nowadays to get large amounts of research money quickly through the more traditional sources. That is not to say that governments are unsupportive of research, quite the opposite, but they have limited budgets, and it is increasingly difficult to be able to obtain all the funds you need and quickly.

Another marvelous thing about BCRF is the community spirit that it engenders. BCRF brings all the top people involved in breast cancer research together, physically once a year and in spirit over the rest of the year. That leads to better exchange of ideas, and that is the way progress is made--not by people sitting and working in isolation, but by bringing large groups of people together. This is what makes BCRF so important and so valuable.

Read more about Dr. Smith's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Ian E. Smith to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Walter Willett to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Walter Willett to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Walter Willett to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Walter Willett to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I trained in internal medicine at the University of Michigan but after teaching community medicine and public health in Tanzania for three years, I became interested in those fields and returned to the US to complete a doctorate in public health at Harvard School of Public Health. There I became interested in breast cancer, a topic that was being investigated by senior faculty in our department. The challenge was to understand why rates of breast cancer were so high in Western countries; if we could understand the causes, prevention might be possible.

I started college as a physics major, but when I saw what the senior people in that field were doing, it didn't look exciting to me. So I transferred to food science and then became more interested more broadly in human health. What I've done in my career is put together a lot of these pieces -- research approaches learned in physics, understanding of diets through food science, and knowledge about human health through training in medicine and internal medicine.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: My primary goal is to understand the causes of breast cancer and to find ways to prevent it. BCRF has been enormously helpful, especially by allowing us to begin research for which funding from traditional mechanisms, such as the National Institutes of Health, would have been difficult or not possible.

One of the most important ways in which BCRF has helped our research is by launching the Growing Up Today Study (GUTS), which enrolled girls and their brothers when they were 10-14 years of age. One of the challenges of breast cancer is that many of the risk factors seem to be operating before adulthood; this is not unique to breast cancer, but it is different than heart disease or diabetes where factors acting within a few years of diagnosis are most important. We know this from some several leads, such as the atomic bombing of Nagasaki and Hiroshima; for women over age 40, even big doses of radiation had limited effect on their breast cancer risk. However, if they were irradiated when they were children or young adults, several decades later, an increase in breast cancer risk was seen. We have to wait decades to see the full impact of environmental factors, such as radiation, on breast cancer. This long delay between the "cause" and actual initial effects on breast cancer creates some tremendous challenges for us as researchers of environmental risk factors for breast cancer.

Another challenge we face is that some environmental factors, such as exposure to pesticides, are difficult to measure. However, when we as epidemiologists talk about "environment," we usually are referring to pretty much everything except genetics. If we look at this very broad definition of environment, we have learned quite a bit about breast cancer. GUTS is a good example of what BCRF has supported. The study members are the offspring of the participants in the Nurses' Health Study II, whom we started studying about 15 years ago.

GUTS is the only large-scale study of diet and lifestyle factors in children; we enrolled about 25,000 individuals as young adolescents (10-14 years of age). We are repeatedly measuring diet, physical activity, and other activities of the participants by sending out questionnaires annually. Our main aim is to follow this generation until they develop breast cancer, which mostly is still several decades down the road, but already we've learned a lot about factors that influence breast cancer risk factors such as height, age at menarche, and benign breast disease (a precursor of breast cancer).

These studies are an "investment" that will pay off over decades, not the five-year window that is required by National Institutes of Health. And we've also been able to do some very interesting work looking in hormonal factors in Mongolia. Additionally, BCRF support has enabled us to pool the data from large cohort studies around the world to be able to look specifically at risk factors for estrogen receptor negative breast cancer. In many ways, BCRF has allowed us to take research directions that otherwise would not have been possible.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: One of the most important technological advances has been modern computing. We sometimes overlook that, but the ability to collect a large amount of data and analyze it underlies every bit of our research. Modern genetic analysis, genome-wide association studies, and whole genome sequencing technologies have yet to reach their full potential in revealing information about breast cancer and our genetic makeup. In some ways, we have known all along that the non-genetic factors are the most important for breast cancer. We have clues from studies that compare breast cancer rates in different countries where there may be an eight-fold difference among them. Also we know from long-term epidemiologic studies that when people move from low-risk countries to the United States, a high-risk country, they develop high rates of breast cancer. Obviously, it was not their genetics that were changing over time. It was something about the non-genetic factors that was very important.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: Much of our research is looking at earlier periods in life. We now have added a younger cohort of women, the Nurses' Health Study II, whom we purposely enrolled as young adults, 25 to 43 of age. They have provided many new insights on factors related to breast cancer. We have collected data on their diets during high school, as well as information from their mothers, who are able to describe their pregnancies, including information on diet and breast-feeding. We are able to put together the lifetime experience pretty well for our cohort members, and much of our work will be focused on those early-life factors and the same factors operating at different periods across the lifespan.

BCRF funding has also enabled us to collect mammograms of women in Nurses' Health Study II. The mammograms allow us to look at changes in the breast well before a diagnosis of breast cancer. We are also incorporating new genetic information, gene expression and DNA methylation data. We are putting together all these pieces of what happens throughout a lifetime for the same individuals. These pieces have been looked at one at a time, but I think that it is important to incorporate all this information on the same people to get the most complete picture of the precursors of breast cancer.

Also, it is now clear that breast cancer is not a single disease, and that we are increasingly being able to define it by molecular characteristics. It is clear that different forms of breast cancer have different causes, and being able to define cases more specifically will assist our efforts to find strategies for prevention.

Q: What other projects are you currently working on?

A: There are many different elements to the Nurses' Health studies in addition to breast cancer, such as other major health outcomes including cardiovascular disease, diabetes, dementia, and Parkinson's disease. We are learning a lot from looking at mechanisms leading to a variety of diseases and we are applying that knowledge to cancer. For example, inflammation, which is one of the underlying pathways thought to lead to breast cancer, is also implicated in heart disease, diabetes, and other cancers. Looking at only one disease at a time predates modern biology.

We are also doing a study on men, where we are examining conditions of prostate cancer and also other major cancers that occur in both men and women. Again, we gain insights from different populations. Pulling together data on diet and lifestyle from populations all around the world, which we're able to do for the first time, is turning out to be very valuable as well. So, opportunities for research at this point in time are almost endless. It's a very exciting time in science.

Q: How close are we to preventing and curing all forms of breast cancer?

A: With regard to prevention, progress has been more challenging and slower for breast cancer than for diabetes and heart disease. We have identified fairly simple diet and lifestyle ways to prevent over 90% of diabetes and over 80% of heart disease. But, we know how to prevent only around about half of breast cancer. For example, avoiding weight gain during adult life, not using hormone replacement therapy, and keeping alcohol consumption quite low could prevent about 50% of breast cancer deaths that occur after menopause. We still know less about pre-menopausal breast cancer but we have found some factors that are related to risk and are avoidable, such as high consumption of meat and alcohol.

We are a long way from being able to prevent all breast cancers. And I think one of the realizations, as the result of research, has been that some of it is built into our way of life in ways that we don't want to change. For example, we know now that if women start having children immediately after the onset of menstruation and have one child every year or two, which is what traditional populations did, that would dramatically reduce breast cancer incidence. But, that would also lead to over-population, affect a woman's ability to go to school, and have many undesired consequences. Because some of the reasons for our high rates of breast cancer are due to factors that we don't want to change, I think we will probably need to use some pharmacologic means to reduce breast cancer rates to the point that it is a rare disease. For example, designer types of oral contraceptives will probably eventually play an important role in helping to reduce breast cancer risk. While we have made progress, there is still a long way to go.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has impacted breast cancer research in many different ways. I can't begin to describe all the ways that other investigators use this support -- research on the underlying biology, early treatment, and early diagnosis are all very strongly supported by BCRF. In our own work, BCRF has been enormously important in allowing us to prepare the platform to study breast cancer from early adolescence onward. That has not yet happened anywhere else in the world, and it would not have happened in our work had it not been for BCRF.

Read more about Dr. Willett's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Walter Willett to discuss his current work and interest in breast cancer research. Read on to learn more.

Q: Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A: I trained in internal medicine at the University of Michigan but after teaching community medicine and public health in Tanzania for three years, I became interested in those fields and returned to the US to complete a doctorate in public health at Harvard School of Public Health. There I became interested in breast cancer, a topic that was being investigated by senior faculty in our department. The challenge was to understand why rates of breast cancer were so high in Western countries; if we could understand the causes, prevention might be possible.

I started college as a physics major, but when I saw what the senior people in that field were doing, it didn't look exciting to me. So I transferred to food science and then became more interested more broadly in human health. What I've done in my career is put together a lot of these pieces -- research approaches learned in physics, understanding of diets through food science, and knowledge about human health through training in medicine and internal medicine.

Q: Briefly describe your BCRF-funded research project. What are some laboratory and/or clinical experiences that inspired your work? What are your primary goals for this research?

A: My primary goal is to understand the causes of breast cancer and to find ways to prevent it. BCRF has been enormously helpful, especially by allowing us to begin research for which funding from traditional mechanisms, such as the National Institutes of Health, would have been difficult or not possible.

One of the most important ways in which BCRF has helped our research is by launching the Growing Up Today Study (GUTS), which enrolled girls and their brothers when they were 10-14 years of age. One of the challenges of breast cancer is that many of the risk factors seem to be operating before adulthood; this is not unique to breast cancer, but it is different than heart disease or diabetes where factors acting within a few years of diagnosis are most important. We know this from some several leads, such as the atomic bombing of Nagasaki and Hiroshima; for women over age 40, even big doses of radiation had limited effect on their breast cancer risk. However, if they were irradiated when they were children or young adults, several decades later, an increase in breast cancer risk was seen. We have to wait decades to see the full impact of environmental factors, such as radiation, on breast cancer. This long delay between the "cause" and actual initial effects on breast cancer creates some tremendous challenges for us as researchers of environmental risk factors for breast cancer.

Another challenge we face is that some environmental factors, such as exposure to pesticides, are difficult to measure. However, when we as epidemiologists talk about "environment," we usually are referring to pretty much everything except genetics. If we look at this very broad definition of environment, we have learned quite a bit about breast cancer. GUTS is a good example of what BCRF has supported. The study members are the offspring of the participants in the Nurses' Health Study II, whom we started studying about 15 years ago.

GUTS is the only large-scale study of diet and lifestyle factors in children; we enrolled about 25,000 individuals as young adolescents (10-14 years of age). We are repeatedly measuring diet, physical activity, and other activities of the participants by sending out questionnaires annually. Our main aim is to follow this generation until they develop breast cancer, which mostly is still several decades down the road, but already we've learned a lot about factors that influence breast cancer risk factors such as height, age at menarche, and benign breast disease (a precursor of breast cancer).

These studies are an "investment" that will pay off over decades, not the five-year window that is required by National Institutes of Health. And we've also been able to do some very interesting work looking in hormonal factors in Mongolia. Additionally, BCRF support has enabled us to pool the data from large cohort studies around the world to be able to look specifically at risk factors for estrogen receptor negative breast cancer. In many ways, BCRF has allowed us to take research directions that otherwise would not have been possible.

Q: Are there specific scientific developments and/or technologies that have made your work possible? What additional advancements can help to enhance your progress?

A: One of the most important technological advances has been modern computing. We sometimes overlook that, but the ability to collect a large amount of data and analyze it underlies every bit of our research. Modern genetic analysis, genome-wide association studies, and whole genome sequencing technologies have yet to reach their full potential in revealing information about breast cancer and our genetic makeup. In some ways, we have known all along that the non-genetic factors are the most important for breast cancer. We have clues from studies that compare breast cancer rates in different countries where there may be an eight-fold difference among them. Also we know from long-term epidemiologic studies that when people move from low-risk countries to the United States, a high-risk country, they develop high rates of breast cancer. Obviously, it was not their genetics that were changing over time. It was something about the non-genetic factors that was very important.

Q: What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A: Much of our research is looking at earlier periods in life. We now have added a younger cohort of women, the Nurses' Health Study II, whom we purposely enrolled as young adults, 25 to 43 of age. They have provided many new insights on factors related to breast cancer. We have collected data on their diets during high school, as well as information from their mothers, who are able to describe their pregnancies, including information on diet and breast-feeding. We are able to put together the lifetime experience pretty well for our cohort members, and much of our work will be focused on those early-life factors and the same factors operating at different periods across the lifespan.

BCRF funding has also enabled us to collect mammograms of women in Nurses' Health Study II. The mammograms allow us to look at changes in the breast well before a diagnosis of breast cancer. We are also incorporating new genetic information, gene expression and DNA methylation data. We are putting together all these pieces of what happens throughout a lifetime for the same individuals. These pieces have been looked at one at a time, but I think that it is important to incorporate all this information on the same people to get the most complete picture of the precursors of breast cancer.

Also, it is now clear that breast cancer is not a single disease, and that we are increasingly being able to define it by molecular characteristics. It is clear that different forms of breast cancer have different causes, and being able to define cases more specifically will assist our efforts to find strategies for prevention.

Q: What other projects are you currently working on?

A: There are many different elements to the Nurses' Health studies in addition to breast cancer, such as other major health outcomes including cardiovascular disease, diabetes, dementia, and Parkinson's disease. We are learning a lot from looking at mechanisms leading to a variety of diseases and we are applying that knowledge to cancer. For example, inflammation, which is one of the underlying pathways thought to lead to breast cancer, is also implicated in heart disease, diabetes, and other cancers. Looking at only one disease at a time predates modern biology.

We are also doing a study on men, where we are examining conditions of prostate cancer and also other major cancers that occur in both men and women. Again, we gain insights from different populations. Pulling together data on diet and lifestyle from populations all around the world, which we're able to do for the first time, is turning out to be very valuable as well. So, opportunities for research at this point in time are almost endless. It's a very exciting time in science.

Q: How close are we to preventing and curing all forms of breast cancer?

A: With regard to prevention, progress has been more challenging and slower for breast cancer than for diabetes and heart disease. We have identified fairly simple diet and lifestyle ways to prevent over 90% of diabetes and over 80% of heart disease. But, we know how to prevent only around about half of breast cancer. For example, avoiding weight gain during adult life, not using hormone replacement therapy, and keeping alcohol consumption quite low could prevent about 50% of breast cancer deaths that occur after menopause. We still know less about pre-menopausal breast cancer but we have found some factors that are related to risk and are avoidable, such as high consumption of meat and alcohol.

We are a long way from being able to prevent all breast cancers. And I think one of the realizations, as the result of research, has been that some of it is built into our way of life in ways that we don't want to change. For example, we know now that if women start having children immediately after the onset of menstruation and have one child every year or two, which is what traditional populations did, that would dramatically reduce breast cancer incidence. But, that would also lead to over-population, affect a woman's ability to go to school, and have many undesired consequences. Because some of the reasons for our high rates of breast cancer are due to factors that we don't want to change, I think we will probably need to use some pharmacologic means to reduce breast cancer rates to the point that it is a rare disease. For example, designer types of oral contraceptives will probably eventually play an important role in helping to reduce breast cancer risk. While we have made progress, there is still a long way to go.

Q: In your opinion, how has BCRF impacted breast cancer research?

A: BCRF has impacted breast cancer research in many different ways. I can't begin to describe all the ways that other investigators use this support -- research on the underlying biology, early treatment, and early diagnosis are all very strongly supported by BCRF. In our own work, BCRF has been enormously important in allowing us to prepare the platform to study breast cancer from early adolescence onward. That has not yet happened anywhere else in the world, and it would not have happened in our work had it not been for BCRF.

Read more about Dr. Willett's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Walter Willett to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Antonio Wolff to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Antonio Wolff to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q. Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.metatag_normalized[].attributes.content
BCRF sat down with Dr. Antonio Wolff to discuss his current work and interest in breast cancer research. Read on to learn more.
 
Q. Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

# data[].attributes.body.value
BCRF sat down with Dr. Antonio Wolff to discuss his current work and interest in breast cancer research. Read on to learn more.

Q. Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A. Medicine is something I've thought about pursuing since elementary school, even though everyone in my very large family is in either business or high education. From Rio de Janeiro, Brazil, where the university educational system is very similar to Europe's, I found myself at age 16 applying to medical school. I therefore later on had to create my own "liberal arts curriculum" to round out my scientific education and took advantage of my love for reading and my curiosity about the world we live in and its history. While in medical school in Rio, I mostly used American medical textbooks as sources, and so it was natural for me to decide to come to the US in the late 1980s for my post-graduate training. I had a six-year plan, and this was 24 years ago.

When I first came to Johns Hopkins in 1992, I was almost instantly attracted to breast cancer because of two major convening factors: one was the incredible number of scientific discoveries in breast cancer coming to fruition at the time, many with immediate relevance to the care of patients; and the second was the many role models I met at Hopkins and elsewhere. Before the 1990s, most scientific developments in cancer were happening in hematologic malignancies, or blood cancers, partly due to the ease of collecting and studying blood and bone marrow tumor specimens from patients with leukemias and lymphomas, and this attracted a lot of smart people to those fields. With the identification of the tumor suppressor genes (e.g. p53 and the breast cancer susceptibility genes, BRCA1 and BRCA2) in the 1990s, we began to see breast cancer as a perfect example of how improved understanding of the major drivers in tumor growth had implications for not only diagnosis but also treatment.

Also, giants in breast cancer, such as Bernard Fisher, MD (who received the BCRF Jill Rose Award in 2003), and Gianni Bonadonna, MD, to name just a few, started in the 1970s and 1980s to change our understanding about not only surgery but also the role of treatments like chemotherapy following surgery (called "systemic adjuvant therapy"). Their work and that of so many others illustrated that adjuvant systemic therapy was effective in reducing the risk of recurrence for those with early-stage breast cancer. Until then, to maximize the reduction in the risk of recurrence and metastasis, surgical oncologists used to remove large sections of both cancerous and healthy breast tissues. However, by then we had finally learned that excessively removing otherwise healthy tissues beyond those affected by the disease was not only unnecessary and debilitating in many ways, but sometimes detrimental too. Today, lumpectomy (also called "breast conservation surgery") accompanied by radiation has become an appropriate and equally effective alternative to mastectomy for most women. In addition, we were also developing ways to individualize risk, so that we could offer women at greater risk adjuvant systemic treatments, such as tamoxifen and chemotherapy early on and so much more since. These developments truly revolutionized the way we approach breast cancer. I was very fortunate to be at the right place and at the right time in the 1990s, and to have easy access to so many of the leading thinkers who were generous with their time and who continue to inspire me.

Q. Briefly describe how BCRF funding has affected TBCRC as an organization and its research agenda. What are some laboratory and/or clinical experiences that led to the creation of TBCRC? What are the primary objectives of current TBCRC research?

A. Building on the work of so many and in many ways standing on their shoulders, the Translational Breast Cancer Research Consortium (TBCRC) may well be the next step in the evolution of "team science." Established in 2005 by an initial grant from BCRF, TBCRC is a collaborative effort by a multidisciplinary team of laboratory scientists and clinical researchers and pursues focused clinical trials that integrate clinical and laboratory studies in an effort to accelerate progress in breast cancer. Uniting the efforts of 17 major academic breast cancer programs in the US, TBCRC has activated 24 clinical trials, including 10 that had reached their accrual goals by January 2012. Thus far, almost 2,000 breast cancer patients have been part of TBCRC trials, including about 700 of them enrolled in prospective studies. There are currently 13 clinical trials open to patient enrollment, and several other clinical studies are under development.

Preceding these efforts and starting in the mid-1980s, clinical trials were expanded so that each included hundreds or thousands of patients often across country borders. Parallel efforts led by investigators in Oxford, England to pool the findings from separate but similar clinical trials as part of a multinational effort allowed us to recognize that small improvements in percentage points could translate into enormous, absolute number of individuals who could potentially benefit from new treatments. For instance, more than 230,000 US women are newly diagnosed with breast cancer each year. If a new intervention is shown to be effective in 1% of newly diagnosed women, you're talking about 2,300 lives just in one country. A lot of individual, small baby steps — such as improved detection, better local therapy with surgery and radiation therapy, and systemic treatments — when combined will result in an enormous impact on the lives of individual patients.

These incremental advances are particularly significant in breast cancer, and we now have the tools to increasingly look at individual patients to expand on the gains mentioned above. This is a disease comprised of several phenotypes or subtypes, like estrogen receptor positive (ER+), HER2 positive (HER2+), and triple negative. Not all breast cancers have the same triggers and drivers, and not all respond to treatments the same way. Therefore, there is a critical need to individualize decision-making for each patient, and consequently to design studies that also no longer approach breast cancer as a single entity. Today, there is even better understanding that not all ER+ breast tumors respond equally to endocrine therapy, and the same can be said about HER2+ disease and response to anti-HER2 therapies like trastuzumab (Herceptin®), and about triple negative breast cancer and chemotherapy.

