GUMC research summaries for AACR Cancer Prevention Meeting

November 18, 2008

Washington, DC -- Researchers from Lombardi Comprehensive Cancer Center/Georgetown University Medical Center will present numerous scientific findings at the Seventh Annual AACR International Conference on Frontiers in Cancer Prevention Research in Washington, Nov. 16-19, 2008. Presentations by Lombardi researchers include topics such as colonoscopy use among black women, pregnancy and breast cancer, genetic testing feasibility prior to breast cancer surgery, BRCA1/2 uninformative results and distress, BRCA1-related cancer development, and estrogen-related breast cancers.

In addition, three distinguished Lombardi members were selected to give oral presentations at the meeting. They include:Lombardi researchers provided the following summaries of their work to be presented in the two poster sessions. (Each summary is followed by the poster number and session).

Colonoscopy Utilization in the Black Women's Health Study

A study sample from the Black Women's Health Study of 10,992 black women between the ages of 50 and 72 in 1997 found that women who utilized mammography were more likely to have a colonoscopy than women who never participated in screening. Promoting multiple concurrent cancer screenings may be the best approach to increasing colonoscopy utilization for women.

Poster Session B, Tuesday 5-7:30 pm, Hall D, B32

Authors: Lucile L. Adams-Campbell*, Kepher Makambi*, Charles Mouton, Julie Palmer, Lynn Rosenberg.
*Lombardi Comprehensive Cancer Center/Georgetown University Medical Center, Howard University Cancer Center, Boston University, Slone Epidemiology Center

Predictors of BRCA1/2 genetic testing in a population of newly diagnosed breast cancer patients

Genetic testing for mutations in BRCA1/2 can influence surgical decisions for women recently diagnosed with breast cancer who have not undergone definitive surgery. Women who find they are carriers of a BRCA1/2 mutation may, for example, choose bilateral mastectomies rather than breast conservation due to the high risk of developing a second breast cancer. The goal of this study was to identify predictors of BRCA1/2 testing in this population of women. Factors associated with genetic testing included higher risk of carrying a BRCA1/2 mutation, marital status, perceived risk of breast cancer recurrence, lack of surgical recommendation, discussion of genetic counseling with a physician and concerns regarding body image. These results are relevant for clinical practice as physicians identify newly diagnosed patients for referral to a genetic counselor. The data presented suggest that a referral may be more appropriate in women who do not have a specific recommendation for type of surgery and that a surgeon's recommendation for genetic counseling is predictive of whether a patient will pursue genetic testing. We have demonstrated the feasibility and utility of genetic counseling and testing for newly diagnosed patients which may lead to wider clinical application of genetic services in the time prior to surgery.

Poster Session B, Tuesday 5-7:30 pm, Hall D, B8

Authors: Rachel Nusbaum,* Scott Kelly,* Beth N. Peshkin,* Claudine Isaacs,* Sarah Kelleher,* Patti Vegella,* Kara-Grace Leventhal,* Shawna Willey,* Costanza Cocilovo,* Rebecca Evangelista,* Colette Magnant,* Jessica Rowse, Andrea Forman, Elizabeth Carroll, Lina Jandorf, Heiddis Valdimarsdottir and Marc D. Schwartz*
* Lombardi Comprehensive Cancer Center/Georgetown University Medical Center, Mount Sinai School of Medicine, Oncological Sciences, New York, NY.

Long-Term Outcomes of Affected Women who Received Uninformative BRCA1/2 Results

BRCA1/2 genetic testing assesses hereditary breast and ovarian cancer risk. The majority of women who undergo BRCA1/2 testing receive uninformative results, which means that testing does not reveal the presence of a change or mutation. In other words, these genes appear to be functioning properly. Such a result, especially in the context of women who have had breast cancer and who have a family history of breast and/or ovarian cancer, does not rule out the possibility that a hereditary risk for cancer still exists. Thus, breast cancer survivors who receive these results may still have elevated risks of developing a second breast or ovarian cancer, and subsequently, may experience increased levels of distress as their cancer risk is uncertain.

The purpose of our study was to investigate the long term predictors of distress, preventative surgical decision making, and quality of life outcomes among breast cancer survivors who received uninformative BRCA1/2 results 4-8 years prior. All women were at high-risk of carrying a BRCA1/2 mutation by virtue of their personal and family history of cancer. Our main findings suggest that the factors influencing long-term distress include pre-test levels of high distress and, for women who opt to remove their ovaries, the timing of their decision to remove their ovaries. The data presented are among the first to show that the receipt of an uninformative result can significantly impact long-term behavioral and psychological outcomes among breast cancer survivors. These findings suggest that this population of women may benefit from adjuncts to genetic counseling to assist with education and decision-making around cancer risk and from long term follow up to help manage distress.

