Two years ago, Dr. Karen Antman and the Herbert Irving Comprehensive Cancer Center received a large grant from the Avon Products Foundation to fund research in the area of breast cancer. This grant supports a number of initiatives within the Cancer Center, all focused on furthering research and patient services in the area of breast cancer. These efforts were recently highlighted in a national conference that was held at Columbia on November 8, 2001. The conference brought together researchers from the ten cancer centers around the country that are funded by the Avon Products Foundation.

A major aspect of this Program is the provision of up to $50,000 in pilot funds for research projects; this is particularly directed towards young investigators. We would like to pay special tribute to some of these investigators whose research has focused in the area of cancer prevention and public health as it relates to breast cancer.

Andrew Joe, MD, is conducting a pilot study titled, “A Comparative Study of Biomarker Expression in Tumor Biology in Cases of African-American and White Women With Breast Cancer.” In this study, Dr. Joe and colleagues have collected tissue specimens from African-American and white women with breast cancer and compared the samples for a number of tumor markers, including cyclin D1, p27Kip1, p21 ZIP1, p16, and IGFR. In addition to studies in breast cancer, Dr. Joe’s recent work includes a study of the anticancer effects of resveratrol.

Suh-Hang Hank Juo, MD, PhD, of the Columbia Genome Center and the Department of Epidemiology in the School of Public Health, received funding from the Avon Products Foundation to conduct a study titled, “Genetic Linkage Study of Familial Breast Cancer.” In this project, 23 Ashkenazi Jewish families were selected from the Metropolitan New York Breast Cancer study database. The families shared the following criteria: 1) at least three breast cancer cases in the family; 2) at least three available DNA samples; and 3) no bilateral families (i.e., no family had history of breast cancer on both the maternal and paternal sides). The researchers conducted a statistical power calculation on these 23 families using simulation studies. An expected LOD score (which measures the probability of a genetic linkage) of 0.8 was obtained, although the maximum LOD score can reach as high as 2.03. On this basis, the researchers believed that there were too few informative families in the New York Registry. They currently are seeking family data from other national breast cancer family registries.

Alfred I. Neugut, MD, PhD, was awarded a grant from the Avon Products Foundation for a study titled, “Mammography Use Among Older Breast Cancer Survivors.” This investigation used the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare claims database to compare 21,218 breast cancer survivors with 21,421 non-cancer controls on their use of mammography. All of the subjects in the study were older than 65 years of age and resided in a SEER area (comprising about 14 percent of the United States). The breast cancer survivors (cases) were women with an initial diagnosis of breast cancer, stages 0-3, between 1990 and 1993, who survived for at least 24 months, while the controls were a random sample of Medicare beneficiaries who were frequency-matched to the cases for age. The study found that breast cancer survivors were more than three times as likely as controls to have received a mammogram in the six years following diagnosis and treatment, controlling for age, race, stage at diagnosis, and type of cancer treatment. Predictors of mammography included white race, younger age, earlier stage at diagnosis, having had a mastectomy, and lower number of comorbidities. The proportion of cases that had a mammogram decreased over time, from 62 percent in the first two years after treatment to 53 percent in years five and six. The percentage of control subjects who had mammography were significantly lower, and decreased with time as well, from 30 percent in years one and two to 27 percent in years five and six. The study concluded that breast cancer survivors are much more likely than others to receive a mammography—a finding consistent with elevated risk for a new primary breast cancer.

Stay tuned for research highlights from other Avon Project investigators in the next issue. To see research highlights of Avon Project investigators from past issues, click here.