With these insights, it also means that there is a plethora of new drugs and ideas. We as scientists and physicians have an enormous responsibility when thinking about new large randomized trials involving thousands of patients. Clinical trial participants are entrusting us to design appropriate studies and ask the right questions. In many cases, these individuals are facing a very challenging time in their lives for themselves and for their families. So, these studies must be based on solid evidence. We also need to ensure that the studies are asking meaningful questions and are appropriately powered to do so, and the need to collaborate with statisticians specializing in clinical trial design, patient advocates, laboratory scientists, and experts in pathology and cancer imaging has never been greater. We must also do these studies in a reasonable amount of time, so that we will have relevant answers in a timely fashion, then must disseminate these answers to change clinical practice in a meaningful way and benefit patients.

Even though there were mechanisms to help facilitate large-scale clinical trials involving multiple institutions and thousands of patients, many of my colleagues and I realized that we were trying to re-invent the wheel each time we had to put together smaller and complex clinical trials that relied on matching clinical data on outcome with tumor specimens from these patients for lab studies. These are complex studies that cannot be done by a single institution, and they often require biopsies to be taken at different times during treatment and access to fresh tissue. Researchers are trying to detect very early on changes in tissues that may ultimately correlate with which patients are most likely to benefit or not from a specific intervention. Furthermore, collecting and storing tissues is an amazing investment, but it is very difficult to attract funding, because sometimes there is not an immediate scientific question to be answered.

Recognizing all these challenges, I had the privilege to join forces with several BCRF grantees to come together to form a consortium and we named it the TBCRC. This would allow us greater intellectual independence and flexibility to conduct studies that were scientifically necessary but sometimes not of great interest to individual pharmaceutical companies, and sometimes too small and too complex to be done through more traditional and established research mechanisms like the National Cancer Institute clinical trial cooperative groups. Our goal was and continues to be to have a more nimble process to design and activate studies, while eliminating many of the barriers commonly associated with clinical trials.

Q. What is the structure of TBCRC? How has the organization evolved?

A. TBCRC is essentially "a center without walls" and operates with a very small infrastructure. To keep overhead at a minimum so that all the funds could be channeled towards research support, TBCRC operated for many years with only two part-time staff: our business manager Cindy Morin and our program manager Robyn Burns, PhD. I have served as its Executive Officer since 2006. My own institution (Johns Hopkins) realized early on the potential of this new idea and generously provided pro bono administrative and contracts management support for the TBCRC member institutions. Since then, TBCRC has grown to 17 institutions with over 200 faculty and staff individuals participating in its activities, and we recently hired two full-time staff to help oversee the development of research studies and to handle contracts among the TBCRC institutions and with its foundation supporters.

Most importantly, we realized early on the critical intellectual and patient assets we had and the need to engage them. TBCRC emphasizes multidisciplinary research and care. Our members include medical oncologists, surgeons, radiation oncologists, basic scientists, and imaging specialists. With the wealth of scientific wisdom and bubbling ideas, we soon created smaller working groups that meets by phone monthly and in person at least twice a year. Working groups in disease subtypes were established: endocrine resistance; HER2 resistance; and triple negative disease. We also established a correlative science working group to support these disease-oriented working groups. Since patients are the primary reason for all we do, each TBCRC member institution identified a patient advocate to represent them and their patients in a patient advocate working group. Finally, as nothing happens as if by magic, we asked the institutions to identify research coordinators and contract managers to band together in their own working groups. It is a lot of people, but much of their work is done by phone and via e-mail to expedite things and minimize costs. Also, a nice side benefit has been the establishment of common processes across institutions, which in many cases have benefited their own efforts outside of TBCRC.

Q. What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A. I see three main trends: 1) therapy individualization; 2) further refinement of tumor subtypes driven by specific interventions; and 3) improved public understanding of the need for tissue repositories. This combination of trends can dramatically improve patient outcomes.

One of the most remarkable examples of therapy individualization is the availability of anti-HER2 therapies, and the development of improved predictive markers of treatment benefit. Trastuzumab was quickly brought to patients' bedside in the late 1990s. Improvement in standard pathology measures and testing of new measures like gene expression profiling in the 2000s were largely due to studies using tissues collected from earlier clinical trials. Through patient tissues, we can assess the regulation of genes, look at gene expression, and the activation of cellular pathways (like ER, HER2, and PI3 kinase), and better understand how all this comes together so that we can gradually further develop techniques and treat patients with truly individualized care. But, if we are going to individualize care, we must also make sure we have excellent pathologic testing for markers that will influence treatment decisions, so that we can recommend the right treatment to the right patient, and this has been a focus of my personal work since 2005.

Also, I see in the near future therapy individualization beyond the major subtypes of breast cancer we now have, and this will allow us to further refine treatment decisions in a meaningful way. Like everything we do today, this can only be achieved through the collaborative interaction of experts with very diverse backgrounds, including clinician researchers, laboratory scientists, epidemiologists, biostatisticians, and bioinformaticians. In other words, this is a very large village and organizations like the BCRF have played a key role to help bring us all together.

The large-scale studies from the 1980s made us realize the importance of prospectively collecting tissue specimens from patients. We may not be able to fully understand all the data embedded in these tumor specimens now, but as technology evolves our understanding will evolve too. Also, these tissue blocks become incredibly valued over time as we learn about the clinical outcome of the patients associated with them, especially if these are patients who first presented with early-stage breast cancer. Therefore, in this partnership between researchers and patients, we must engage them and explain the critical nature of efforts to collect tissue and blood specimens for present and for future use.

Q. How close are we to preventing and curing all forms of breast cancer?

A. We cannot promise the public — those affected by cancer and those who support cancer research — that we will be able to cure cancer in just a few years. However, we can promise that we will further improve on the gains of the last few decades and continue to improve strategies to reduce risk, methods of early detection, and treatments to further reduce the morbidity and mortality of this disease. We will further understand what drives the development of cancer, who are the patients at greatest risk for developing cancer for the first time, and who are those at greatest risk for disease recurrence. By individualizing treatment, we help avoid exposing patients to unnecessary treatments and wasting limited resources. We now better understand how truly complex cancer is and I think the public understands this too. Therefore, we must act responsibly, engage the public, treat them as equal partners, keep them informed along the way, and translate new discoveries into clinical practice as soon as feasible.

Q. In your opinion, how has BCRF impacted breast cancer research?

A. What the BCRF leadership and scientific advisors have done is absolutely unique. They have ultimately identified a large number of productive and committed individuals who believe in what they do. BCRF provides investigators with resources that are otherwise not available to pursue new ideas and partnerships. Researchers have used BCRF grants to complement funds from the National Cancer Institute and from other organizations to test new concepts and pilot innovative studies. By bringing all these individuals together and putting resources on the table, BCRF has fostered scientific collaborations and cross-fertilization of ideas that have directly impacted the lives of many women.

BCRF has also taken other critical steps to help communicate, engage, and educate the public on what scientific research is and on the critical role the public can have. What we learned from the HIV and breast cancer fields is that when scientific investigators engage and collaborate with patient advocates, foundations, and community organizers, we raise awareness. This awareness translates into momentum, into political and social will, and ultimately into additional resources that are especially critical in difficult economic times. Therefore, organizations like BCRF have helped groups come together to overcome major obstacles to discover new knowledge, implement new clinical trials, analyze results, translate them into clinical practice, and ultimately improve the outcome of so many women diagnosed with breast cancer or at risk of developing it. It truly takes an enormous village to have an impact, and I am honored to be a part of it.

Read more about Dr. Wolff's current research project funded by BCRF.

# data[].attributes.body.processed
BCRF sat down with Dr. Antonio Wolff to discuss his current work and interest in breast cancer research. Read on to learn more.

Q. Tell us about yourself as a scientist and how you became interested in breast cancer research. Did you ever seriously consider another kind of career than that of the sciences?

A. Medicine is something I've thought about pursuing since elementary school, even though everyone in my very large family is in either business or high education. From Rio de Janeiro, Brazil, where the university educational system is very similar to Europe's, I found myself at age 16 applying to medical school. I therefore later on had to create my own "liberal arts curriculum" to round out my scientific education and took advantage of my love for reading and my curiosity about the world we live in and its history. While in medical school in Rio, I mostly used American medical textbooks as sources, and so it was natural for me to decide to come to the US in the late 1980s for my post-graduate training. I had a six-year plan, and this was 24 years ago.

When I first came to Johns Hopkins in 1992, I was almost instantly attracted to breast cancer because of two major convening factors: one was the incredible number of scientific discoveries in breast cancer coming to fruition at the time, many with immediate relevance to the care of patients; and the second was the many role models I met at Hopkins and elsewhere. Before the 1990s, most scientific developments in cancer were happening in hematologic malignancies, or blood cancers, partly due to the ease of collecting and studying blood and bone marrow tumor specimens from patients with leukemias and lymphomas, and this attracted a lot of smart people to those fields. With the identification of the tumor suppressor genes (e.g. p53 and the breast cancer susceptibility genes, BRCA1 and BRCA2) in the 1990s, we began to see breast cancer as a perfect example of how improved understanding of the major drivers in tumor growth had implications for not only diagnosis but also treatment.

Also, giants in breast cancer, such as Bernard Fisher, MD (who received the BCRF Jill Rose Award in 2003), and Gianni Bonadonna, MD, to name just a few, started in the 1970s and 1980s to change our understanding about not only surgery but also the role of treatments like chemotherapy following surgery (called "systemic adjuvant therapy"). Their work and that of so many others illustrated that adjuvant systemic therapy was effective in reducing the risk of recurrence for those with early-stage breast cancer. Until then, to maximize the reduction in the risk of recurrence and metastasis, surgical oncologists used to remove large sections of both cancerous and healthy breast tissues. However, by then we had finally learned that excessively removing otherwise healthy tissues beyond those affected by the disease was not only unnecessary and debilitating in many ways, but sometimes detrimental too. Today, lumpectomy (also called "breast conservation surgery") accompanied by radiation has become an appropriate and equally effective alternative to mastectomy for most women. In addition, we were also developing ways to individualize risk, so that we could offer women at greater risk adjuvant systemic treatments, such as tamoxifen and chemotherapy early on and so much more since. These developments truly revolutionized the way we approach breast cancer. I was very fortunate to be at the right place and at the right time in the 1990s, and to have easy access to so many of the leading thinkers who were generous with their time and who continue to inspire me.

Q. Briefly describe how BCRF funding has affected TBCRC as an organization and its research agenda. What are some laboratory and/or clinical experiences that led to the creation of TBCRC? What are the primary objectives of current TBCRC research?

A. Building on the work of so many and in many ways standing on their shoulders, the Translational Breast Cancer Research Consortium (TBCRC) may well be the next step in the evolution of "team science." Established in 2005 by an initial grant from BCRF, TBCRC is a collaborative effort by a multidisciplinary team of laboratory scientists and clinical researchers and pursues focused clinical trials that integrate clinical and laboratory studies in an effort to accelerate progress in breast cancer. Uniting the efforts of 17 major academic breast cancer programs in the US, TBCRC has activated 24 clinical trials, including 10 that had reached their accrual goals by January 2012. Thus far, almost 2,000 breast cancer patients have been part of TBCRC trials, including about 700 of them enrolled in prospective studies. There are currently 13 clinical trials open to patient enrollment, and several other clinical studies are under development.

Preceding these efforts and starting in the mid-1980s, clinical trials were expanded so that each included hundreds or thousands of patients often across country borders. Parallel efforts led by investigators in Oxford, England to pool the findings from separate but similar clinical trials as part of a multinational effort allowed us to recognize that small improvements in percentage points could translate into enormous, absolute number of individuals who could potentially benefit from new treatments. For instance, more than 230,000 US women are newly diagnosed with breast cancer each year. If a new intervention is shown to be effective in 1% of newly diagnosed women, you're talking about 2,300 lives just in one country. A lot of individual, small baby steps — such as improved detection, better local therapy with surgery and radiation therapy, and systemic treatments — when combined will result in an enormous impact on the lives of individual patients.

These incremental advances are particularly significant in breast cancer, and we now have the tools to increasingly look at individual patients to expand on the gains mentioned above. This is a disease comprised of several phenotypes or subtypes, like estrogen receptor positive (ER+), HER2 positive (HER2+), and triple negative. Not all breast cancers have the same triggers and drivers, and not all respond to treatments the same way. Therefore, there is a critical need to individualize decision-making for each patient, and consequently to design studies that also no longer approach breast cancer as a single entity. Today, there is even better understanding that not all ER+ breast tumors respond equally to endocrine therapy, and the same can be said about HER2+ disease and response to anti-HER2 therapies like trastuzumab (Herceptin®), and about triple negative breast cancer and chemotherapy.

With these insights, it also means that there is a plethora of new drugs and ideas. We as scientists and physicians have an enormous responsibility when thinking about new large randomized trials involving thousands of patients. Clinical trial participants are entrusting us to design appropriate studies and ask the right questions. In many cases, these individuals are facing a very challenging time in their lives for themselves and for their families. So, these studies must be based on solid evidence. We also need to ensure that the studies are asking meaningful questions and are appropriately powered to do so, and the need to collaborate with statisticians specializing in clinical trial design, patient advocates, laboratory scientists, and experts in pathology and cancer imaging has never been greater. We must also do these studies in a reasonable amount of time, so that we will have relevant answers in a timely fashion, then must disseminate these answers to change clinical practice in a meaningful way and benefit patients.

Even though there were mechanisms to help facilitate large-scale clinical trials involving multiple institutions and thousands of patients, many of my colleagues and I realized that we were trying to re-invent the wheel each time we had to put together smaller and complex clinical trials that relied on matching clinical data on outcome with tumor specimens from these patients for lab studies. These are complex studies that cannot be done by a single institution, and they often require biopsies to be taken at different times during treatment and access to fresh tissue. Researchers are trying to detect very early on changes in tissues that may ultimately correlate with which patients are most likely to benefit or not from a specific intervention. Furthermore, collecting and storing tissues is an amazing investment, but it is very difficult to attract funding, because sometimes there is not an immediate scientific question to be answered.

Recognizing all these challenges, I had the privilege to join forces with several BCRF grantees to come together to form a consortium and we named it the TBCRC. This would allow us greater intellectual independence and flexibility to conduct studies that were scientifically necessary but sometimes not of great interest to individual pharmaceutical companies, and sometimes too small and too complex to be done through more traditional and established research mechanisms like the National Cancer Institute clinical trial cooperative groups. Our goal was and continues to be to have a more nimble process to design and activate studies, while eliminating many of the barriers commonly associated with clinical trials.

Q. What is the structure of TBCRC? How has the organization evolved?

A. TBCRC is essentially "a center without walls" and operates with a very small infrastructure. To keep overhead at a minimum so that all the funds could be channeled towards research support, TBCRC operated for many years with only two part-time staff: our business manager Cindy Morin and our program manager Robyn Burns, PhD. I have served as its Executive Officer since 2006. My own institution (Johns Hopkins) realized early on the potential of this new idea and generously provided pro bono administrative and contracts management support for the TBCRC member institutions. Since then, TBCRC has grown to 17 institutions with over 200 faculty and staff individuals participating in its activities, and we recently hired two full-time staff to help oversee the development of research studies and to handle contracts among the TBCRC institutions and with its foundation supporters.

Most importantly, we realized early on the critical intellectual and patient assets we had and the need to engage them. TBCRC emphasizes multidisciplinary research and care. Our members include medical oncologists, surgeons, radiation oncologists, basic scientists, and imaging specialists. With the wealth of scientific wisdom and bubbling ideas, we soon created smaller working groups that meets by phone monthly and in person at least twice a year. Working groups in disease subtypes were established: endocrine resistance; HER2 resistance; and triple negative disease. We also established a correlative science working group to support these disease-oriented working groups. Since patients are the primary reason for all we do, each TBCRC member institution identified a patient advocate to represent them and their patients in a patient advocate working group. Finally, as nothing happens as if by magic, we asked the institutions to identify research coordinators and contract managers to band together in their own working groups. It is a lot of people, but much of their work is done by phone and via e-mail to expedite things and minimize costs. Also, a nice side benefit has been the establishment of common processes across institutions, which in many cases have benefited their own efforts outside of TBCRC.

Q. What direction(s)/trends do you see emerging in breast cancer research in the next 10 years?

A. I see three main trends: 1) therapy individualization; 2) further refinement of tumor subtypes driven by specific interventions; and 3) improved public understanding of the need for tissue repositories. This combination of trends can dramatically improve patient outcomes.

One of the most remarkable examples of therapy individualization is the availability of anti-HER2 therapies, and the development of improved predictive markers of treatment benefit. Trastuzumab was quickly brought to patients' bedside in the late 1990s. Improvement in standard pathology measures and testing of new measures like gene expression profiling in the 2000s were largely due to studies using tissues collected from earlier clinical trials. Through patient tissues, we can assess the regulation of genes, look at gene expression, and the activation of cellular pathways (like ER, HER2, and PI3 kinase), and better understand how all this comes together so that we can gradually further develop techniques and treat patients with truly individualized care. But, if we are going to individualize care, we must also make sure we have excellent pathologic testing for markers that will influence treatment decisions, so that we can recommend the right treatment to the right patient, and this has been a focus of my personal work since 2005.

Also, I see in the near future therapy individualization beyond the major subtypes of breast cancer we now have, and this will allow us to further refine treatment decisions in a meaningful way. Like everything we do today, this can only be achieved through the collaborative interaction of experts with very diverse backgrounds, including clinician researchers, laboratory scientists, epidemiologists, biostatisticians, and bioinformaticians. In other words, this is a very large village and organizations like the BCRF have played a key role to help bring us all together.

The large-scale studies from the 1980s made us realize the importance of prospectively collecting tissue specimens from patients. We may not be able to fully understand all the data embedded in these tumor specimens now, but as technology evolves our understanding will evolve too. Also, these tissue blocks become incredibly valued over time as we learn about the clinical outcome of the patients associated with them, especially if these are patients who first presented with early-stage breast cancer. Therefore, in this partnership between researchers and patients, we must engage them and explain the critical nature of efforts to collect tissue and blood specimens for present and for future use.

Q. How close are we to preventing and curing all forms of breast cancer?

A. We cannot promise the public — those affected by cancer and those who support cancer research — that we will be able to cure cancer in just a few years. However, we can promise that we will further improve on the gains of the last few decades and continue to improve strategies to reduce risk, methods of early detection, and treatments to further reduce the morbidity and mortality of this disease. We will further understand what drives the development of cancer, who are the patients at greatest risk for developing cancer for the first time, and who are those at greatest risk for disease recurrence. By individualizing treatment, we help avoid exposing patients to unnecessary treatments and wasting limited resources. We now better understand how truly complex cancer is and I think the public understands this too. Therefore, we must act responsibly, engage the public, treat them as equal partners, keep them informed along the way, and translate new discoveries into clinical practice as soon as feasible.

Q. In your opinion, how has BCRF impacted breast cancer research?

A. What the BCRF leadership and scientific advisors have done is absolutely unique. They have ultimately identified a large number of productive and committed individuals who believe in what they do. BCRF provides investigators with resources that are otherwise not available to pursue new ideas and partnerships. Researchers have used BCRF grants to complement funds from the National Cancer Institute and from other organizations to test new concepts and pilot innovative studies. By bringing all these individuals together and putting resources on the table, BCRF has fostered scientific collaborations and cross-fertilization of ideas that have directly impacted the lives of many women.

BCRF has also taken other critical steps to help communicate, engage, and educate the public on what scientific research is and on the critical role the public can have. What we learned from the HIV and breast cancer fields is that when scientific investigators engage and collaborate with patient advocates, foundations, and community organizers, we raise awareness. This awareness translates into momentum, into political and social will, and ultimately into additional resources that are especially critical in difficult economic times. Therefore, organizations like BCRF have helped groups come together to overcome major obstacles to discover new knowledge, implement new clinical trials, analyze results, translate them into clinical practice, and ultimately improve the outcome of so many women diagnosed with breast cancer or at risk of developing it. It truly takes an enormous village to have an impact, and I am honored to be a part of it.

Read more about Dr. Wolff's current research project funded by BCRF.

# data[].attributes.field_meta_tags.description
BCRF sat down with Dr. Antonio Wolff to discuss his current work and interest in breast cancer research. Read on to learn more.

