ARRA IMPACT REPORT:
Environmental Determinants of Breast Cancer
Public Health Burden
Over 200,000 new cases of breast cancer are diagnosed each year in the United States resulting in approximately 40,000 deaths. Findings emerging over the last 20 years confirm a huge environmental influence – greater than heredity - in the disease. However, despite intense investigation, the root causes of breast cancer are largely unknown. ARRA funds allowed research and outreach teams to pursue their ideas more completely and rapidly. Consistent with ARRA goals, supplements focused on jobs throughout the project:post-doctoral and research associates, data processor, and financial assistant. The supplement allowed the program to make insights and pursue community engagement.
The Breast Cancer and the Environment Research Program (BCERP) is designed to examine a select set of chemicals that could affect breast cancer risk at an early age. The chosen endpoint, early onset of puberty, is among the most widely accepted indicators of risk for developing the cancer. The combined population / laboratory study includes approximately 400 girls from the Bay Area of San Francisco (in concert with 800 other girls in collaborative nationwide studies) from ages 6 – 8 years to maturity, at about age 20. The results of the investigation are expected to identify and characterize some common reagents and dietary components that could alter the progression of puberty and highlight practical prevention strategies to reduce the incidence of breast cancer.
The ARRA supplement continues the project's focus on environmental influences on puberty and breast cancer in women and using that information to inform studies on animal models. A major area of shared information is understanding gene variation that could place an individual at risk should she come in contact with an exposure at a specific time. The investigators examined 77 genes of interest among the girls and made preliminary determinations connecting certain variations in genes associated with metabolism and obesity with earlier progression through puberty. These data provide a strong basis for understanding and providing preventive messages on the interaction of environmental influence, including diet, with individual genetics in breast cancer susceptibility.2
Basic Science Advances1
- With improved state of the art laboratory equipment, a UCLA team made impressive insights into the nature and response of mammary glands and their stem cells to common exposures. ARRA funds allowed the team to upgrade their confocal –type microscope with solid state lasers that enable better resolution and can allow “virtual slices” to be made through cells and tissues.
- Exposure studies were expanded in areas of architecture, development, & growth of Human Mammary Epithelial Cell mammospheres, a novel system consisting of balls of cells that more closely mimic natural tissue. The studies produced novel insights into the role of cell surface glycans, the sugar chains that project out from cells into the external fluid, and also the impact of chemical perturbants such as BPA (bis-phenol A) which induced dramatic changes in the morphology of mammosphere cultures.
Community Outreach and Engagement1,3
Outreach engineers worked as part of the scientific team and opened numerous channels for engagement with the community.
- A series of “tea talks” was held with community members and families of members of the puberty study, discussed above. Study results for individuals were provided privately to study participants and their families, but these group discussions allowed some overall findings to be shared and questions answered in an informal setting.
- In bi-directional conversations with local communities, an information video and booklet, “The Breast Biologues” were produced.The free products in English and Spanish provide an engaging educational kit that explain show breast cancer may develop and how exposures at specific developmental points in a person’s life can alter future disease risk.4
- Environmental Chemical Exposure Fact Sheets (including major sources of exposure and information on how to reduce exposures) were produced in both English and Spanish.
- A BCERP Key Messaging Toolkit for Parents and Caregivers was developed through a contract with Public Communications Inc.and included BCERP community engagement specialists and investigators. The toolkit is based on findings from BCERP studies, and other breast cancer research, regarding environmental exposures and personal susceptibility factors and how these may influence breast cancer. This toolkit represents the synthesis of the BCERP findings as of March 2012, and the translation of those findings into integrated messages at appropriate education levels that can be broadly disseminated to affected communities (e.g., parents, general public, breast cancer and other disease advocacy organizations).The toolkit materials will be made freely available through electronic outlets.5
- The Community-based Research Infrastructure to Better Science (CRIBS) 6 program includes outreach and training efforts focused on mentoring community-academic teams to attain competence in conducting community based participatory research (CBPR) on breast cancer, the environment, and disparities. Communities and academic partners participating in CRIBS training will have the skill set to address knowledge gaps and CBPR results can be utilized to change health-related outcomes. To date, the CRIBS program has:
- Designed and implemented 11 outreach workshops across the state of California. The workshops gave community members, community organization representatives and academically trained researchers an overview of community-based research, an introduction to the California Breast Cancer Research Program's Community Research Collaboration (CRC) funding mechanism, an overview of environment/disparities science, and application instructions for the CRIBS Intensive Training Program (ITP). Workshop participants included 272 individuals from 11 cities and the surrounding areas
- Developed and implemented the application process for the CRIBS ITP and provided one-on-one and webinar based technical assistance to 90 individuals. As a result, 22 applications were reviewed and 12 teams of 2-3 individuals were accepted into the CRIBS ITP.
Contributing NIH Institutes & Centers
- National Cancer Institute (NCI)
- National Institute of Environmental Health Sciences (NIEHS)