Poster Session B, Tuesday 5-7:30 pm, Hall D, B9

Authors: Patti Vegella,* Kristi Graves,* Scott Kelly,* Grace Zawistowski,* Allison Porter, Beth Peshkin,* Tiffani DeMarco* and Marc Schwartz*.
*Lombardi Comprehensive Cancer Center/Georgetown University Medical Center

Stat5a and pregnancy protection in the CERM mouse model

Note: This abstract was highly rated, earning the lead author an AACR Scholar-in-Training Award.

We are examining specific factors that might influence how pregnancy may be related to development of breast cancer. Epidemiological studies have shown that early pregnancy may reduce the risk of later breast cancer but it is also known that a small increase in the risk of developing breast cancer is seen within 2 years of pregnancy. Our study examined whether or not a protein called Stat5a that is known to be activated by pregnancy would alter the presentation of non-invasive ER+ breast disease in mice following pregnancy. We found no evidence to show that Stat5a plays a role in the presentation of ER+ disease following pregnancy.

Poster Session A, Monday 6-8:30pm, Hall D, A6

Authors: Anne M. Miermont* and Priscilla A. Furth*
*Lombardi Comprehensive Cancer Center/Georgetown University Medical Center

Association between FGFR2 SNPs, breast cancer risk factors, and clinical and pathological features of breast tumors in the Western New York Exposures and Breast Cancer (WEB) study

Previous genome-wide screening studies have identified that certain variations in the FGFR2 (fibroblast growth facto receptor 2) gene sequence were associated with about 60 percent increase in breast cancer risk. Here we confirmed these findings in the Western New York Exposures and Breast Cancer study, a population-based case-control study. In addition, we also investigated the interaction of these sequence variations with known breast cancer risk factors, lifestyle exposures, and clinical and pathological features of breast tumors, in relation to breast cancer risk. Our results support the hypothesis that FGFR2 is involved in estrogen-related breast carcinogenesis, suggested by the association with estrogen receptor positive tumors and reproductive history.

Poster Session A, Monday 6-8:30pm, Hall D, A74

Authors: Catalin Marian* , Jing Nie, Amy Millen, Maurizio Trevisan, M Russell, Thomas Nochajski, Christine Ambrosone, Alan Hutson, Stephen Edge, Dominica Vito, Peter G. Shields*, Jo Freudenheim.
*Lombardi Comprehensive Cancer Center/Georgetown University Medical Center, Roswell Park Cancer Institute, and State University of New York at Buffalo

Decreased expression of TGF-β family members appears to be an acquired phenotype of progression to malignancy in the context of loss of BRCA1 in mammary epithelial cells

Note: This abstract was highly rated, earning the lead author an AACR Scholar-in-Training Award.

BRCA1 is a protein whose mutation is associated with an increased risk of developing breast cancer. In a previous study we found that functional loss of this protein was associated with decreased expression of a growth inhibitory pathway called TGF-β. We decided to test if loss of this inhibitory pathway was directly related to loss of BRCA1 function or occurred during the development of BRCA1 mutation related breast cancer. Our study showed that there was no direct association between loss of BRCA1 function and loss of this inhibitory pathway; instead loss of the inhibitory pathway appears to be acquired as part of the BRCA1-mutation-related cancer development process.

Poster Session B, Tuesday 5-7:30 pm, Hall D, B71

Authors: Shahin Assefnia,* Shermaine K. Mitchell* and Priscilla A. Furth*
*Lombardi Comprehensive Cancer Center/Georgetown University Medical Center
About Lombardi Comprehensive Cancer Center

The Lombardi Comprehensive Cancer Center, part of Georgetown University Medical Center and Georgetown University Hospital, seeks to improve the diagnosis, treatment, and prevention of cancer through innovative basic and clinical research, patient care, community education and outreach, and the training of cancer specialists of the future. Lombardi is one of only 41 comprehensive cancer centers in the nation, as designated by the National Cancer Institute, and the only one in the Washington, DC, area. For more information, go to

About Georgetown University Medical Center

Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through our partnership with MedStar Health). Our mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO), home to 60 percent of the university's sponsored research funding.

Georgetown University Medical Center

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