# data[].attributes.metatag_normalized[].attributes.content
BCRF Responds to New Mammography Study | BCRF

# data[].attributes.metatag_normalized[].attributes.content
On Tuesday, the British Medical Journal published a study that questions the value of mammograms. One of the largest studies of mammography, the Canadian investigation involved 90,000 women and took 25 years to complete. The size and the scope of the study have caused the media to take note. However, the report does not offer any new data, but rather provides follow-up on an old trial, one that was used with many others to formulate today’s breast screening guidelines.
Regular mammography has long been an issue of debate in the medical community. While mammograms are not perfect tests, BCRF’s scientific leadership, Dr. Larry Norton, Scientific Director, and Dr. Clifford Hudis, Chair of the Scientific Advisory Board, join the large majority of the scientific community in recommending that women of average risk take current screening guidelines—including annual mammograms starting at age 40—seriously. We continue to believe it is a critical step in minimizing a woman’s chances of dying from breast cancer.
Screening, by providing early detection, not only increases survival rates but also minimizes the chances of needing a mastectomy or requiring chemotherapy. And just as importantly, annual mammograms can reduce the risk of metastasis, because it’s only when cancer spreads that it turns lethal (metastasis is the cause of 90 percent of cancer deaths).
While the Canadian study found that death rates from breast cancer and from all causes were the same in women who obtained mammograms and those who did not, many questions have been raised about the quality of the mammograms used in the study, as well as how the patients were randomized to the “mammography or not” arms of the trial. In a statement released yesterday, the American College of Radiology (ACR) says the results are “flawed and misleading.” Our scientific leadership agrees with the ACR in its concern that this report of an old trial could put millions of women at unnecessary risk by steering them away from appropriate breast screening.
While mammograms may not yet be perfect, screening continues to be important while organizations like ours invest in research to find better methods. Currently, grantees supported by BCRF are working diligently to develop better (that is, more “accurately predictive”) imagine tools to improve upon mammography. In addition, our funding is enabling discoveries that better prevent and control breast cancer. We are studying the fundamental properties of breast cancer cells and their environment, with a mind to making advances not only in early detection and prevention, but also in curative therapies to thwart metastatic disease. Our researchers are uncovering modifiable risk factors to help men and women proactively reduce their chances of cancer and investigating chemoprevention strategies to thwart the development of breast cancer. They are creating sophisticated tests to evaluate the genetic and molecular makeup of tumors to personalize and optimize treatment. And they are developing therapies that kill cancer cells by stimulating the immune system.
As we have learned in the last 20 years, breast cancer is a complex disease with myriad layers and connections to other cancers as well as other illnesses. There is no easy solution to one of the world’s biggest problems, but we shouldn’t be so quick to disregard one of the best methods we have to detect this disease. Mammography is central to current breast cancer control strategies. BCRF—and the scientific community at large—clearly has more to do, but our work also depends on the support of many. Now, more than ever, we need a public that is educated about the status of breast cancer management now and engaged with us in seeking advances for the future.
 

# data[].attributes.metatag_normalized[].attributes.content
On Tuesday, the British Medical Journal published a study that questions the value of mammograms. One of the largest studies of mammography, the Canadian investigation involved 90,000 women and took 25 years to complete. The size and the scope of the study have caused the media to take note. However, the report does not offer any new data, but rather provides follow-up on an old trial, one that was used with many others to formulate today’s breast screening guidelines.

# data[].attributes.metatag_normalized[].attributes.content
Our Scientific Advisors offer insight on a Canadian study that questions the value of screening.

# data[].attributes.metatag_normalized[].attributes.content
On Tuesday, the British Medical Journal published a study that questions the value of mammograms. One of the largest studies of mammography, the Canadian investigation involved 90,000 women and took 25 years to complete. The size and the scope of the study have caused the media to take note. However, the report does not offer any new data, but rather provides follow-up on an old trial, one that was used with many others to formulate today’s breast screening guidelines.

# data[].attributes.body.value
On Tuesday, the British Medical Journal published a study that questions the value of mammograms. One of the largest studies of mammography, the Canadian investigation involved 90,000 women and took 25 years to complete. The size and the scope of the study have caused the media to take note. However, the report does not offer any new data, but rather provides follow-up on an old trial, one that was used with many others to formulate today’s breast screening guidelines.

Regular mammography has long been an issue of debate in the medical community. While mammograms are not perfect tests, BCRF’s scientific leadership, Dr. Larry Norton, Scientific Director, and Dr. Clifford Hudis, Chair of the Scientific Advisory Board, join the large majority of the scientific community in recommending that women of average risk take current screening guidelines—including annual mammograms starting at age 40—seriously. We continue to believe it is a critical step in minimizing a woman’s chances of dying from breast cancer.

Screening, by providing early detection, not only increases survival rates but also minimizes the chances of needing a mastectomy or requiring chemotherapy. And just as importantly, annual mammograms can reduce the risk of metastasis, because it’s only when cancer spreads that it turns lethal (metastasis is the cause of 90 percent of cancer deaths).

While the Canadian study found that death rates from breast cancer and from all causes were the same in women who obtained mammograms and those who did not, many questions have been raised about the quality of the mammograms used in the study, as well as how the patients were randomized to the “mammography or not” arms of the trial. In a statement released yesterday, the American College of Radiology (ACR) says the results are “flawed and misleading.” Our scientific leadership agrees with the ACR in its concern that this report of an old trial could put millions of women at unnecessary risk by steering them away from appropriate breast screening.

While mammograms may not yet be perfect, screening continues to be important while organizations like ours invest in research to find better methods. Currently, grantees supported by BCRF are working diligently to develop better (that is, more “accurately predictive”) imagine tools to improve upon mammography. In addition, our funding is enabling discoveries that better prevent and control breast cancer. We are studying the fundamental properties of breast cancer cells and their environment, with a mind to making advances not only in early detection and prevention, but also in curative therapies to thwart metastatic disease. Our researchers are uncovering modifiable risk factors to help men and women proactively reduce their chances of cancer and investigating chemoprevention strategies to thwart the development of breast cancer. They are creating sophisticated tests to evaluate the genetic and molecular makeup of tumors to personalize and optimize treatment. And they are developing therapies that kill cancer cells by stimulating the immune system.

As we have learned in the last 20 years, breast cancer is a complex disease with myriad layers and connections to other cancers as well as other illnesses. There is no easy solution to one of the world’s biggest problems, but we shouldn’t be so quick to disregard one of the best methods we have to detect this disease. Mammography is central to current breast cancer control strategies. BCRF—and the scientific community at large—clearly has more to do, but our work also depends on the support of many. Now, more than ever, we need a public that is educated about the status of breast cancer management now and engaged with us in seeking advances for the future.

# data[].attributes.body.processed
On Tuesday, the British Medical Journal published a study that questions the value of mammograms. One of the largest studies of mammography, the Canadian investigation involved 90,000 women and took 25 years to complete. The size and the scope of the study have caused the media to take note. However, the report does not offer any new data, but rather provides follow-up on an old trial, one that was used with many others to formulate today’s breast screening guidelines.

Regular mammography has long been an issue of debate in the medical community. While mammograms are not perfect tests, BCRF’s scientific leadership, Dr. Larry Norton, Scientific Director, and Dr. Clifford Hudis, Chair of the Scientific Advisory Board, join the large majority of the scientific community in recommending that women of average risk take current screening guidelines—including annual mammograms starting at age 40—seriously. We continue to believe it is a critical step in minimizing a woman’s chances of dying from breast cancer.

Screening, by providing early detection, not only increases survival rates but also minimizes the chances of needing a mastectomy or requiring chemotherapy. And just as importantly, annual mammograms can reduce the risk of metastasis, because it’s only when cancer spreads that it turns lethal (metastasis is the cause of 90 percent of cancer deaths).

While the Canadian study found that death rates from breast cancer and from all causes were the same in women who obtained mammograms and those who did not, many questions have been raised about the quality of the mammograms used in the study, as well as how the patients were randomized to the “mammography or not” arms of the trial. In a statement released yesterday, the American College of Radiology (ACR) says the results are “flawed and misleading.” Our scientific leadership agrees with the ACR in its concern that this report of an old trial could put millions of women at unnecessary risk by steering them away from appropriate breast screening.

While mammograms may not yet be perfect, screening continues to be important while organizations like ours invest in research to find better methods. Currently, grantees supported by BCRF are working diligently to develop better (that is, more “accurately predictive”) imagine tools to improve upon mammography. In addition, our funding is enabling discoveries that better prevent and control breast cancer. We are studying the fundamental properties of breast cancer cells and their environment, with a mind to making advances not only in early detection and prevention, but also in curative therapies to thwart metastatic disease. Our researchers are uncovering modifiable risk factors to help men and women proactively reduce their chances of cancer and investigating chemoprevention strategies to thwart the development of breast cancer. They are creating sophisticated tests to evaluate the genetic and molecular makeup of tumors to personalize and optimize treatment. And they are developing therapies that kill cancer cells by stimulating the immune system.

As we have learned in the last 20 years, breast cancer is a complex disease with myriad layers and connections to other cancers as well as other illnesses. There is no easy solution to one of the world’s biggest problems, but we shouldn’t be so quick to disregard one of the best methods we have to detect this disease. Mammography is central to current breast cancer control strategies. BCRF—and the scientific community at large—clearly has more to do, but our work also depends on the support of many. Now, more than ever, we need a public that is educated about the status of breast cancer management now and engaged with us in seeking advances for the future.

# data[].attributes.field_subtitle
Our Scientific Advisors offer insight on a Canadian study that questions the value of screening.

# data[].attributes.title
In the Spotlight: BCRF Scientific Leaders Comment on the Latest Breast Cancer Headlines

# data[].attributes.metatag_normalized[].attributes.content
In the Spotlight: BCRF Scientific Leaders Comment on the Latest Breast Cancer Headlines | BCRF

# data[].attributes.metatag_normalized[].attributes.content
Check out BCRF's latest "in the spotlight" where BCRF scientific leaders comment on the latest breast cancer headlines, including New York Times articles.

# data[].attributes.metatag_normalized[].attributes.content
In the Spotlight: BCRF Scientific Leaders Comment on the Latest Breast Cancer Headlines

# data[].attributes.metatag_normalized[].attributes.content
New York Times Magazine article, titled "Our Feel-Good War on Breast Cancer," raises the important question, among others: When it comes to breast cancer, are we doing more harm than good? The Breast Cancer Research Foundation's Director of Communications and Engagement, Sabrina Dupré, asked BCRF scientific leaders, Drs. Larry Norton (Scientific Director) and Clifford Hudis (Chairman, Scientific Advisory Board), a few questions of her own.

# data[].attributes.metatag_normalized[].attributes.content
In the Spotlight: BCRF Scientific Leaders Comment on the Latest Breast Cancer Headlines

# data[].attributes.metatag_normalized[].attributes.content
New York Times Magazine article, titled "Our Feel-Good War on Breast Cancer," raises the important question, among others: When it comes to breast cancer, are we doing more harm than good? The Breast Cancer Research Foundation's Director of Communications and Engagement, Sabrina Dupré, asked BCRF scientific leaders, Drs. Larry Norton (Scientific Director) and Clifford Hudis (Chairman, Scientific Advisory Board), a few questions of her own.

# data[].attributes.metatag_normalized[].attributes.content
In the Spotlight: BCRF Scientific Leaders Comment on the Latest Breast Cancer Headlines

# data[].attributes.body.value
New York Times Magazine article, titled "Our Feel-Good War on Breast Cancer," raises the important question, among others: When it comes to breast cancer, are we doing more harm than good? The Breast Cancer Research Foundation's Director of Communications and Engagement, Sabrina Dupré, asked BCRF scientific leaders, Drs. Larry Norton (Scientific Director) and Clifford Hudis (Chairman, Scientific Advisory Board), a few questions of her own.

Q: Lately, a number of critics assert that the breast cancer awareness movement has achieved its goal of awareness and is now at the point of unnecessarily heightening fears. How do you respond?

A: LN: The goal of universal awareness that breast health is important is far from having been achieved. Only about 60% of women who should be getting screened are doing so. In addition, behaviors that we know with certainty increase one's risk of getting and dying of breast cancer - such as using post-menopausal combination hormone replacement or being obese - are still not connected in everyone's mind as dangerous. It is critical that we continue to educate people about such dangerous behaviors.

CH: I agree. Further, just a few decades ago, the word "cancer" itself could hardly be uttered. Thanks to the awareness movement, and I've heard this many times from patients themselves, millions of people have been comforted simply by knowing that they are not alone in what can be an incredible isolating journey. In addition, one of the positive outcomes of the breast cancer awareness movement is that it has demonstrated that there is less to fear from the diagnosis of cancer than people used to think. Frankly, only by confusing "knowledge" with "fear" could one conclude that awareness could be harmful.

Q: You mention screening, currently a widely-debated topic in terms of its efficacy and value. What's being done to improve diagnostic screening?

A: LN: Many people might not realize that there is much research going on to try to make detection more sensitive, accurate and accessible - by improved imaging technologies, identification of individuals at higher than average risk, and even development of new screening methods including blood tests.

CH: The Breast Cancer Research Foundation, for example, is currently supporting two kinds of research to accomplish this. First, the investigators supported by the BCRF are developing better (that is, more accurately predictive) imaging tools to improve upon mammography. Second, we are enabling the development of what are called "predictive tests" or molecular diagnostics. These tests can "interrogate" the cells that are obtained at biopsy so that doctors can more accurately predict their future behavior. The goal is to identify a potential problem and then, in the least intrusive way possible, either confirm that it has the potential to adversely affect health or confirm that we can safely avoid or limit treatment. In the end, all of this depends on two things: a willingness to invest more resources, and an informed general public that is educated about risks and benefits and is engaged with us in seeking accurate answers.

Q: The most commonly talked about screening tool is the mammogram. Is it 100% effective?

A: CH: No test is 100% effective, and there are many factors that contribute to the challenge of detecting breast cancer: the density of a patient's breast, the sensitivity of the diagnostic tool itself, and so forth. An additional complication is that breast cancer itself is not one singular disease, but instead a collection of related diseases that may appear differently using screening tools. The only solution is continued research. At the same time, the one thing we know is that the increased use of mammography has been associated with the discovery of smaller cancers that are more easily treated and with improved survival, even if some cancers are still missed.

Q: So why do people still endorse mammography when we know it's imperfect?

LN: Here's the biology: at some time between the second a single cell turns cancerous and when it has grown into a large mass, it will spread, or metastasize, to other parts of the body and become life-threatening. The objective of the mammogram is to find the cancerous process before that dire moment. The fact is that mammograms are still the best general screening test we have. Just because something is good but imperfect doesn't mean we should abandon it! The time to replace mammography will be when we have a more perfect test, and that is exactly why BCRF, for example, is involved in funding research to improve the sensitivity and accuracy of screening tests like mammograms. We all want to get to that day as soon as possible.

CH: Agreed. And research has shown, time and again, that mammograms are indeed effective in detecting many cancers for which early therapy makes a major difference in the cure rate.

Q: Okay. But the possibility remains that mammograms sometimes "miss" detecting breast cancer or, at the other end of the spectrum, produce unnecessarily worrisome false positive results. True?

A: LN: It is true that some cancers are missed by mammograms because of the combination of factors that Cliff mentioned earlier.

CH: Still, a mammogram is the simplest way to lower one's risk of premature death from breast cancer - in other words, to save lives. The way a mammogram saves lives is by identifying abnormalities in the breast that may represent cancer so we can intervene early on. The only way to prove whether or not these abnormalities are, in fact, cancer is to then perform a biopsy. The biopsy, in turn, produces either one of two possible outcomes - the result is "positive" (meaning it confirms cancer), treatment ensues and lives are saved, or it is "negative" (meaning it confirms a benign diagnosis) and treatment is either unnecessary or limited.

LN: Yes, biopsies are invasive and therefore sometimes unpleasant. But the question is: which is worse? Having a biopsy that turns out not to show cancer or not having a biopsy and missing a potentially curable cancer? The term "unnecessary" is a post-hoc judgment. I sometimes explain it this way: If someone fires an arrow at you, do you choose to not step out of its way because sometimes that arrow will miss its mark? If you do not step out of the way and then the arrow does hit you, would you feel that you had made a good decision? Alternatively, had you chosen to step away, and the arrow misses you, would it be rational to assume that it would have missed you anyway, that stepping away was "unnecessary"?

Q: Back to the breast cancer awareness movement. Another critique is that many awareness activities, particularly social events like walks, seem to focus on the faces of "survivorship." Do you think these campaigns are doing so at the expense of excluding those with metastatic disease?

A: LN: First of all, making the claim that all breast cancer organizations or campaigns focus only on people who have survived after a diagnosis of primary breast cancer (cancer in the breast only) and ignore those with metastatic breast cancer is an erroneous generalization. Many organizations, including BCRF, make a point to include and be relevant to people - men and women - with all stages of breast cancer, from those whose disease has spread to those without disease who are interested in prevention. And for many of those people, the public statement that they have had breast cancer and are leading full, rich, and productive lives is very important and it would be cruel and unfair to deny them that opportunity. We applaud efforts to bring people with metastatic disease into the circle of survivorship, camaraderie and mutual support that has proven so valuable to many who have had only primary disease.

CH: The groups that provide support, fundraising, access to care, scientific education, and awareness, all have their own specific missions and goals. Some or many may have previously concentrated on patients with earlier stages of the disease because their focus was, for instance, the benefits of screening. In recent years, because of advances in treatment (many of which have been supported directly by BCRF), more patients are surviving and living well despite a diagnosis of metastatic breast cancer, and this group of patients is increasingly visible and vocal. Are they as visible and vocal as others in all of these advocacy groups? Possibly not. But this can be addressed organically as groups respond to all of the needs of our community.

Q: What is being done to address metastatic breast cancer?

A: CH: Everyday, we increase our understanding of even smaller subsets of breast cancer, defined by ever more sophisticated tools. That's why we've been able to achieve advances in treatment that have been proven to extend life and that have reduced toxicity compared to what we were able to do in the past. BCRF, for example, is constantly looking at where the next most promising steps lie and is substantially increasing its investment in this area.

LN: The bottom line is simple: more research is needed. We have yet to identify with 100% accuracy which breast cancers will metastasize. We have yet to develop cures for 100% of people with metastatic disease. That is why metastasis is such a focus of BCRF grant making. In fact, BCRF has invested almost half of its $40 million in 2012 grants to this topic. Furthermore, we have earmarked the entire $27 million in a new initiative called the Evelyn Lauder Founder's Fund for a global collaborative investigation of the molecular underpinnings of metastasis.

Q: So many women (108 women in the US alone) still die of breast cancer each day. Many people can't help but wonder-is research doing enough?

A: CH: For someone facing a serious diagnosis, traditionally incurable, it has to be true that not enough is being done. But we need to recognize the advances that have been made. Because of research, we have emerged from a world of "one-size-fits all" treatment, recognizing, for example, that some cancers are better controlled by blocking estrogen while others are best treated with anti-HER2 drugs. And the ability to customize treatment for each individual continues to improve thanks in part to the research that BCRF supports.

LN: Just because much remains to be accomplished does not mean that we should denigrate the progress that we have already made. Indeed, the scientific process that has brought us this far is pointing in profoundly exciting new directions. Sometimes this progress is not evident in national statistics on mortality because, unfortunately, not every American has access to the best screening or best care. We need to do better in that area, too. But progress, which is never rapid enough, will not accompany resignation to the status quo or despondency. Accomplishing all of our goals, including the defeat of metastatic cancer, demands our enthusiasm, energy and optimism.

Q: What can individuals or institutions do to make an impact, be it their own health or the breast cancer movement?

A: CH: We are learning how a number of lifestyle and behavioral changes can help reduce an individual's chance of dying from breast cancer, and so I encourage every person to take ownership over their wellness, whether it be through maintaining a healthy body weight, exercising, avoiding hormone replacement therapies, and also by obtaining the best possible care including maintenance of screening standards.

LN: Most people are not aware of how underfunded cancer research is when compared to the magnitude of the cancer problem. One-third to one-half of all Americans will die of cancer unless we continue to make progress. Yet, as a nation we spend about a seventh of what we spend on soft drinks and about a third of what we spend on tobacco advertising on all forms of cancer research from all sources - philanthropic, government and industry. To eradicate cancer we do not need a massive sacrifice, but rather a mass commitment. We can find the answers in science-the opportunities have never been greater - if only we dedicate ourselves to that mission.

# data[].attributes.body.processed
New York Times Magazine article, titled "Our Feel-Good War on Breast Cancer," raises the important question, among others: When it comes to breast cancer, are we doing more harm than good? The Breast Cancer Research Foundation's Director of Communications and Engagement, Sabrina Dupré, asked BCRF scientific leaders, Drs. Larry Norton (Scientific Director) and Clifford Hudis (Chairman, Scientific Advisory Board), a few questions of her own.

Q: Lately, a number of critics assert that the breast cancer awareness movement has achieved its goal of awareness and is now at the point of unnecessarily heightening fears. How do you respond?

A: LN: The goal of universal awareness that breast health is important is far from having been achieved. Only about 60% of women who should be getting screened are doing so. In addition, behaviors that we know with certainty increase one's risk of getting and dying of breast cancer - such as using post-menopausal combination hormone replacement or being obese - are still not connected in everyone's mind as dangerous. It is critical that we continue to educate people about such dangerous behaviors.

CH: I agree. Further, just a few decades ago, the word "cancer" itself could hardly be uttered. Thanks to the awareness movement, and I've heard this many times from patients themselves, millions of people have been comforted simply by knowing that they are not alone in what can be an incredible isolating journey. In addition, one of the positive outcomes of the breast cancer awareness movement is that it has demonstrated that there is less to fear from the diagnosis of cancer than people used to think. Frankly, only by confusing "knowledge" with "fear" could one conclude that awareness could be harmful.

Q: You mention screening, currently a widely-debated topic in terms of its efficacy and value. What's being done to improve diagnostic screening?

A: LN: Many people might not realize that there is much research going on to try to make detection more sensitive, accurate and accessible - by improved imaging technologies, identification of individuals at higher than average risk, and even development of new screening methods including blood tests.

CH: The Breast Cancer Research Foundation, for example, is currently supporting two kinds of research to accomplish this. First, the investigators supported by the BCRF are developing better (that is, more accurately predictive) imaging tools to improve upon mammography. Second, we are enabling the development of what are called "predictive tests" or molecular diagnostics. These tests can "interrogate" the cells that are obtained at biopsy so that doctors can more accurately predict their future behavior. The goal is to identify a potential problem and then, in the least intrusive way possible, either confirm that it has the potential to adversely affect health or confirm that we can safely avoid or limit treatment. In the end, all of this depends on two things: a willingness to invest more resources, and an informed general public that is educated about risks and benefits and is engaged with us in seeking accurate answers.

Q: The most commonly talked about screening tool is the mammogram. Is it 100% effective?

A: CH: No test is 100% effective, and there are many factors that contribute to the challenge of detecting breast cancer: the density of a patient's breast, the sensitivity of the diagnostic tool itself, and so forth. An additional complication is that breast cancer itself is not one singular disease, but instead a collection of related diseases that may appear differently using screening tools. The only solution is continued research. At the same time, the one thing we know is that the increased use of mammography has been associated with the discovery of smaller cancers that are more easily treated and with improved survival, even if some cancers are still missed.

Q: So why do people still endorse mammography when we know it's imperfect?

LN: Here's the biology: at some time between the second a single cell turns cancerous and when it has grown into a large mass, it will spread, or metastasize, to other parts of the body and become life-threatening. The objective of the mammogram is to find the cancerous process before that dire moment. The fact is that mammograms are still the best general screening test we have. Just because something is good but imperfect doesn't mean we should abandon it! The time to replace mammography will be when we have a more perfect test, and that is exactly why BCRF, for example, is involved in funding research to improve the sensitivity and accuracy of screening tests like mammograms. We all want to get to that day as soon as possible.

CH: Agreed. And research has shown, time and again, that mammograms are indeed effective in detecting many cancers for which early therapy makes a major difference in the cure rate.

Q: Okay. But the possibility remains that mammograms sometimes "miss" detecting breast cancer or, at the other end of the spectrum, produce unnecessarily worrisome false positive results. True?

A: LN: It is true that some cancers are missed by mammograms because of the combination of factors that Cliff mentioned earlier.

CH: Still, a mammogram is the simplest way to lower one's risk of premature death from breast cancer - in other words, to save lives. The way a mammogram saves lives is by identifying abnormalities in the breast that may represent cancer so we can intervene early on. The only way to prove whether or not these abnormalities are, in fact, cancer is to then perform a biopsy. The biopsy, in turn, produces either one of two possible outcomes - the result is "positive" (meaning it confirms cancer), treatment ensues and lives are saved, or it is "negative" (meaning it confirms a benign diagnosis) and treatment is either unnecessary or limited.

LN: Yes, biopsies are invasive and therefore sometimes unpleasant. But the question is: which is worse? Having a biopsy that turns out not to show cancer or not having a biopsy and missing a potentially curable cancer? The term "unnecessary" is a post-hoc judgment. I sometimes explain it this way: If someone fires an arrow at you, do you choose to not step out of its way because sometimes that arrow will miss its mark? If you do not step out of the way and then the arrow does hit you, would you feel that you had made a good decision? Alternatively, had you chosen to step away, and the arrow misses you, would it be rational to assume that it would have missed you anyway, that stepping away was "unnecessary"?

Q: Back to the breast cancer awareness movement. Another critique is that many awareness activities, particularly social events like walks, seem to focus on the faces of "survivorship." Do you think these campaigns are doing so at the expense of excluding those with metastatic disease?

A: LN: First of all, making the claim that all breast cancer organizations or campaigns focus only on people who have survived after a diagnosis of primary breast cancer (cancer in the breast only) and ignore those with metastatic breast cancer is an erroneous generalization. Many organizations, including BCRF, make a point to include and be relevant to people - men and women - with all stages of breast cancer, from those whose disease has spread to those without disease who are interested in prevention. And for many of those people, the public statement that they have had breast cancer and are leading full, rich, and productive lives is very important and it would be cruel and unfair to deny them that opportunity. We applaud efforts to bring people with metastatic disease into the circle of survivorship, camaraderie and mutual support that has proven so valuable to many who have had only primary disease.

CH: The groups that provide support, fundraising, access to care, scientific education, and awareness, all have their own specific missions and goals. Some or many may have previously concentrated on patients with earlier stages of the disease because their focus was, for instance, the benefits of screening. In recent years, because of advances in treatment (many of which have been supported directly by BCRF), more patients are surviving and living well despite a diagnosis of metastatic breast cancer, and this group of patients is increasingly visible and vocal. Are they as visible and vocal as others in all of these advocacy groups? Possibly not. But this can be addressed organically as groups respond to all of the needs of our community.

Q: What is being done to address metastatic breast cancer?

A: CH: Everyday, we increase our understanding of even smaller subsets of breast cancer, defined by ever more sophisticated tools. That's why we've been able to achieve advances in treatment that have been proven to extend life and that have reduced toxicity compared to what we were able to do in the past. BCRF, for example, is constantly looking at where the next most promising steps lie and is substantially increasing its investment in this area.

LN: The bottom line is simple: more research is needed. We have yet to identify with 100% accuracy which breast cancers will metastasize. We have yet to develop cures for 100% of people with metastatic disease. That is why metastasis is such a focus of BCRF grant making. In fact, BCRF has invested almost half of its $40 million in 2012 grants to this topic. Furthermore, we have earmarked the entire $27 million in a new initiative called the Evelyn Lauder Founder's Fund for a global collaborative investigation of the molecular underpinnings of metastasis.

Q: So many women (108 women in the US alone) still die of breast cancer each day. Many people can't help but wonder-is research doing enough?

A: CH: For someone facing a serious diagnosis, traditionally incurable, it has to be true that not enough is being done. But we need to recognize the advances that have been made. Because of research, we have emerged from a world of "one-size-fits all" treatment, recognizing, for example, that some cancers are better controlled by blocking estrogen while others are best treated with anti-HER2 drugs. And the ability to customize treatment for each individual continues to improve thanks in part to the research that BCRF supports.

LN: Just because much remains to be accomplished does not mean that we should denigrate the progress that we have already made. Indeed, the scientific process that has brought us this far is pointing in profoundly exciting new directions. Sometimes this progress is not evident in national statistics on mortality because, unfortunately, not every American has access to the best screening or best care. We need to do better in that area, too. But progress, which is never rapid enough, will not accompany resignation to the status quo or despondency. Accomplishing all of our goals, including the defeat of metastatic cancer, demands our enthusiasm, energy and optimism.

Q: What can individuals or institutions do to make an impact, be it their own health or the breast cancer movement?

A: CH: We are learning how a number of lifestyle and behavioral changes can help reduce an individual's chance of dying from breast cancer, and so I encourage every person to take ownership over their wellness, whether it be through maintaining a healthy body weight, exercising, avoiding hormone replacement therapies, and also by obtaining the best possible care including maintenance of screening standards.

LN: Most people are not aware of how underfunded cancer research is when compared to the magnitude of the cancer problem. One-third to one-half of all Americans will die of cancer unless we continue to make progress. Yet, as a nation we spend about a seventh of what we spend on soft drinks and about a third of what we spend on tobacco advertising on all forms of cancer research from all sources - philanthropic, government and industry. To eradicate cancer we do not need a massive sacrifice, but rather a mass commitment. We can find the answers in science-the opportunities have never been greater - if only we dedicate ourselves to that mission.

# data[].attributes.field_meta_tags.description
Check out BCRF's latest "in the spotlight" where BCRF scientific leaders comment on the latest breast cancer headlines, including New York Times articles.

# data[].attributes.title
The Hamptons Paddle & Party for Pink Raises $1.5 Million

# data[].attributes.metatag_normalized[].attributes.content
The Hamptons Paddle & Party for Pink Raises $1.5 Million | BCRF

# data[].attributes.metatag_normalized[].attributes.content
On August 16, our annual Hamptons Paddle & Party for Pink raised $1.5 million for breast cancer research, a new record for the summer fundraiser. Created by longtime BCRF supporter Maria Baum, the two-part event is a perfect mix of surf and style.
A loving wife, mother of four and accomplished businesswoman, Maria was diagnosed with breast cancer in 2011 at the age of 42. The news was totally unexpected, as she had no family history of the disease. When she received the call from her doctor, it changed her life.
After her diagnosis, Maria immediately changed her way of living. A diet once filled with processed foods and little physical activity now centered on exercise and organic fruits and vegetables. Thanks to an introduction from her friend Richard Perry, Maria also picked up paddle boarding as a way to balance her body and mind. She found the practice effective and therapeutic—and it planted an idea in her head.  
Inspired by her journey with breast cancer, Maria felt the need to help other women and men affected by the disease. She and her husband, Larry, combined Maria’s goal to give back with her love of paddle boarding by organizing a small race and party in the Hamptons with the help of friends Richard and Lisa Perry. They were blown away by the community’s support, and Maria recognized the event’s potential to make an even greater impact.
In 2011, the Baums and the Perrys came to BCRF with their idea and, together, the Hampton’s Paddle & Party for Pink was created. Today, the two-part event kicks off in the morning with a World Paddle Association paddleboard race at Havens Beach in Sag Harbor, NY. At sunset, the Perrys welcome supporters to their waterfront residence for an evening party to raise funds for research.
This year, 200 paddlers competed during the morning race and hundreds of guests gathered that evening to support BCRF’s mission to advance the world's most promising research. Attendees included host Tracy Anderson, Leonard Lauder, William Lauder, Mary-Kate Olsen & Olivier Sarkozy, Ashley Olsen, Martha Stewart and Donna Karan. In addition, we had an amazing auction on CharityBuzz.com that accompanied the event to raise more critical funds for research.
We can’t wait to do it again next year!

# data[].attributes.metatag_normalized[].attributes.content
The Hamptons Paddle & Party for Pink Raises $1.5 Million

# data[].attributes.metatag_normalized[].attributes.content
On August 16, our annual Hamptons Paddle & Party for Pink raised $1.5 million for breast cancer research, a new record for the summer fundraiser. Created by longtime BCRF supporter Maria Baum, the two-part event is a perfect mix of surf and style.
A loving wife, mother of four and accomplished businesswoman, Maria was diagnosed with breast cancer in 2011 at the age of 42. The news was totally unexpected, as she had no family history of the disease. When she received the call from her doctor, it changed her life.

# data[].attributes.metatag_normalized[].attributes.content
The Hamptons Paddle & Party for Pink Raises $1.5 Million

# data[].attributes.metatag_normalized[].attributes.content
On August 16, our annual Hamptons Paddle & Party for Pink raised $1.5 million for breast cancer research, a new record for the summer fundraiser. Created by longtime BCRF supporter Maria Baum, the two-part event is a perfect mix of surf and style.
A loving wife, mother of four and accomplished businesswoman, Maria was diagnosed with breast cancer in 2011 at the age of 42. The news was totally unexpected, as she had no family history of the disease. When she received the call from her doctor, it changed her life.

# data[].attributes.metatag_normalized[].attributes.content
The Hamptons Paddle & Party for Pink Raises $1.5 Million

# data[].attributes.body.value
On August 16, our annual Hamptons Paddle & Party for Pink raised $1.5 million for breast cancer research, a new record for the summer fundraiser. Created by longtime BCRF supporter Maria Baum, the two-part event is a perfect mix of surf and style.

A loving wife, mother of four and accomplished businesswoman, Maria was diagnosed with breast cancer in 2011 at the age of 42. The news was totally unexpected, as she had no family history of the disease. When she received the call from her doctor, it changed her life.

After her diagnosis, Maria immediately changed her way of living. A diet once filled with processed foods and little physical activity now centered on exercise and organic fruits and vegetables. Thanks to an introduction from her friend Richard Perry, Maria also picked up paddle boarding as a way to balance her body and mind. She found the practice effective and therapeutic—and it planted an idea in her head.

Inspired by her journey with breast cancer, Maria felt the need to help other women and men affected by the disease. She and her husband, Larry, combined Maria’s goal to give back with her love of paddle boarding by organizing a small race and party in the Hamptons with the help of friends Richard and Lisa Perry. They were blown away by the community’s support, and Maria recognized the event’s potential to make an even greater impact.

In 2011, the Baums and the Perrys came to BCRF with their idea and, together, the Hampton’s Paddle & Party for Pink was created. Today, the two-part event kicks off in the morning with a World Paddle Association paddleboard race at Havens Beach in Sag Harbor, NY. At sunset, the Perrys welcome supporters to their waterfront residence for an evening party to raise funds for research.

This year, 200 paddlers competed during the morning race and hundreds of guests gathered that evening to support BCRF’s mission to advance the world's most promising research. Attendees included host Tracy Anderson, Leonard Lauder, William Lauder, Mary-Kate Olsen & Olivier Sarkozy, Ashley Olsen, Martha Stewart and Donna Karan. In addition, we had an amazing auction on CharityBuzz.com that accompanied the event to raise more critical funds for research.

We can’t wait to do it again next year!

# data[].attributes.body.processed
On August 16, our annual Hamptons Paddle & Party for Pink raised $1.5 million for breast cancer research, a new record for the summer fundraiser. Created by longtime BCRF supporter Maria Baum, the two-part event is a perfect mix of surf and style.

A loving wife, mother of four and accomplished businesswoman, Maria was diagnosed with breast cancer in 2011 at the age of 42. The news was totally unexpected, as she had no family history of the disease. When she received the call from her doctor, it changed her life.

After her diagnosis, Maria immediately changed her way of living. A diet once filled with processed foods and little physical activity now centered on exercise and organic fruits and vegetables. Thanks to an introduction from her friend Richard Perry, Maria also picked up paddle boarding as a way to balance her body and mind. She found the practice effective and therapeutic—and it planted an idea in her head.

Inspired by her journey with breast cancer, Maria felt the need to help other women and men affected by the disease. She and her husband, Larry, combined Maria’s goal to give back with her love of paddle boarding by organizing a small race and party in the Hamptons with the help of friends Richard and Lisa Perry. They were blown away by the community’s support, and Maria recognized the event’s potential to make an even greater impact.

In 2011, the Baums and the Perrys came to BCRF with their idea and, together, the Hampton’s Paddle & Party for Pink was created. Today, the two-part event kicks off in the morning with a World Paddle Association paddleboard race at Havens Beach in Sag Harbor, NY. At sunset, the Perrys welcome supporters to their waterfront residence for an evening party to raise funds for research.

This year, 200 paddlers competed during the morning race and hundreds of guests gathered that evening to support BCRF’s mission to advance the world's most promising research. Attendees included host Tracy Anderson, Leonard Lauder, William Lauder, Mary-Kate Olsen & Olivier Sarkozy, Ashley Olsen, Martha Stewart and Donna Karan. In addition, we had an amazing auction on CharityBuzz.com that accompanied the event to raise more critical funds for research.

We can’t wait to do it again next year!

# data[].attributes.metatag_normalized[].attributes.content
Is a Cancer-Free World Possible?  | BCRF

# data[].attributes.metatag_normalized[].attributes.content
Here at BCRF, we have always recognized the need to allow our scientists the freedom and creativity to pursue promising research. It’s the principle we were founded on. But as federal funding for cancer research becomes increasingly scarce, it’s become even more important.
In a blog post for The American Society of Clinical Oncology, Chairman of BCRF’s Scientific Advisory Board Dr. Clifford Hudis laments the National Institutes of Health (NIH) and its lack of investment in research. Although cancer now affects almost half of all Americans, enrollment in NIH-funded clinical trials is being slashed and grant applications are being rejected. And every time a researcher is turned down, another opportunity is lost for a breakthrough that could potentially affect millions of people.
Read Dr. Hudis’ thoughts on how limiting resources are slowing progress, and then let us know your take.
 
A World Free From the Fear of Cancer — Is It Possible?
This post originally appeared on CancerProgress.Net. Reprinted with permission from The American Society of Clinical Oncology. 
By every definition, ASCO’s 50th Annual Meeting was a huge success. The halls were buzzing as nearly 35,000 attendees from the world’s cancer community shared excitement about cancer research progress.  
Yet, as the good news was unveiled, I couldn’t help but wonder: what can we do to make sure that meetings like this happen again and again? 
This was a banner year for federally funded cancer research trials – all four of the abstracts selected for ASCO’s plenary session were backed by funding from the National Institutes of Health (NIH), as were so many of the other studies that captured news headlines. 
But the U.S. clinical research system that brought us here is facing unprecedented challenges that could limit its ability to support the scope and scale of research we saw presented this year.  
Today the purchasing power of the NIH is 23% lower than it was in 2003. And while valiant efforts have been made to stretch every dollar, we are beginning to see the real-world impact of plummeting funding.
Already, enrollment in NIH-funded cancer clinical trials has been slashed. In 2009, about 29,000 adult patients participated in these trials. But recently, the NCI announced plans to cut enrollment by 15% over the next few years, scaling yearly enrollment back to as low as 17,000 patients in intervention trials.
Continue reading at The ASCO Post. 

# data[].attributes.metatag_normalized[].attributes.content
Here at BCRF, we have always recognized the need to allow our scientists the freedom and creativity to pursue promising research. It’s the principle we were founded on. But as federal funding for cancer research becomes increasingly scarce, it’s become even more important.

# data[].attributes.metatag_normalized[].attributes.content
Our Scientific Advisory Board Chairman Weighs In

# data[].attributes.metatag_normalized[].attributes.content
Here at BCRF, we have always recognized the need to allow our scientists the freedom and creativity to pursue promising research. It’s the principle we were founded on. But as federal funding for cancer research becomes increasingly scarce, it’s become even more important.

# data[].attributes.body.value
Here at BCRF, we have always recognized the need to allow our scientists the freedom and creativity to pursue promising research. It’s the principle we were founded on. But as federal funding for cancer research becomes increasingly scarce, it’s become even more important.

In a blog post for The American Society of Clinical Oncology, Chairman of BCRF’s Scientific Advisory Board Dr. Clifford Hudis laments the National Institutes of Health (NIH) and its lack of investment in research. Although cancer now affects almost half of all Americans, enrollment in NIH-funded clinical trials is being slashed and grant applications are being rejected. And every time a researcher is turned down, another opportunity is lost for a breakthrough that could potentially affect millions of people.

Read Dr. Hudis’ thoughts on how limiting resources are slowing progress, and then let us know your take.

A World Free From the Fear of Cancer — Is It Possible?

This post originally appeared on CancerProgress.Net. Reprinted with permission from The American Society of Clinical Oncology.

By every definition, ASCO’s 50th Annual Meeting was a huge success. The halls were buzzing as nearly 35,000 attendees from the world’s cancer community shared excitement about cancer research progress.

Yet, as the good news was unveiled, I couldn’t help but wonder: what can we do to make sure that meetings like this happen again and again?

This was a banner year for federally funded cancer research trials – all four of the abstracts selected for ASCO’s plenary session were backed by funding from the National Institutes of Health (NIH), as were so many of the other studies that captured news headlines.

But the U.S. clinical research system that brought us here is facing unprecedented challenges that could limit its ability to support the scope and scale of research we saw presented this year.

Today the purchasing power of the NIH is 23% lower than it was in 2003. And while valiant efforts have been made to stretch every dollar, we are beginning to see the real-world impact of plummeting funding.

Already, enrollment in NIH-funded cancer clinical trials has been slashed. In 2009, about 29,000 adult patients participated in these trials. But recently, the NCI announced plans to cut enrollment by 15% over the next few years, scaling yearly enrollment back to as low as 17,000 patients in intervention trials.

Continue reading at The ASCO Post.

# data[].attributes.body.processed
Here at BCRF, we have always recognized the need to allow our scientists the freedom and creativity to pursue promising research. It’s the principle we were founded on. But as federal funding for cancer research becomes increasingly scarce, it’s become even more important.

In a blog post for The American Society of Clinical Oncology, Chairman of BCRF’s Scientific Advisory Board Dr. Clifford Hudis laments the National Institutes of Health (NIH) and its lack of investment in research. Although cancer now affects almost half of all Americans, enrollment in NIH-funded clinical trials is being slashed and grant applications are being rejected. And every time a researcher is turned down, another opportunity is lost for a breakthrough that could potentially affect millions of people.

Read Dr. Hudis’ thoughts on how limiting resources are slowing progress, and then let us know your take.

A World Free From the Fear of Cancer — Is It Possible?

This post originally appeared on CancerProgress.Net. Reprinted with permission from The American Society of Clinical Oncology.

By every definition, ASCO’s 50th Annual Meeting was a huge success. The halls were buzzing as nearly 35,000 attendees from the world’s cancer community shared excitement about cancer research progress.

Yet, as the good news was unveiled, I couldn’t help but wonder: what can we do to make sure that meetings like this happen again and again?

This was a banner year for federally funded cancer research trials – all four of the abstracts selected for ASCO’s plenary session were backed by funding from the National Institutes of Health (NIH), as were so many of the other studies that captured news headlines.

But the U.S. clinical research system that brought us here is facing unprecedented challenges that could limit its ability to support the scope and scale of research we saw presented this year.

Today the purchasing power of the NIH is 23% lower than it was in 2003. And while valiant efforts have been made to stretch every dollar, we are beginning to see the real-world impact of plummeting funding.

Already, enrollment in NIH-funded cancer clinical trials has been slashed. In 2009, about 29,000 adult patients participated in these trials. But recently, the NCI announced plans to cut enrollment by 15% over the next few years, scaling yearly enrollment back to as low as 17,000 patients in intervention trials.

Continue reading at The ASCO Post.

# data[].attributes.field_subtitle
Our Scientific Advisory Board Chairman Weighs In 

# data[].attributes.title
Every 2 Minutes, a Woman in the U.S. Is Diagnosed With Breast Cancer

# data[].attributes.metatag_normalized[].attributes.content
Every 2 Minutes, a Woman in the U.S. Is Diagnosed With Breast Cancer | BCRF

# data[].attributes.metatag_normalized[].attributes.content
Every two minutes, a woman in the United States is diagnosed with breast cancer. Research is helping us better understand how to best treat and prevent the disease. Join us.

# data[].attributes.metatag_normalized[].attributes.content
Every 2 Minutes, a Woman in the U.S. Is Diagnosed With Breast Cancer

# data[].attributes.metatag_normalized[].attributes.content
Every two minutes, a woman in the United States is diagnosed with breast cancer. Research is helping us better understand how to best treat and prevent the disease. Join us.

# data[].attributes.metatag_normalized[].attributes.content
Every 2 Minutes, a Woman in the U.S. Is Diagnosed With Breast Cancer

# data[].attributes.metatag_normalized[].attributes.content
Every two minutes, a woman in the United States is diagnosed with breast cancer. Research is helping us better understand how to best treat and prevent the disease. Join us.

# data[].attributes.metatag_normalized[].attributes.content
Every 2 Minutes, a Woman in the U.S. Is Diagnosed With Breast Cancer

# data[].attributes.body.value
Every two minutes, a woman in the United States is diagnosed with breast cancer. Research is helping us better understand how to best treat and prevent the disease. Join us.

# data[].attributes.body.processed
Every two minutes, a woman in the United States is diagnosed with breast cancer. Research is helping us better understand how to best treat and prevent the disease. Join us.

# data[].attributes.metatag_normalized[].attributes.content
Since our founding by Evelyn Lauder in 1993, we have funded millions of research hours that's led to better treatment and brighter outcomes. Learn about our impact.

# data[].attributes.metatag_normalized[].attributes.content
Since our founding by Evelyn Lauder in 1993, we have funded millions of research hours that's led to better treatment and brighter outcomes. Learn about our impact.

# data[].attributes.metatag_normalized[].attributes.content
Since our founding by Evelyn Lauder in 1993, we have funded millions of research hours that's led to better treatment and brighter outcomes. Learn about our impact.

# data[].attributes.body.value
Since our founding by Evelyn Lauder in 1993, we have funded millions of research hours that's led to better treatment and brighter outcomes. Learn about our impact.

# data[].attributes.body.processed
Since our founding by Evelyn Lauder in 1993, we have funded millions of research hours that's led to better treatment and brighter outcomes. Learn about our impact.

# data[].attributes.title
There Are Nearly 3 Million Breast Cancer Survivors in the U.S. Alone

# data[].attributes.metatag_normalized[].attributes.content
There Are Nearly 3 Million Breast Cancer Survivors in the U.S. Alone | BCRF

# data[].attributes.metatag_normalized[].attributes.content
Research is making a difference. Today, there are almost 3 million breast cancer survivors in the U.S. alone. We're grateful for the progress we've made, but we won't stop until no woman or man dies from breast cancer ever again.

# data[].attributes.metatag_normalized[].attributes.content
There Are Nearly 3 Million Breast Cancer Survivors in the U.S. Alone

# data[].attributes.metatag_normalized[].attributes.content
Research is making a difference. Today, there are almost 3 million breast cancer survivors in the U.S. alone. We're grateful for the progress we've made, but we won't stop until no woman or man dies from breast cancer ever again.

# data[].attributes.metatag_normalized[].attributes.content
There Are Nearly 3 Million Breast Cancer Survivors in the U.S. Alone

# data[].attributes.metatag_normalized[].attributes.content
Research is making a difference. Today, there are almost 3 million breast cancer survivors in the U.S. alone. We're grateful for the progress we've made, but we won't stop until no woman or man dies from breast cancer ever again.

# data[].attributes.metatag_normalized[].attributes.content
There Are Nearly 3 Million Breast Cancer Survivors in the U.S. Alone

# data[].attributes.body.value
Research is making a difference. Today, there are almost 3 million breast cancer survivors in the U.S. alone. We're grateful for the progress we've made, but we won't stop until no woman or man dies from breast cancer ever again.

# data[].attributes.body.processed
Research is making a difference. Today, there are almost 3 million breast cancer survivors in the U.S. alone. We're grateful for the progress we've made, but we won't stop until no woman or man dies from breast cancer ever again.

# data[].attributes.metatag_normalized[].attributes.content
For some, turning 50 is cause for a midlife crisis. For veteran sailor Jon Litt and his good friend and sailing partner Paul Dunay, the milestone became the opportunity of a lifetime. The “weekend warrior” mates decided to sail 635 nautical miles in the Newport Bermuda Race, the largest amateur race on the east coast—and raise money for BCRF.
Though the friends had done their fair share of racing in the Connecticut sailing community, they had never added a charitable component. To celebrate a birthday and support a cause that affected loved ones in both their families was a chance the duo couldn’t turn down.
“You don’t see many men talking about this topic, so we thought we’d raise money and bring attention to breast cancer the way they do in other sports,” said Dunay. The two set a lofty goal of $50,000 and crossed their fingers they’d hit the number by the close of sailing season. They didn’t have to worry; Team Terrapin surpassed its goal in a few weeks. “I don’t know if we hit a nerve, but we received an outpouring of support from family, friends and their circles.”
Though Team Terrapin didn’t win the big race, Litt and Dunay are still proud of what they’ve accomplished. “We’ve brought attention to the disease, raised money for research and risked our lives for the women we love.”
 

# data[].attributes.metatag_normalized[].attributes.content
For some, turning 50 is cause for a midlife crisis. For veteran sailor Jon Litt and his good friend and sailing partner Paul Dunay, the milestone became the opportunity of a lifetime. The “weekend warrior” mates decided to sail 635 nautical miles in the Newport Bermuda Race, the largest amateur race on the east coast—and raise money for BCRF.

# data[].attributes.metatag_normalized[].attributes.content
Sailors Race 635 Nautical Miles, Raise $50,000 for BCRF

# data[].attributes.metatag_normalized[].attributes.content
For some, turning 50 is cause for a midlife crisis. For veteran sailor Jon Litt and his good friend and sailing partner Paul Dunay, the milestone became the opportunity of a lifetime. The “weekend warrior” mates decided to sail 635 nautical miles in the Newport Bermuda Race, the largest amateur race on the east coast—and raise money for BCRF.

# data[].attributes.body.value
For some, turning 50 is cause for a midlife crisis. For veteran sailor Jon Litt and his good friend and sailing partner Paul Dunay, the milestone became the opportunity of a lifetime. The “weekend warrior” mates decided to sail 635 nautical miles in the Newport Bermuda Race, the largest amateur race on the east coast—and raise money for BCRF.

Though the friends had done their fair share of racing in the Connecticut sailing community, they had never added a charitable component. To celebrate a birthday and support a cause that affected loved ones in both their families was a chance the duo couldn’t turn down.

“You don’t see many men talking about this topic, so we thought we’d raise money and bring attention to breast cancer the way they do in other sports,” said Dunay. The two set a lofty goal of $50,000 and crossed their fingers they’d hit the number by the close of sailing season. They didn’t have to worry; Team Terrapin surpassed its goal in a few weeks. “I don’t know if we hit a nerve, but we received an outpouring of support from family, friends and their circles.”

Though Team Terrapin didn’t win the big race, Litt and Dunay are still proud of what they’ve accomplished. “We’ve brought attention to the disease, raised money for research and risked our lives for the women we love.”

# data[].attributes.body.processed
For some, turning 50 is cause for a midlife crisis. For veteran sailor Jon Litt and his good friend and sailing partner Paul Dunay, the milestone became the opportunity of a lifetime. The “weekend warrior” mates decided to sail 635 nautical miles in the Newport Bermuda Race, the largest amateur race on the east coast—and raise money for BCRF.

Though the friends had done their fair share of racing in the Connecticut sailing community, they had never added a charitable component. To celebrate a birthday and support a cause that affected loved ones in both their families was a chance the duo couldn’t turn down.

“You don’t see many men talking about this topic, so we thought we’d raise money and bring attention to breast cancer the way they do in other sports,” said Dunay. The two set a lofty goal of $50,000 and crossed their fingers they’d hit the number by the close of sailing season. They didn’t have to worry; Team Terrapin surpassed its goal in a few weeks. “I don’t know if we hit a nerve, but we received an outpouring of support from family, friends and their circles.”

Though Team Terrapin didn’t win the big race, Litt and Dunay are still proud of what they’ve accomplished. “We’ve brought attention to the disease, raised money for research and risked our lives for the women we love.”

# data[].attributes.field_subtitle
Sailors Race 635 Nautical Miles, Raise $50,000 for BCRF 

# data[].attributes.title
New Breast Cancer Gene Discovered in High-Risk Families 

# data[].attributes.metatag_normalized[].attributes.content
New Breast Cancer Gene Discovered in High-Risk Families  | BCRF

# data[].attributes.metatag_normalized[].attributes.content
While breast cancers are known to run in families, they are rarely a direct result of mutated genes inherited from a parent. In fact, inherited, or hereditary, cases account for only 5 - 10 percent of all breast cancers.
Mutations in the BRCA1 and BRCA2 genes are the most common cause of hereditary breast cancer. Their discovery in the mid-1990s led to the development of genetic tests that have significantly improved screening and prevention of breast and ovarian cancer.
However, while many hereditary breast cancers are explained by mutations in the BRCA genes, many other severely affected families do not carry mutations in these genes, leaving a gap in screening and prevention opportunities.
“We know of about two dozen genes with either a strong or intermediate effect [on breast cancer risk],” Dr. Kenneth Offit, BCRF grantee and cancer genetics expert, said in a CBS2 New York news story.
A study in the August 7 edition of the New England Journal of Medicine reports that another gene, known as PALB2, may be nearly as important as the BRCA genes in breast cancer risk. Mutations in PALB2 were previously linked to inherited breast cancer, but the extent of this effect wasn’t fully understood.  In the article, an international team led by Dr. Marc Tischkowitz at the University of Cambridge, reported that the lifetime risk of breast cancer in a woman with the PALB2 mutation is about 9 times higher than in the general population, less than that for mutations in BRC1 and closer to the risk associated with BRCA2.
“The lifetime risk of breast cancer linked to mutations in PALB2 climbs to 58 percent for those with two or more close relatives with breast cancer diagnosed under age 50,” said genetics expert Dr. Fergus Couch. The risk of developing male breast cancer also increased more than eight-fold in men with the PALB2 mutation.
The good news is that even though PALB2 mutations are very rare, accounting for only 1 to 2 percent of inherited breast cancers, genetic tests that screen for PALB2 mutations are already available. Commenting on the significance of these findings, Dr. Jeffrey N. Weitzel noted that, “While testing for PALB2 and other rare gene variants associated with breast cancer is now included in more comprehensive genetic testing panels, little was known about the actual risks. This new study gives people with a PALB2 mutation much better information on their risk.”
Study investigators emphasize that additional studies are needed to fully explain the risks associated with the PALB2 mutation. Dr. Susan Domchek clarified that, “Although this is a very important study, we need more families involved in this type of work to better define breast cancer risks as well as to define risks of other cancers such as pancreatic cancer, [which was also increased in people with PALB2 mutations].”
“We think of the PALB2 genes as ‘BRCA3’,” said Mary-Claire King of the University of Washington and director of the BCRF New York Breast Cancer Study. “Since 2010, we have been screening PALB2 in all our study participants, and have encountered critical mutations in families with breast cancer. Very interestingly, though, in the New York Breast Cancer Study—all of whose participants are Ashkenazi Jewish breast cancer patients and their families—there are no families at all with cancer-causing mutations in PALB2. We will know more by the time of the BCRF luncheon in October, but at present, it appears that PALB2 is at most a very minor player in the story of inherited breast cancer among Jewish women.”  

BCRF grantees, Jeffrey N. Weitzel, MD (City of Hope, Duarte CA), Susan M. Domchek, MD (University of Pennsylvania, Philadelphia, PA), Mary-Claire King, PhD (University of Washington, Seattle, WA) and Fergus J. Couch, PhD (Mayo Clinic, Rochester, MN) were co-authors on the New England Journal of Medicine report. 
 
Reference: Breast-Cancer Risk in Families with Mutations in PALB2.  Antoniou, et al., N Engl J Med. 2014 Aug 7;371(6):497-506.

# data[].attributes.metatag_normalized[].attributes.content
New Breast Cancer Gene Discovered in High-Risk Families

# data[].attributes.metatag_normalized[].attributes.content
While breast cancers are known to run in families, they are rarely a direct result of mutated genes inherited from a parent. In fact, inherited, or hereditary, cases account for only 5 - 10 percent of all breast cancers.
Mutations in the BRCA1 and BRCA2 genes are the most common cause of hereditary breast cancer. Their discovery in the mid-1990s led to the development of genetic tests that have significantly improved screening and prevention of breast and ovarian cancer.

# data[].attributes.metatag_normalized[].attributes.content
New Breast Cancer Gene Discovered in High-Risk Families

# data[].attributes.metatag_normalized[].attributes.content
While breast cancers are known to run in families, they are rarely a direct result of mutated genes inherited from a parent. In fact, inherited, or hereditary, cases account for only 5 - 10 percent of all breast cancers.
Mutations in the BRCA1 and BRCA2 genes are the most common cause of hereditary breast cancer. Their discovery in the mid-1990s led to the development of genetic tests that have significantly improved screening and prevention of breast and ovarian cancer.

# data[].attributes.metatag_normalized[].attributes.content
New Breast Cancer Gene Discovered in High-Risk Families

# data[].attributes.body.value
While breast cancers are known to run in families, they are rarely a direct result of mutated genes inherited from a parent. In fact, inherited, or hereditary, cases account for only 5 - 10 percent of all breast cancers.

Mutations in the BRCA1 and BRCA2 genes are the most common cause of hereditary breast cancer. Their discovery in the mid-1990s led to the development of genetic tests that have significantly improved screening and prevention of breast and ovarian cancer.

However, while many hereditary breast cancers are explained by mutations in the BRCA genes, many other severely affected families do not carry mutations in these genes, leaving a gap in screening and prevention opportunities.

“We know of about two dozen genes with either a strong or intermediate effect [on breast cancer risk],” Dr. Kenneth Offit, BCRF grantee and cancer genetics expert, said in a CBS2 New York news story.

A study in the August 7 edition of the New England Journal of Medicine reports that another gene, known as PALB2, may be nearly as important as the BRCA genes in breast cancer risk. Mutations in PALB2 were previously linked to inherited breast cancer, but the extent of this effect wasn’t fully understood.  In the article, an international team led by Dr. Marc Tischkowitz at the University of Cambridge, reported that the lifetime risk of breast cancer in a woman with the PALB2 mutation is about 9 times higher than in the general population, less than that for mutations in BRC1 and closer to the risk associated with BRCA2.

“The lifetime risk of breast cancer linked to mutations in PALB2 climbs to 58 percent for those with two or more close relatives with breast cancer diagnosed under age 50,” said genetics expert Dr. Fergus Couch. The risk of developing male breast cancer also increased more than eight-fold in men with the PALB2 mutation.

The good news is that even though PALB2 mutations are very rare, accounting for only 1 to 2 percent of inherited breast cancers, genetic tests that screen for PALB2 mutations are already available. Commenting on the significance of these findings, Dr. Jeffrey N. Weitzel noted that, “While testing for PALB2 and other rare gene variants associated with breast cancer is now included in more comprehensive genetic testing panels, little was known about the actual risks. This new study gives people with a PALB2 mutation much better information on their risk.”

Study investigators emphasize that additional studies are needed to fully explain the risks associated with the PALB2 mutation. Dr. Susan Domchek clarified that, “Although this is a very important study, we need more families involved in this type of work to better define breast cancer risks as well as to define risks of other cancers such as pancreatic cancer, [which was also increased in people with PALB2 mutations].”

“We think of the PALB2 genes as ‘BRCA3’,” said Mary-Claire King of the University of Washington and director of the BCRF New York Breast Cancer Study. “Since 2010, we have been screening PALB2 in all our study participants, and have encountered critical mutations in families with breast cancer. Very interestingly, though, in the New York Breast Cancer Study—all of whose participants are Ashkenazi Jewish breast cancer patients and their families—there are no families at all with cancer-causing mutations in PALB2. We will know more by the time of the BCRF luncheon in October, but at present, it appears that PALB2 is at most a very minor player in the story of inherited breast cancer among Jewish women.”

BCRF grantees, Jeffrey N. Weitzel, MD (City of Hope, Duarte CA), Susan M. Domchek, MD (University of Pennsylvania, Philadelphia, PA), Mary-Claire King, PhD (University of Washington, Seattle, WA) and Fergus J. Couch, PhD (Mayo Clinic, Rochester, MN) were co-authors on the New England Journal of Medicine report.

Reference: Breast-Cancer Risk in Families with Mutations in PALB2.  Antoniou, et al., N Engl J Med. 2014 Aug 7;371(6):497-506.

# data[].attributes.body.processed
While breast cancers are known to run in families, they are rarely a direct result of mutated genes inherited from a parent. In fact, inherited, or hereditary, cases account for only 5 - 10 percent of all breast cancers.

Mutations in the BRCA1 and BRCA2 genes are the most common cause of hereditary breast cancer. Their discovery in the mid-1990s led to the development of genetic tests that have significantly improved screening and prevention of breast and ovarian cancer.

However, while many hereditary breast cancers are explained by mutations in the BRCA genes, many other severely affected families do not carry mutations in these genes, leaving a gap in screening and prevention opportunities.

“We know of about two dozen genes with either a strong or intermediate effect [on breast cancer risk],” Dr. Kenneth Offit, BCRF grantee and cancer genetics expert, said in a CBS2 New York news story.

A study in the August 7 edition of the New England Journal of Medicine reports that another gene, known as PALB2, may be nearly as important as the BRCA genes in breast cancer risk. Mutations in PALB2 were previously linked to inherited breast cancer, but the extent of this effect wasn’t fully understood.  In the article, an international team led by Dr. Marc Tischkowitz at the University of Cambridge, reported that the lifetime risk of breast cancer in a woman with the PALB2 mutation is about 9 times higher than in the general population, less than that for mutations in BRC1 and closer to the risk associated with BRCA2.

“The lifetime risk of breast cancer linked to mutations in PALB2 climbs to 58 percent for those with two or more close relatives with breast cancer diagnosed under age 50,” said genetics expert Dr. Fergus Couch. The risk of developing male breast cancer also increased more than eight-fold in men with the PALB2 mutation.

The good news is that even though PALB2 mutations are very rare, accounting for only 1 to 2 percent of inherited breast cancers, genetic tests that screen for PALB2 mutations are already available. Commenting on the significance of these findings, Dr. Jeffrey N. Weitzel noted that, “While testing for PALB2 and other rare gene variants associated with breast cancer is now included in more comprehensive genetic testing panels, little was known about the actual risks. This new study gives people with a PALB2 mutation much better information on their risk.”

Study investigators emphasize that additional studies are needed to fully explain the risks associated with the PALB2 mutation. Dr. Susan Domchek clarified that, “Although this is a very important study, we need more families involved in this type of work to better define breast cancer risks as well as to define risks of other cancers such as pancreatic cancer, [which was also increased in people with PALB2 mutations].”

“We think of the PALB2 genes as ‘BRCA3’,” said Mary-Claire King of the University of Washington and director of the BCRF New York Breast Cancer Study. “Since 2010, we have been screening PALB2 in all our study participants, and have encountered critical mutations in families with breast cancer. Very interestingly, though, in the New York Breast Cancer Study—all of whose participants are Ashkenazi Jewish breast cancer patients and their families—there are no families at all with cancer-causing mutations in PALB2. We will know more by the time of the BCRF luncheon in October, but at present, it appears that PALB2 is at most a very minor player in the story of inherited breast cancer among Jewish women.”

BCRF grantees, Jeffrey N. Weitzel, MD (City of Hope, Duarte CA), Susan M. Domchek, MD (University of Pennsylvania, Philadelphia, PA), Mary-Claire King, PhD (University of Washington, Seattle, WA) and Fergus J. Couch, PhD (Mayo Clinic, Rochester, MN) were co-authors on the New England Journal of Medicine report.

Reference: Breast-Cancer Risk in Families with Mutations in PALB2.  Antoniou, et al., N Engl J Med. 2014 Aug 7;371(6):497-506.

# data[].attributes.title
How Sailing Brought Me Closer to a Breast Cancer Survivor—My Birth Mom

# data[].attributes.metatag_normalized[].attributes.content
How Sailing Brought Me Closer to a Breast Cancer Survivor—My Birth Mom | BCRF

# data[].attributes.metatag_normalized[].attributes.content
When Ashley Bell's birth mother was diagnosed with breast cancer, Ashley knew she wanted to get involved with raising money for research. A sailing enthusiast, she combined her love for sailing and her drive to support research.
The Seattle sailing community rallied behind her and The Pink Boat Regatta was born. Read on for Ashley's inspirational story.
This post originally appeared on the Huffington Post.
I came to Seattle by way of California, and before that, Winnipeg, where I was born and grew up. I was adopted at birth, and met my biological mother when I was 19 years old -- well after her first diagnosis, treatment and remission from breast cancer at age 38. It really didn't register at the time how close I came to never having known my mother, who's now the closest thing I have to a sister and best friend.
Four years ago in Seattle, I stepped foot on a sailboat for the first time and never looked back. Sailing, and particularly racing, taught me a lot about who I am and what kind of life I want. It taught me how to be fearless when it mattered most, in a sport where safety coming first means the ability to react when you might be exhausted, cold, wet or just plain terrified by the conditions. I fell in love with it, and started getting involved any way that I could.
Just two years later, I found myself competing in a world-class regatta at one of the best sailing venues in the world, the San Francisco Bay. It was there I met a local sailor preparing to sail around the world in support of breast cancer research. Coincidentally, I had also just received the news that my mother had been diagnosed with breast cancer for the second time. This time, it was very real. She was my mother now, and I was present to experience it with her. Needless to say, finding out about an opportunity to be part of something which combined my passion for sailing and a cause so close to my own heart and family struck a chord. My crew and I went back down to SF to participate in the first pink boat regatta the following month and had so much fun, we knew it had to come to Seattle.
Continue reading at the Huffington Post.

# data[].attributes.metatag_normalized[].attributes.content
How Sailing Brought Me Closer to a Breast Cancer Survivor—My Birth Mom

# data[].attributes.metatag_normalized[].attributes.content
When Ashley Bell's birth mother was diagnosed with breast cancer, Ashley knew she wanted to get involved with raising money for research. A sailing enthusiast, she combined her love for sailing and her drive to support research.
The Seattle sailing community rallied behind her and The Pink Boat Regatta was born. Read on for Ashley's inspirational story.
This post originally appeared on the Huffington Post.

# data[].attributes.metatag_normalized[].attributes.content
How Sailing Brought Me Closer to a Breast Cancer Survivor—My Birth Mom

# data[].attributes.metatag_normalized[].attributes.content
A BCRF Fundraiser Combines Her Love for Sailing With Raising Funds for Research

# data[].attributes.metatag_normalized[].attributes.content
When Ashley Bell's birth mother was diagnosed with breast cancer, Ashley knew she wanted to get involved with raising money for research. A sailing enthusiast, she combined her love for sailing and her drive to support research.
The Seattle sailing community rallied behind her and The Pink Boat Regatta was born. Read on for Ashley's inspirational story.
This post originally appeared on the Huffington Post.

# data[].attributes.metatag_normalized[].attributes.content
How Sailing Brought Me Closer to a Breast Cancer Survivor—My Birth Mom

# data[].attributes.body.value
When Ashley Bell's birth mother was diagnosed with breast cancer, Ashley knew she wanted to get involved with raising money for research. A sailing enthusiast, she combined her love for sailing and her drive to support research.

The Seattle sailing community rallied behind her and The Pink Boat Regatta was born. Read on for Ashley's inspirational story.

This post originally appeared on the Huffington Post.

I came to Seattle by way of California, and before that, Winnipeg, where I was born and grew up. I was adopted at birth, and met my biological mother when I was 19 years old -- well after her first diagnosis, treatment and remission from breast cancer at age 38. It really didn't register at the time how close I came to never having known my mother, who's now the closest thing I have to a sister and best friend.

Four years ago in Seattle, I stepped foot on a sailboat for the first time and never looked back. Sailing, and particularly racing, taught me a lot about who I am and what kind of life I want. It taught me how to be fearless when it mattered most, in a sport where safety coming first means the ability to react when you might be exhausted, cold, wet or just plain terrified by the conditions. I fell in love with it, and started getting involved any way that I could.

Just two years later, I found myself competing in a world-class regatta at one of the best sailing venues in the world, the San Francisco Bay. It was there I met a local sailor preparing to sail around the world in support of breast cancer research. Coincidentally, I had also just received the news that my mother had been diagnosed with breast cancer for the second time. This time, it was very real. She was my mother now, and I was present to experience it with her. Needless to say, finding out about an opportunity to be part of something which combined my passion for sailing and a cause so close to my own heart and family struck a chord. My crew and I went back down to SF to participate in the first pink boat regatta the following month and had so much fun, we knew it had to come to Seattle.

Continue reading at the Huffington Post.

# data[].attributes.body.processed
When Ashley Bell's birth mother was diagnosed with breast cancer, Ashley knew she wanted to get involved with raising money for research. A sailing enthusiast, she combined her love for sailing and her drive to support research.

The Seattle sailing community rallied behind her and The Pink Boat Regatta was born. Read on for Ashley's inspirational story.

This post originally appeared on the Huffington Post.

I came to Seattle by way of California, and before that, Winnipeg, where I was born and grew up. I was adopted at birth, and met my biological mother when I was 19 years old -- well after her first diagnosis, treatment and remission from breast cancer at age 38. It really didn't register at the time how close I came to never having known my mother, who's now the closest thing I have to a sister and best friend.

Four years ago in Seattle, I stepped foot on a sailboat for the first time and never looked back. Sailing, and particularly racing, taught me a lot about who I am and what kind of life I want. It taught me how to be fearless when it mattered most, in a sport where safety coming first means the ability to react when you might be exhausted, cold, wet or just plain terrified by the conditions. I fell in love with it, and started getting involved any way that I could.

Just two years later, I found myself competing in a world-class regatta at one of the best sailing venues in the world, the San Francisco Bay. It was there I met a local sailor preparing to sail around the world in support of breast cancer research. Coincidentally, I had also just received the news that my mother had been diagnosed with breast cancer for the second time. This time, it was very real. She was my mother now, and I was present to experience it with her. Needless to say, finding out about an opportunity to be part of something which combined my passion for sailing and a cause so close to my own heart and family struck a chord. My crew and I went back down to SF to participate in the first pink boat regatta the following month and had so much fun, we knew it had to come to Seattle.

Continue reading at the Huffington Post.

# data[].attributes.field_subtitle
A BCRF Fundraiser Combines Her Love for Sailing With Raising Funds for Research

# data[].attributes.metatag_normalized[].attributes.content
My mom was first diagnosed with breast cancer in 1986. I was young and don’t really remember much except that she had semi-permanent marks on her chest where she was radiated and a few wigs and turbans in her closet that she ended up not needing.
Fifteen years later, the disease came back with a vengeance. This time, it metastasized in her hip and spreading quickly. She passed away in 2002 at 59 years old. Since that time, I’ve wanted to do something special to honor her memory and contribute to the eradication of the disease. I’ve participated in a few breast cancer walks and made some donations, but I knew (hoped) there was something more I could do for a cause very close to my heart.
As luck would have it, at the beginning of this past year, I received an email from a local dog fancier, inquiring if Iʼd be interested in collaborating to create a calendar to raise money for breast cancer research. I am a pet photographer (and a lawyer), and the calendar would consist of images of adorable puppies in pink scenes. She and her petsitter had done a similar calendar a few years earlier with a litter of puppies she agreed to help when the owner was diagnosed with breast cancer. The two of them spent a few weeks photographing the litter — dubbed the “Pink Ribbon Puppies” — in pink scenes. With the help of a local printer, a calendar was designed and printed and in just a little over a month, they raised $16,000. After another friend was diagnosed, she thought it would be a good time to do another calendar. A serendipitous Google search for Dallas-based pet photographers led her to contact me.
We met at a local coffee shop and started brainstorming. What was originally to be a few days of photographing Labrador puppies quickly morphed into much more. It's funny, but neither of us really remembers exactly how the evolution happened, it was so natural! We're both single professional women with too many dogs and we just pretty much instantly clicked—a good thing because we've spent a lot of time together this year!
We, along with a third woman, formalized Pink Ribbon Puppies, filing for incorporation and 501c3 status. Iʼve since spent the last six or seven months photographing lots of puppies in pink scenes along with developing and designing products to sell. Our “models” are all puppies, typically 7-9 weeks old (and therefore, not exactly well trained — luckily, my partner in crime is an excellent wrangler!). They are all either from reputable breeders with health-tested dogs or are from local rescue organizations.
Pink Ribbon Puppies, Inc. is currently made up of just the three of us, all volunteers and all with very busy lives outside of the project. We’re two lawyers and a consultant who also happen to be a pet photographer, a dog breeder, and a mom. I personally wear a lot of different hats): photography, post processing, graphic design, art directing, web and social media management, sales, packaging/shipping, vendor relations, product development. It’s been all-consuming, but as with any passion, I make time (admittedly, the puppy kisses help!).
We launched the official Pink Ribbon Puppies, Inc. this month, in conjunction with Breast Cancer Awareness month. This year, Pink Ribbon Puppies is offering two 9x12 wall calendars, one featuring Labrador puppies and another featuring “Friends of Labradors” ranging from a Great Dane to a rescued Pomeranian mix. In addition, we are selling 4x6 pocket calendars, note cards, and greeting cards - and a line of holiday cards will be released soon. And weʼll be adding more products as we go forward! And 100 percent of the proceeds benefit the Breast Cancer Research Foundation.
I am a dog person —I have three of my own — and I come by it naturally. Growing up, we always had at least one dog, usually more, and they were considered members of our family. I love them, and my mom did too. So it has seemed fitting that dogs figure prominently in my version of honoring her memory.
All net proceeds will be donated to The Breast Cancer Research Foundation. The decision as to where to donate the funds was actually pretty easy - the proceeds from the previous calendar when to BCRF and it was a no brainer to do the same. Very few nonprofits can boost that over 90 percent of their budgets are spent on the programs and services they exist to deliver. 
About the Author: 
Debbie Bryant is the photographer behind thank Dog. photography. She's been photographing pets since 2009. Motivated by losing her mom to breast cancer in 2002, she partnered up with Carrie Eberhardt in 2013 to relaunch launch Pink Ribbon Puppies, Inc.

# data[].attributes.metatag_normalized[].attributes.content
My mom was first diagnosed with breast cancer in 1986. I was young and don’t really remember much except that she had semi-permanent marks on her chest where she was radiated and a few wigs and turbans in her closet that she ended up not needing.

# data[].attributes.metatag_normalized[].attributes.content
Pink Ribbon Puppies works with local rescue dogs to create beautiful merchandise that benefits research.

# data[].attributes.metatag_normalized[].attributes.content
My mom was first diagnosed with breast cancer in 1986. I was young and don’t really remember much except that she had semi-permanent marks on her chest where she was radiated and a few wigs and turbans in her closet that she ended up not needing.

# data[].attributes.body.value
My mom was first diagnosed with breast cancer in 1986. I was young and don’t really remember much except that she had semi-permanent marks on her chest where she was radiated and a few wigs and turbans in her closet that she ended up not needing.

Fifteen years later, the disease came back with a vengeance. This time, it metastasized in her hip and spreading quickly. She passed away in 2002 at 59 years old. Since that time, I’ve wanted to do something special to honor her memory and contribute to the eradication of the disease. I’ve participated in a few breast cancer walks and made some donations, but I knew (hoped) there was something more I could do for a cause very close to my heart.

As luck would have it, at the beginning of this past year, I received an email from a local dog fancier, inquiring if Iʼd be interested in collaborating to create a calendar to raise money for breast cancer research. I am a pet photographer (and a lawyer), and the calendar would consist of images of adorable puppies in pink scenes. She and her petsitter had done a similar calendar a few years earlier with a litter of puppies she agreed to help when the owner was diagnosed with breast cancer. The two of them spent a few weeks photographing the litter — dubbed the “Pink Ribbon Puppies” — in pink scenes. With the help of a local printer, a calendar was designed and printed and in just a little over a month, they raised $16,000. After another friend was diagnosed, she thought it would be a good time to do another calendar. A serendipitous Google search for Dallas-based pet photographers led her to contact me.

We met at a local coffee shop and started brainstorming. What was originally to be a few days of photographing Labrador puppies quickly morphed into much more. It's funny, but neither of us really remembers exactly how the evolution happened, it was so natural! We're both single professional women with too many dogs and we just pretty much instantly clicked—a good thing because we've spent a lot of time together this year!

We, along with a third woman, formalized Pink Ribbon Puppies, filing for incorporation and 501c3 status. Iʼve since spent the last six or seven months photographing lots of puppies in pink scenes along with developing and designing products to sell. Our “models” are all puppies, typically 7-9 weeks old (and therefore, not exactly well trained — luckily, my partner in crime is an excellent wrangler!). They are all either from reputable breeders with health-tested dogs or are from local rescue organizations.

Pink Ribbon Puppies, Inc. is currently made up of just the three of us, all volunteers and all with very busy lives outside of the project. We’re two lawyers and a consultant who also happen to be a pet photographer, a dog breeder, and a mom. I personally wear a lot of different hats): photography, post processing, graphic design, art directing, web and social media management, sales, packaging/shipping, vendor relations, product development. It’s been all-consuming, but as with any passion, I make time (admittedly, the puppy kisses help!).

We launched the official Pink Ribbon Puppies, Inc. this month, in conjunction with Breast Cancer Awareness month. This year, Pink Ribbon Puppies is offering two 9x12 wall calendars, one featuring Labrador puppies and another featuring “Friends of Labradors” ranging from a Great Dane to a rescued Pomeranian mix. In addition, we are selling 4x6 pocket calendars, note cards, and greeting cards - and a line of holiday cards will be released soon. And weʼll be adding more products as we go forward! And 100 percent of the proceeds benefit the Breast Cancer Research Foundation.

I am a dog person —I have three of my own — and I come by it naturally. Growing up, we always had at least one dog, usually more, and they were considered members of our family. I love them, and my mom did too. So it has seemed fitting that dogs figure prominently in my version of honoring her memory.

All net proceeds will be donated to The Breast Cancer Research Foundation. The decision as to where to donate the funds was actually pretty easy - the proceeds from the previous calendar when to BCRF and it was a no brainer to do the same. Very few nonprofits can boost that over 90 percent of their budgets are spent on the programs and services they exist to deliver.

About the Author:

Debbie Bryant is the photographer behind thank Dog. photography. She's been photographing pets since 2009. Motivated by losing her mom to breast cancer in 2002, she partnered up with Carrie Eberhardt in 2013 to relaunch launch Pink Ribbon Puppies, Inc.

# data[].attributes.body.processed
My mom was first diagnosed with breast cancer in 1986. I was young and don’t really remember much except that she had semi-permanent marks on her chest where she was radiated and a few wigs and turbans in her closet that she ended up not needing.

Fifteen years later, the disease came back with a vengeance. This time, it metastasized in her hip and spreading quickly. She passed away in 2002 at 59 years old. Since that time, I’ve wanted to do something special to honor her memory and contribute to the eradication of the disease. I’ve participated in a few breast cancer walks and made some donations, but I knew (hoped) there was something more I could do for a cause very close to my heart.

As luck would have it, at the beginning of this past year, I received an email from a local dog fancier, inquiring if Iʼd be interested in collaborating to create a calendar to raise money for breast cancer research. I am a pet photographer (and a lawyer), and the calendar would consist of images of adorable puppies in pink scenes. She and her petsitter had done a similar calendar a few years earlier with a litter of puppies she agreed to help when the owner was diagnosed with breast cancer. The two of them spent a few weeks photographing the litter — dubbed the “Pink Ribbon Puppies” — in pink scenes. With the help of a local printer, a calendar was designed and printed and in just a little over a month, they raised $16,000. After another friend was diagnosed, she thought it would be a good time to do another calendar. A serendipitous Google search for Dallas-based pet photographers led her to contact me.

We met at a local coffee shop and started brainstorming. What was originally to be a few days of photographing Labrador puppies quickly morphed into much more. It's funny, but neither of us really remembers exactly how the evolution happened, it was so natural! We're both single professional women with too many dogs and we just pretty much instantly clicked—a good thing because we've spent a lot of time together this year!

We, along with a third woman, formalized Pink Ribbon Puppies, filing for incorporation and 501c3 status. Iʼve since spent the last six or seven months photographing lots of puppies in pink scenes along with developing and designing products to sell. Our “models” are all puppies, typically 7-9 weeks old (and therefore, not exactly well trained — luckily, my partner in crime is an excellent wrangler!). They are all either from reputable breeders with health-tested dogs or are from local rescue organizations.

Pink Ribbon Puppies, Inc. is currently made up of just the three of us, all volunteers and all with very busy lives outside of the project. We’re two lawyers and a consultant who also happen to be a pet photographer, a dog breeder, and a mom. I personally wear a lot of different hats): photography, post processing, graphic design, art directing, web and social media management, sales, packaging/shipping, vendor relations, product development. It’s been all-consuming, but as with any passion, I make time (admittedly, the puppy kisses help!).

We launched the official Pink Ribbon Puppies, Inc. this month, in conjunction with Breast Cancer Awareness month. This year, Pink Ribbon Puppies is offering two 9x12 wall calendars, one featuring Labrador puppies and another featuring “Friends of Labradors” ranging from a Great Dane to a rescued Pomeranian mix. In addition, we are selling 4x6 pocket calendars, note cards, and greeting cards - and a line of holiday cards will be released soon. And weʼll be adding more products as we go forward! And 100 percent of the proceeds benefit the Breast Cancer Research Foundation.

I am a dog person —I have three of my own — and I come by it naturally. Growing up, we always had at least one dog, usually more, and they were considered members of our family. I love them, and my mom did too. So it has seemed fitting that dogs figure prominently in my version of honoring her memory.

All net proceeds will be donated to The Breast Cancer Research Foundation. The decision as to where to donate the funds was actually pretty easy - the proceeds from the previous calendar when to BCRF and it was a no brainer to do the same. Very few nonprofits can boost that over 90 percent of their budgets are spent on the programs and services they exist to deliver.

About the Author:

Debbie Bryant is the photographer behind thank Dog. photography. She's been photographing pets since 2009. Motivated by losing her mom to breast cancer in 2002, she partnered up with Carrie Eberhardt in 2013 to relaunch launch Pink Ribbon Puppies, Inc.

# data[].attributes.field_subtitle
Pink Ribbon Puppies works with local rescue dogs to create beautiful merchandise that benefits research.

# data[].attributes.title
BCRF Grantee Mary-Claire King Honored With Prestigious Lasker Award

# data[].attributes.metatag_normalized[].attributes.content
BCRF Grantee Mary-Claire King Honored With Prestigious Lasker Award | BCRF

# data[].attributes.metatag_normalized[].attributes.content
BCRF congratulates Dr. Mary-Claire King on her Lasker-Koshland Special Achievement Award in Medical Science.  Since 1945, the Albert and Mary Lasker Foundation Awards Program has recognized the contributions of scientists, physicians, and public servants who have made major advances in the understanding, diagnosis, treatment, cure and prevention of human disease. The Lasker Awards often presage future recognition by the Nobel committee, so they have become popularly known as "American Nobels."
The 2014 Lasker-Koshland Award honors scientists for their bold, imaginative and diverse scientific and human rights accomplishments. A BCRF grantee since 1997, Dr. King discovered the BRCA1 gene locus that causes hereditary breast cancer and deployed DNA strategies that reunite missing persons with their families. Her work has touched millions of families around the world.
Read more about Dr. King's award-winning research in this September 8, 2014, article from The New York Times.

# data[].attributes.metatag_normalized[].attributes.content
BCRF Grantee Mary-Claire King Honored With Prestigious Lasker Award

# data[].attributes.metatag_normalized[].attributes.content
BCRF congratulates Dr. Mary-Claire King on her Lasker-Koshland Special Achievement Award in Medical Science.  Since 1945, the Albert and Mary Lasker Foundation Awards Program has recognized the contributions of scientists, physicians, and public servants who have made major advances in the understanding, diagnosis, treatment, cure and prevention of human disease.

# data[].attributes.metatag_normalized[].attributes.content
BCRF Grantee Mary-Claire King Honored With Prestigious Lasker Award

# data[].attributes.metatag_normalized[].attributes.content
Longtime grantee recognized for "bold, imaginative and diverse contributions to medical science."

# data[].attributes.metatag_normalized[].attributes.content
BCRF congratulates Dr. Mary-Claire King on her Lasker-Koshland Special Achievement Award in Medical Science.  Since 1945, the Albert and Mary Lasker Foundation Awards Program has recognized the contributions of scientists, physicians, and public servants who have made major advances in the understanding, diagnosis, treatment, cure and prevention of human disease.

# data[].attributes.metatag_normalized[].attributes.content
BCRF Grantee Mary-Claire King Honored With Prestigious Lasker Award

# data[].attributes.body.value
BCRF congratulates Dr. Mary-Claire King on her Lasker-Koshland Special Achievement Award in Medical Science.  Since 1945, the Albert and Mary Lasker Foundation Awards Program has recognized the contributions of scientists, physicians, and public servants who have made major advances in the understanding, diagnosis, treatment, cure and prevention of human disease. The Lasker Awards often presage future recognition by the Nobel committee, so they have become popularly known as "American Nobels."

The 2014 Lasker-Koshland Award honors scientists for their bold, imaginative and diverse scientific and human rights accomplishments. A BCRF grantee since 1997, Dr. King discovered the BRCA1 gene locus that causes hereditary breast cancer and deployed DNA strategies that reunite missing persons with their families. Her work has touched millions of families around the world.

Read more about Dr. King's award-winning research in this September 8, 2014, article from The New York Times.

# data[].attributes.body.processed
BCRF congratulates Dr. Mary-Claire King on her Lasker-Koshland Special Achievement Award in Medical Science.  Since 1945, the Albert and Mary Lasker Foundation Awards Program has recognized the contributions of scientists, physicians, and public servants who have made major advances in the understanding, diagnosis, treatment, cure and prevention of human disease. The Lasker Awards often presage future recognition by the Nobel committee, so they have become popularly known as "American Nobels."

The 2014 Lasker-Koshland Award honors scientists for their bold, imaginative and diverse scientific and human rights accomplishments. A BCRF grantee since 1997, Dr. King discovered the BRCA1 gene locus that causes hereditary breast cancer and deployed DNA strategies that reunite missing persons with their families. Her work has touched millions of families around the world.

Read more about Dr. King's award-winning research in this September 8, 2014, article from The New York Times.

# data[].attributes.field_subtitle
Longtime grantee recognized for "bold, imaginative and diverse contributions to medical science."

# data[].attributes.title
Collaborating to Improve Care at the 2014 Breast Cancer Symposium

# data[].attributes.metatag_normalized[].attributes.content
Collaborating to Improve Care at the 2014 Breast Cancer Symposium | BCRF

# data[].attributes.metatag_normalized[].attributes.content
Last week, BCRF traveled to San Francisco to attend the 2014 Breast Cancer Symposium held by the American Society of Clinical Oncology (ASCO). Initiated in 2007, the annual session provides an opportunity for physicians and clinical investigators from around the globe to share the latest developments across all aspects of breast cancer. 
“The Breast Cancer Symposium has become a wonderful meeting that translates the latest research into routine clinical practice, so more patients can benefit more quickly from the advances made in all disciplines around the world,” said Dr. Clifford Hudis, Chairman of BCRF’s Scientific Advisory Board and ASCO’s 2013 President.
The theme of the symposium, “Enhancing Clinical Care Through Collaboration,” couldn’t have been more in sync with BCRF’s philosophy of joining forces to bring an end to breast cancer. Many BCRF grantees, in fact, participated in a number of the symposium’s meetings as both discussants and presenters.
Here are some highlights:
Risk Assessment, Screening & PreventionThe discovery of BRCA1 and BRCA2, along with other cancer-associated gene mutations, paved the way for the development of genetic tests. Despite the potential these discoveries hold, many challenges remain in interpreting the results of multi-gene tests for patient counseling and cancer therapy. At the symposium, experts emphasized the need for continued research to better understand the clinical significance of newly discovered genetic mutations and the importance of family history in assessing breast cancer risk. BCRF has long supported the work of leaders in this field including Drs. Fergus Couch, Mary-Claire King, Katherine Nathanson, Kenneth Offit, Sir Bruce Ponder, Lajos Pusztai, Chuck Perou, Jeffrey Weitzel and others.
Breast cancer screening for the general or “normal” risk, population is currently limited to mammography, a hot topic because of the risks versus benefits debate in women under 50. Dr. Stephen Feig, an expert on the subject and a research radiologist at the University of California, Irvine, emphasized the importance of continued screening for all women in San Francisco. He cited clinical trials demonstrating that up to 85 percent of women diagnosed with breast cancer—and more than 60 percent of women between ages 40-49—do not have a family history of the disease. These studies suggest that for women with a family history limited screening could result in many cancers going undetected until much later, making them potentially more difficult to treat.
The conversation continued with a discussion on anti-estrogen drugs such as Tamoxifen and Raloxifene, a class of drugs known as SERMs (Selective Estrogen Receptor Modulators), which have shown to prevent breast cancer or its recurrence in high-risk women. This strategy, called chemo-prevention, requires long-term treatment (typically five years), but many women stop their therapy prematurely because of side effects. Knowing which women will benefit from these drugs could reduce the incidence of side effects and lead to the development of alternative strategies. BCRF grantee Dr. Jack Cuzick presented data from a clinical prevention trial, supported in part by BCRF, suggesting that changes in breast density could help predict the a patient’s response to Tamoxifen. This would allow doctors to find out early whether a woman should continue the standard five-year Tamoxifen treatment.   
ImmunotherapyThe immune system works by balancing on and off switches to regulate how the body responds to infection. Two proteins that turn off immune response, called CTLA-4 and PD-1/PD-L1, are often hyper-activated in tumor cells, allowing the tumor to go undetected by the immune system. The FDA recently approved immunotherapies to block these proteins after recent clinical trials showed a significant improvement in metastatic melanoma. In a session chaired by BCRF grantee Dr. Hope Rugo, Dr. Heather McArthur, who is also funded by BCRF, provided an overview of the history of cancer immunotherapy and its potential in breast cancer. Dr. McArthur is currently working with BCRF grantees Drs. Jedd Wolchok and Stephen Solomon to test a pre-surgical combination of immunotherapy to help tackle triple negative breast cancer.
SurvivorshipA person’s journey with breast cancer doesn’t end with the last round of treatment; the effects of chemotherapy, radiation and surgery can impact quality of life for years. Many of the issues facing cancer survivors, including how to best manage and prevent recurrence, were topics of discussion during a session chaired by Dr. Hudis and BCRF grantee Dr. Julie Gralow. Dr. Pamela Goodwin, who is also funded by BCRF, explained that most women with breast cancer tend to be heavier than the general population at the time of diagnosis. As she expounded on obesity’s tie to an increase in metastasis and death, she noted the science underlying this link, including increases in levels of circulating insulin and estrogens as well as inflammatory markers, and emphasized the importance of physical activity.
Adding to the survivorship conversation, BCRF grantee Dr. Sharon Giordano talked bout the long-term effects of systemic chemotherapy, including chemo-induced menopause, hot flashes and other gynecological effects, as well as depression, anxiety, loss of libido and nerve damage. She made it known that preventive and therapeutic strategies are being studied in clinical trials and treatment guidelines are being revised to minimize long-term side effects.
MetastasisMost breast cancers depend on estrogen for growth and, as a result, are referred to as estrogen receptor positive (ER+). While anti-estrogen drugs like Tamoxifen and aromatase inhibitors are effective for most ER+ breast cancers, a persistent problem is late recurrence, considered longer than five years after diagnosis. We understand very little about why tumors come back years after treatment, but resistance to anti-estrogen therapies often occurs in these relapse tumors.During the symposium, BCRF grantees Drs. Suzanne Fuqua, Hope Rugo and Lajos Pusztai presented updates on emerging strategies and new challenges in addressing this concern. Dr. Fuqua’s research raised the possibility that the receptor for the male hormone androgen may play a role in response to anti-estrogen therapies, leading to recurrence or metastasis. Dr. Fuqua also demonstrated how mutations in the estrogen receptor gene, ESR1, play an important role in drug resistance both in metastatic and primary tumors. Dr. Rugo provided an overview of recent clinical trial results highlighting promising combination and targeted therapies for hormone-resistant breast cancers. Dr. Pusztai discussed the current challenges and future promise of tumor-profiling tests in predicting drug response and highlighted the potential of multipurpose drugs for various types of cancer based on common molecular abnormalities.
Breast-conserving TherapyEarly detection of smaller tumors and the use of pre-surgical treatment to reduce tumor size has made breast-conserving therapy (BCT) an option for many women with early stage breast cancer. BCT, a procedure that removes only the affected area of the breast, has been shown to be a safe and effective alternative to mastectomy. BCRF grantees Dr. Stuart Schnitt, a pathologist at Beth Israel Deaconess, and Dr. Bruce Haffty, a radiation oncologist at Rutgers Cancer Institute, shared their views on the challenges in preventing recurrence while preserving a woman’s natural appearance after BCT.
The 2014 Breast Cancer Symposium continued its tradition of focusing on cutting edge yet clinical relevant advances that have the patients and their families top of mind.

# data[].attributes.metatag_normalized[].attributes.content
Collaborating to Improve Care at the 2014 Breast Cancer Symposium

# data[].attributes.metatag_normalized[].attributes.content
Last week, BCRF traveled to San Francisco to attend the 2014 Breast Cancer Symposium held by the American Society of Clinical Oncology (ASCO). Initiated in 2007, the annual session provides an opportunity for physicians and clinical investigators from around the globe to share the latest developments across all aspects of breast cancer. 

# data[].attributes.metatag_normalized[].attributes.content
Collaborating to Improve Care at the 2014 Breast Cancer Symposium

# data[].attributes.metatag_normalized[].attributes.content
BCRF grantees join the conversation at the annual ASCO meeting

# data[].attributes.metatag_normalized[].attributes.content
Last week, BCRF traveled to San Francisco to attend the 2014 Breast Cancer Symposium held by the American Society of Clinical Oncology (ASCO). Initiated in 2007, the annual session provides an opportunity for physicians and clinical investigators from around the globe to share the latest developments across all aspects of breast cancer. 

# data[].attributes.metatag_normalized[].attributes.content
Collaborating to Improve Care at the 2014 Breast Cancer Symposium

# data[].attributes.body.value
Last week, BCRF traveled to San Francisco to attend the 2014 Breast Cancer Symposium held by the American Society of Clinical Oncology (ASCO). Initiated in 2007, the annual session provides an opportunity for physicians and clinical investigators from around the globe to share the latest developments across all aspects of breast cancer.

“The Breast Cancer Symposium has become a wonderful meeting that translates the latest research into routine clinical practice, so more patients can benefit more quickly from the advances made in all disciplines around the world,” said Dr. Clifford Hudis, Chairman of BCRF’s Scientific Advisory Board and ASCO’s 2013 President.

The theme of the symposium, “Enhancing Clinical Care Through Collaboration,” couldn’t have been more in sync with BCRF’s philosophy of joining forces to bring an end to breast cancer. Many BCRF grantees, in fact, participated in a number of the symposium’s meetings as both discussants and presenters.

Here are some highlights:

Risk Assessment, Screening & Prevention
The discovery of BRCA1 and BRCA2, along with other cancer-associated gene mutations, paved the way for the development of genetic tests. Despite the potential these discoveries hold, many challenges remain in interpreting the results of multi-gene tests for patient counseling and cancer therapy. At the symposium, experts emphasized the need for continued research to better understand the clinical significance of newly discovered genetic mutations and the importance of family history in assessing breast cancer risk. BCRF has long supported the work of leaders in this field including Drs. Fergus Couch, Mary-Claire King, Katherine Nathanson, Kenneth Offit, Sir Bruce Ponder, Lajos Pusztai, Chuck Perou, Jeffrey Weitzel and others.

Breast cancer screening for the general or “normal” risk, population is currently limited to mammography, a hot topic because of the risks versus benefits debate in women under 50. Dr. Stephen Feig, an expert on the subject and a research radiologist at the University of California, Irvine, emphasized the importance of continued screening for all women in San Francisco. He cited clinical trials demonstrating that up to 85 percent of women diagnosed with breast cancer—and more than 60 percent of women between ages 40-49—do not have a family history of the disease. These studies suggest that for women with a family history limited screening could result in many cancers going undetected until much later, making them potentially more difficult to treat.

The conversation continued with a discussion on anti-estrogen drugs such as Tamoxifen and Raloxifene, a class of drugs known as SERMs (Selective Estrogen Receptor Modulators), which have shown to prevent breast cancer or its recurrence in high-risk women. This strategy, called chemo-prevention, requires long-term treatment (typically five years), but many women stop their therapy prematurely because of side effects. Knowing which women will benefit from these drugs could reduce the incidence of side effects and lead to the development of alternative strategies. BCRF grantee Dr. Jack Cuzick presented data from a clinical prevention trial, supported in part by BCRF, suggesting that changes in breast density could help predict the a patient’s response to Tamoxifen. This would allow doctors to find out early whether a woman should continue the standard five-year Tamoxifen treatment.

Immunotherapy
The immune system works by balancing on and off switches to regulate how the body responds to infection. Two proteins that turn off immune response, called CTLA-4 and PD-1/PD-L1, are often hyper-activated in tumor cells, allowing the tumor to go undetected by the immune system. The FDA recently approved immunotherapies to block these proteins after recent clinical trials showed a significant improvement in metastatic melanoma. In a session chaired by BCRF grantee Dr. Hope Rugo, Dr. Heather McArthur, who is also funded by BCRF, provided an overview of the history of cancer immunotherapy and its potential in breast cancer. Dr. McArthur is currently working with BCRF grantees Drs. Jedd Wolchok and Stephen Solomon to test a pre-surgical combination of immunotherapy to help tackle triple negative breast cancer.

Survivorship
A person’s journey with breast cancer doesn’t end with the last round of treatment; the effects of chemotherapy, radiation and surgery can impact quality of life for years. Many of the issues facing cancer survivors, including how to best manage and prevent recurrence, were topics of discussion during a session chaired by Dr. Hudis and BCRF grantee Dr. Julie Gralow. Dr. Pamela Goodwin, who is also funded by BCRF, explained that most women with breast cancer tend to be heavier than the general population at the time of diagnosis. As she expounded on obesity’s tie to an increase in metastasis and death, she noted the science underlying this link, including increases in levels of circulating insulin and estrogens as well as inflammatory markers, and emphasized the importance of physical activity.

Adding to the survivorship conversation, BCRF grantee Dr. Sharon Giordano talked bout the long-term effects of systemic chemotherapy, including chemo-induced menopause, hot flashes and other gynecological effects, as well as depression, anxiety, loss of libido and nerve damage. She made it known that preventive and therapeutic strategies are being studied in clinical trials and treatment guidelines are being revised to minimize long-term side effects.

Metastasis
Most breast cancers depend on estrogen for growth and, as a result, are referred to as estrogen receptor positive (ER+). While anti-estrogen drugs like Tamoxifen and aromatase inhibitors are effective for most ER+ breast cancers, a persistent problem is late recurrence, considered longer than five years after diagnosis. We understand very little about why tumors come back years after treatment, but resistance to anti-estrogen therapies often occurs in these relapse tumors.

During the symposium, BCRF grantees Drs. Suzanne Fuqua, Hope Rugo and Lajos Pusztai presented updates on emerging strategies and new challenges in addressing this concern. Dr. Fuqua’s research raised the possibility that the receptor for the male hormone androgen may play a role in response to anti-estrogen therapies, leading to recurrence or metastasis. Dr. Fuqua also demonstrated how mutations in the estrogen receptor gene, ESR1, play an important role in drug resistance both in metastatic and primary tumors. Dr. Rugo provided an overview of recent clinical trial results highlighting promising combination and targeted therapies for hormone-resistant breast cancers. Dr. Pusztai discussed the current challenges and future promise of tumor-profiling tests in predicting drug response and highlighted the potential of multipurpose drugs for various types of cancer based on common molecular abnormalities.

Breast-conserving Therapy
Early detection of smaller tumors and the use of pre-surgical treatment to reduce tumor size has made breast-conserving therapy (BCT) an option for many women with early stage breast cancer. BCT, a procedure that removes only the affected area of the breast, has been shown to be a safe and effective alternative to mastectomy. BCRF grantees Dr. Stuart Schnitt, a pathologist at Beth Israel Deaconess, and Dr. Bruce Haffty, a radiation oncologist at Rutgers Cancer Institute, shared their views on the challenges in preventing recurrence while preserving a woman’s natural appearance after BCT.

The 2014 Breast Cancer Symposium continued its tradition of focusing on cutting edge yet clinical relevant advances that have the patients and their families top of mind.

# data[].attributes.body.processed
Last week, BCRF traveled to San Francisco to attend the 2014 Breast Cancer Symposium held by the American Society of Clinical Oncology (ASCO). Initiated in 2007, the annual session provides an opportunity for physicians and clinical investigators from around the globe to share the latest developments across all aspects of breast cancer.

“The Breast Cancer Symposium has become a wonderful meeting that translates the latest research into routine clinical practice, so more patients can benefit more quickly from the advances made in all disciplines around the world,” said Dr. Clifford Hudis, Chairman of BCRF’s Scientific Advisory Board and ASCO’s 2013 President.

The theme of the symposium, “Enhancing Clinical Care Through Collaboration,” couldn’t have been more in sync with BCRF’s philosophy of joining forces to bring an end to breast cancer. Many BCRF grantees, in fact, participated in a number of the symposium’s meetings as both discussants and presenters.

Here are some highlights:

Risk Assessment, Screening & Prevention
The discovery of BRCA1 and BRCA2, along with other cancer-associated gene mutations, paved the way for the development of genetic tests. Despite the potential these discoveries hold, many challenges remain in interpreting the results of multi-gene tests for patient counseling and cancer therapy. At the symposium, experts emphasized the need for continued research to better understand the clinical significance of newly discovered genetic mutations and the importance of family history in assessing breast cancer risk. BCRF has long supported the work of leaders in this field including Drs. Fergus Couch, Mary-Claire King, Katherine Nathanson, Kenneth Offit, Sir Bruce Ponder, Lajos Pusztai, Chuck Perou, Jeffrey Weitzel and others.

Breast cancer screening for the general or “normal” risk, population is currently limited to mammography, a hot topic because of the risks versus benefits debate in women under 50. Dr. Stephen Feig, an expert on the subject and a research radiologist at the University of California, Irvine, emphasized the importance of continued screening for all women in San Francisco. He cited clinical trials demonstrating that up to 85 percent of women diagnosed with breast cancer—and more than 60 percent of women between ages 40-49—do not have a family history of the disease. These studies suggest that for women with a family history limited screening could result in many cancers going undetected until much later, making them potentially more difficult to treat.

The conversation continued with a discussion on anti-estrogen drugs such as Tamoxifen and Raloxifene, a class of drugs known as SERMs (Selective Estrogen Receptor Modulators), which have shown to prevent breast cancer or its recurrence in high-risk women. This strategy, called chemo-prevention, requires long-term treatment (typically five years), but many women stop their therapy prematurely because of side effects. Knowing which women will benefit from these drugs could reduce the incidence of side effects and lead to the development of alternative strategies. BCRF grantee Dr. Jack Cuzick presented data from a clinical prevention trial, supported in part by BCRF, suggesting that changes in breast density could help predict the a patient’s response to Tamoxifen. This would allow doctors to find out early whether a woman should continue the standard five-year Tamoxifen treatment.

Immunotherapy
The immune system works by balancing on and off switches to regulate how the body responds to infection. Two proteins that turn off immune response, called CTLA-4 and PD-1/PD-L1, are often hyper-activated in tumor cells, allowing the tumor to go undetected by the immune system. The FDA recently approved immunotherapies to block these proteins after recent clinical trials showed a significant improvement in metastatic melanoma. In a session chaired by BCRF grantee Dr. Hope Rugo, Dr. Heather McArthur, who is also funded by BCRF, provided an overview of the history of cancer immunotherapy and its potential in breast cancer. Dr. McArthur is currently working with BCRF grantees Drs. Jedd Wolchok and Stephen Solomon to test a pre-surgical combination of immunotherapy to help tackle triple negative breast cancer.

Survivorship
A person’s journey with breast cancer doesn’t end with the last round of treatment; the effects of chemotherapy, radiation and surgery can impact quality of life for years. Many of the issues facing cancer survivors, including how to best manage and prevent recurrence, were topics of discussion during a session chaired by Dr. Hudis and BCRF grantee Dr. Julie Gralow. Dr. Pamela Goodwin, who is also funded by BCRF, explained that most women with breast cancer tend to be heavier than the general population at the time of diagnosis. As she expounded on obesity’s tie to an increase in metastasis and death, she noted the science underlying this link, including increases in levels of circulating insulin and estrogens as well as inflammatory markers, and emphasized the importance of physical activity.

Adding to the survivorship conversation, BCRF grantee Dr. Sharon Giordano talked bout the long-term effects of systemic chemotherapy, including chemo-induced menopause, hot flashes and other gynecological effects, as well as depression, anxiety, loss of libido and nerve damage. She made it known that preventive and therapeutic strategies are being studied in clinical trials and treatment guidelines are being revised to minimize long-term side effects.

Metastasis
Most breast cancers depend on estrogen for growth and, as a result, are referred to as estrogen receptor positive (ER+). While anti-estrogen drugs like Tamoxifen and aromatase inhibitors are effective for most ER+ breast cancers, a persistent problem is late recurrence, considered longer than five years after diagnosis. We understand very little about why tumors come back years after treatment, but resistance to anti-estrogen therapies often occurs in these relapse tumors.

During the symposium, BCRF grantees Drs. Suzanne Fuqua, Hope Rugo and Lajos Pusztai presented updates on emerging strategies and new challenges in addressing this concern. Dr. Fuqua’s research raised the possibility that the receptor for the male hormone androgen may play a role in response to anti-estrogen therapies, leading to recurrence or metastasis. Dr. Fuqua also demonstrated how mutations in the estrogen receptor gene, ESR1, play an important role in drug resistance both in metastatic and primary tumors. Dr. Rugo provided an overview of recent clinical trial results highlighting promising combination and targeted therapies for hormone-resistant breast cancers. Dr. Pusztai discussed the current challenges and future promise of tumor-profiling tests in predicting drug response and highlighted the potential of multipurpose drugs for various types of cancer based on common molecular abnormalities.

Breast-conserving Therapy
Early detection of smaller tumors and the use of pre-surgical treatment to reduce tumor size has made breast-conserving therapy (BCT) an option for many women with early stage breast cancer. BCT, a procedure that removes only the affected area of the breast, has been shown to be a safe and effective alternative to mastectomy. BCRF grantees Dr. Stuart Schnitt, a pathologist at Beth Israel Deaconess, and Dr. Bruce Haffty, a radiation oncologist at Rutgers Cancer Institute, shared their views on the challenges in preventing recurrence while preserving a woman’s natural appearance after BCT.

The 2014 Breast Cancer Symposium continued its tradition of focusing on cutting edge yet clinical relevant advances that have the patients and their families top of mind.

# data[].attributes.field_subtitle
BCRF grantees join the conversation at the annual ASCO meeting

# data[].attributes.title
The Pink Agenda and Giuliana Rancic Join Forces to Help Survivors Feel Fabulous

# data[].attributes.metatag_normalized[].attributes.content
The Pink Agenda and Giuliana Rancic Join Forces to Help Survivors Feel Fabulous | BCRF

# data[].attributes.metatag_normalized[].attributes.content
Here at BCRF, we work closely with The Pink Agenda, a group of young professionals determined to fund research and improve the odds of those diagnosed with breast cancer. We are proud to announce that the nonprofit recently joined forces with E! News anchor and breast cancer survivor Giuliana Rancic and her philanthropic initiative, FAB-U-WISH™.
The Pink Agenda and FAB-U-WISH™ will team up to grant personal wishes of glitz and glamour to women battling breast cancer. When Rancic was treated for breast cancer in 2011, she found that pampering herself helped maintain her self-confidence and keep her spirits up during treatment.
As a popular TV personality, Rancic had exclusive access to her devoted “glam squad,” a hair, makeup and styling team committed to ensuring she looked and felt good, especially during treatment. After undergoing a double mastectomy and reconstructive surgery, she realized that feeling beautiful and feminine played a critical role in staying optimistic during her journey. Rancic never took her special privileges for granted and, after recovering, looked to share those same benefits with women across the nation.
“When I was battling breast cancer, I found that sometimes the smallest things—having my hair and makeup done, putting on a beautiful outfit, being treated like a princess—often had a huge impact on how I felt,” Rancic said. “Even when the disease seemed like it might get the best of me, getting the ‘Hollywood treatment’ made such a difference. My goal with the Fab-U-Wish and Pink Agenda partnership is to do the exactly the same for other survivors: helping women feel beautiful—and feel better—during their most difficult times.” 

Women who are currently or have undergone treatment in the past year for breast cancer are welcome to dream of what would make them feel fabulous and apply here for their wish to be granted. Friends and family can also nominate a loved one.
“The Pink Agenda believes that engaging today’s generation can go a long way toward finding tomorrow’s cure to breast cancer,” said Lucretia Gilbert, BCRF’s Chief Development Officer and Executive Director of The Pink Agenda. “This new partnership embodies that belief. Together, with Giuliana and the passion of the next generation of leaders, we will grant wishes, improve lives and, most importantly, find a cure.” 

# data[].attributes.metatag_normalized[].attributes.content
The Pink Agenda and Giuliana Rancic Join Forces to Help Survivors Feel Fabulous

# data[].attributes.metatag_normalized[].attributes.content
Here at BCRF, we work closely with The Pink Agenda, a group of young professionals determined to fund research and improve the odds of those diagnosed with breast cancer. We are proud to announce that the nonprofit recently joined forces with E! News anchor and breast cancer survivor Giuliana Rancic and her philanthropic initiative, FAB-U-WISH™.

# data[].attributes.metatag_normalized[].attributes.content
The Pink Agenda and Giuliana Rancic Join Forces to Help Survivors Feel Fabulous

# data[].attributes.metatag_normalized[].attributes.content
FAB-U-WISH™ aims to improve the lives of women during breast cancer journey

# data[].attributes.metatag_normalized[].attributes.content
Here at BCRF, we work closely with The Pink Agenda, a group of young professionals determined to fund research and improve the odds of those diagnosed with breast cancer. We are proud to announce that the nonprofit recently joined forces with E! News anchor and breast cancer survivor Giuliana Rancic and her philanthropic initiative, FAB-U-WISH™.

# data[].attributes.metatag_normalized[].attributes.content
The Pink Agenda and Giuliana Rancic Join Forces to Help Survivors Feel Fabulous

# data[].attributes.body.value
Here at BCRF, we work closely with The Pink Agenda, a group of young professionals determined to fund research and improve the odds of those diagnosed with breast cancer. We are proud to announce that the nonprofit recently joined forces with E! News anchor and breast cancer survivor Giuliana Rancic and her philanthropic initiative, FAB-U-WISH™.

The Pink Agenda and FAB-U-WISH™ will team up to grant personal wishes of glitz and glamour to women battling breast cancer. When Rancic was treated for breast cancer in 2011, she found that pampering herself helped maintain her self-confidence and keep her spirits up during treatment.

As a popular TV personality, Rancic had exclusive access to her devoted “glam squad,” a hair, makeup and styling team committed to ensuring she looked and felt good, especially during treatment. After undergoing a double mastectomy and reconstructive surgery, she realized that feeling beautiful and feminine played a critical role in staying optimistic during her journey. Rancic never took her special privileges for granted and, after recovering, looked to share those same benefits with women across the nation.

“When I was battling breast cancer, I found that sometimes the smallest things—having my hair and makeup done, putting on a beautiful outfit, being treated like a princess—often had a huge impact on how I felt,” Rancic said. “Even when the disease seemed like it might get the best of me, getting the ‘Hollywood treatment’ made such a difference. My goal with the Fab-U-Wish and Pink Agenda partnership is to do the exactly the same for other survivors: helping women feel beautiful—and feel better—during their most difficult times.”

Women who are currently or have undergone treatment in the past year for breast cancer are welcome to dream of what would make them feel fabulous and apply here for their wish to be granted. Friends and family can also nominate a loved one.

“The Pink Agenda believes that engaging today’s generation can go a long way toward finding tomorrow’s cure to breast cancer,” said Lucretia Gilbert, BCRF’s Chief Development Officer and Executive Director of The Pink Agenda. “This new partnership embodies that belief. Together, with Giuliana and the passion of the next generation of leaders, we will grant wishes, improve lives and, most importantly, find a cure.”

# data[].attributes.body.processed
Here at BCRF, we work closely with The Pink Agenda, a group of young professionals determined to fund research and improve the odds of those diagnosed with breast cancer. We are proud to announce that the nonprofit recently joined forces with E! News anchor and breast cancer survivor Giuliana Rancic and her philanthropic initiative, FAB-U-WISH™.

The Pink Agenda and FAB-U-WISH™ will team up to grant personal wishes of glitz and glamour to women battling breast cancer. When Rancic was treated for breast cancer in 2011, she found that pampering herself helped maintain her self-confidence and keep her spirits up during treatment.

As a popular TV personality, Rancic had exclusive access to her devoted “glam squad,” a hair, makeup and styling team committed to ensuring she looked and felt good, especially during treatment. After undergoing a double mastectomy and reconstructive surgery, she realized that feeling beautiful and feminine played a critical role in staying optimistic during her journey. Rancic never took her special privileges for granted and, after recovering, looked to share those same benefits with women across the nation.

“When I was battling breast cancer, I found that sometimes the smallest things—having my hair and makeup done, putting on a beautiful outfit, being treated like a princess—often had a huge impact on how I felt,” Rancic said. “Even when the disease seemed like it might get the best of me, getting the ‘Hollywood treatment’ made such a difference. My goal with the Fab-U-Wish and Pink Agenda partnership is to do the exactly the same for other survivors: helping women feel beautiful—and feel better—during their most difficult times.”

Women who are currently or have undergone treatment in the past year for breast cancer are welcome to dream of what would make them feel fabulous and apply here for their wish to be granted. Friends and family can also nominate a loved one.

“The Pink Agenda believes that engaging today’s generation can go a long way toward finding tomorrow’s cure to breast cancer,” said Lucretia Gilbert, BCRF’s Chief Development Officer and Executive Director of The Pink Agenda. “This new partnership embodies that belief. Together, with Giuliana and the passion of the next generation of leaders, we will grant wishes, improve lives and, most importantly, find a cure.”

# data[].attributes.field_subtitle
FAB-U-WISH™ aims to improve the lives of women during breast cancer journey

# data[].attributes.metatag_normalized[].attributes.content
Breaking Records While Funding Research | BCRF

# data[].attributes.metatag_normalized[].attributes.content
What do breaking a Guinness World Record and raising money for breast cancer research have in common? They both require tenacity, courage, and, as the folks behind One Square Mile of Hope know, the willingness to think outside the box.
One Square Mile of Hope is the brainchild of a small group of friends from Inlet, a tiny town of less than 400 people nestled in New York’s Adirondack Mountains. After Connie Perry, who owns a local kayak business, lost a friend to breast cancer in 2007, she and her neighbors wanted to come up with a creative way to rally behind research.
“Someone in town came up with the idea of a Guinness Record attempt for the largest raft of canoes, kayaks and guide boats,” said Carolyn Belknap, co-chair of the One Square Mile of Hope Committee.
The idea caught on quickly and, in 2008, the first One Square Mile of Hope took to the water. More than 1,100 boats converged on Fourth Lake and shattered the Guinness World Record set in 2001 by 776 boats on Cleveland’s Hinckley Lake. The Inlet team held the record until a Pennsylvania group topped it in 2010.
One Square Mile of Hope’s response? Take it back. And they did, setting a new record in 2011 with 1,902 boats. So in 2013, when a group on Lake Michigan broke One Square Mile’s second time as world champs, there was only one real option for the New York community.
“We geared up to take the record back,” Carolyn said. The One Square Mile of Hope 2014 committee, along with the Kiwanis Club of the Central Adirondacks, began planning in December 2013 to reclaim the Guinness title. The event, which has become a town favorite since its start six years ago, had people registering as soon as it was announced.
“It’s become much more than coming out to raise a little bit of money,” Carolyn said. “It’s the camaraderie and the support people feel for those who have lost someone and those who are survivors.”
So on Saturday, September 13, despite the rainy weather and cool winds, more than 2,700 boats gathered for the third time to reclaim their Guinness World Record and raise more than $100,000 for research. Though the official number will take some time for the Guinness group to confirm, Carolyn is confident that One Square Mile has pulled it off again.
“I’ve already had people asking me if we’ll do it again next year!” she laughed. “It’s quite something to see a small town like this galvanize for a cause. We all know people who have had breast cancer and it’s just caught on here for us.”
Watch a time-lapse video of the event here.

# data[].attributes.metatag_normalized[].attributes.content
What do breaking a Guinness World Record and raising money for breast cancer research have in common? They both require tenacity, courage, and, as the folks behind One Square Mile of Hope know, the willingness to think outside the box.

# data[].attributes.metatag_normalized[].attributes.content
How a group in tiny Inlet, NY, raised more than $100,000 for breast cancer research — and broke a Guinness World Record in the process.

# data[].attributes.metatag_normalized[].attributes.content
What do breaking a Guinness World Record and raising money for breast cancer research have in common? They both require tenacity, courage, and, as the folks behind One Square Mile of Hope know, the willingness to think outside the box.

# data[].attributes.body.value
What do breaking a Guinness World Record and raising money for breast cancer research have in common? They both require tenacity, courage, and, as the folks behind One Square Mile of Hope know, the willingness to think outside the box.

One Square Mile of Hope is the brainchild of a small group of friends from Inlet, a tiny town of less than 400 people nestled in New York’s Adirondack Mountains. After Connie Perry, who owns a local kayak business, lost a friend to breast cancer in 2007, she and her neighbors wanted to come up with a creative way to rally behind research.

“Someone in town came up with the idea of a Guinness Record attempt for the largest raft of canoes, kayaks and guide boats,” said Carolyn Belknap, co-chair of the One Square Mile of Hope Committee.

The idea caught on quickly and, in 2008, the first One Square Mile of Hope took to the water. More than 1,100 boats converged on Fourth Lake and shattered the Guinness World Record set in 2001 by 776 boats on Cleveland’s Hinckley Lake. The Inlet team held the record until a Pennsylvania group topped it in 2010.

One Square Mile of Hope’s response? Take it back. And they did, setting a new record in 2011 with 1,902 boats. So in 2013, when a group on Lake Michigan broke One Square Mile’s second time as world champs, there was only one real option for the New York community.

“We geared up to take the record back,” Carolyn said. The One Square Mile of Hope 2014 committee, along with the Kiwanis Club of the Central Adirondacks, began planning in December 2013 to reclaim the Guinness title. The event, which has become a town favorite since its start six years ago, had people registering as soon as it was announced.

“It’s become much more than coming out to raise a little bit of money,” Carolyn said. “It’s the camaraderie and the support people feel for those who have lost someone and those who are survivors.”

So on Saturday, September 13, despite the rainy weather and cool winds, more than 2,700 boats gathered for the third time to reclaim their Guinness World Record and raise more than $100,000 for research. Though the official number will take some time for the Guinness group to confirm, Carolyn is confident that One Square Mile has pulled it off again.

“I’ve already had people asking me if we’ll do it again next year!” she laughed. “It’s quite something to see a small town like this galvanize for a cause. We all know people who have had breast cancer and it’s just caught on here for us.”

Watch a time-lapse video of the event here.

# data[].attributes.body.processed
What do breaking a Guinness World Record and raising money for breast cancer research have in common? They both require tenacity, courage, and, as the folks behind One Square Mile of Hope know, the willingness to think outside the box.

One Square Mile of Hope is the brainchild of a small group of friends from Inlet, a tiny town of less than 400 people nestled in New York’s Adirondack Mountains. After Connie Perry, who owns a local kayak business, lost a friend to breast cancer in 2007, she and her neighbors wanted to come up with a creative way to rally behind research.

“Someone in town came up with the idea of a Guinness Record attempt for the largest raft of canoes, kayaks and guide boats,” said Carolyn Belknap, co-chair of the One Square Mile of Hope Committee.

The idea caught on quickly and, in 2008, the first One Square Mile of Hope took to the water. More than 1,100 boats converged on Fourth Lake and shattered the Guinness World Record set in 2001 by 776 boats on Cleveland’s Hinckley Lake. The Inlet team held the record until a Pennsylvania group topped it in 2010.

One Square Mile of Hope’s response? Take it back. And they did, setting a new record in 2011 with 1,902 boats. So in 2013, when a group on Lake Michigan broke One Square Mile’s second time as world champs, there was only one real option for the New York community.

“We geared up to take the record back,” Carolyn said. The One Square Mile of Hope 2014 committee, along with the Kiwanis Club of the Central Adirondacks, began planning in December 2013 to reclaim the Guinness title. The event, which has become a town favorite since its start six years ago, had people registering as soon as it was announced.

“It’s become much more than coming out to raise a little bit of money,” Carolyn said. “It’s the camaraderie and the support people feel for those who have lost someone and those who are survivors.”

So on Saturday, September 13, despite the rainy weather and cool winds, more than 2,700 boats gathered for the third time to reclaim their Guinness World Record and raise more than $100,000 for research. Though the official number will take some time for the Guinness group to confirm, Carolyn is confident that One Square Mile has pulled it off again.

“I’ve already had people asking me if we’ll do it again next year!” she laughed. “It’s quite something to see a small town like this galvanize for a cause. We all know people who have had breast cancer and it’s just caught on here for us.”

Watch a time-lapse video of the event here.

# data[].attributes.field_subtitle
How a group in tiny Inlet, NY, raised more than $100,000 for breast cancer research — and broke a Guinness World Record in the process. 

# meta.omitted.detail
Some resources have been omitted because of insufficient authorization.

# meta.omitted.links.item--yOv4VRo.meta.detail
The current user is not allowed to GET the selected resource.

# meta.omitted.links.item--uleErrc.meta.detail
The current user is not allowed to GET the selected resource.

# meta.omitted.links.item--Z4zecC5.meta.detail
The current user is not allowed to GET the selected resource.