Skip to content

Pathways: A Study of Breast Cancer Survivorship - Pathways Studies

Developing a TPMG Pathway for Selective Oncotype DX Testing in Early Breast Cancer

The goal of this project is to determine whether Ki-67 testing, using newer methods, could be used as a replacement for Oncotype DX testing in selected patients with HR+/HER2- breast cancer.

Investigator: Habel, Laurel

Funder: TPMG Delivery Science Projects Program

Radiomic and genomic predictors of breast cancer risk

Improving breast cancer risk prediction models could enable more personalized screening. This would enhance the benefits of screening while limiting the harms. This study will evaluate the performance of multi-feature image risk score models in a large population-based cohort; determine whether image-based scores predict breast cancer risk independently of clinical and genetic predictors; and ransfer the best image-based algorithm from 2D to 3D images.

Investigator: Habel, Laurel

Funder: National Cancer Institute

Energy Balance, mTOR Pathway Signaling, and Breast Cancer Prognosis: The Pathways Study

This application will use the Pathways Study resource to investigate genetic and non-genetic factors in the interplay of energy balance, mTOR signaling, and breast cancer prognosis. mTOR expression will be determined in tumor tissue from tissue microarrays that are being created in the Pathways Study, and its role in breast cancer outcomes will be examined.

Investigator: Kwan, Marilyn

Funder: National Cancer Institute

Breast White Adipose Tissue Inflammation and Breast Cancer Outcomes

We will assess the incidence and severity of breast white adipose tissue (B-WAT) inflammation in mastectomy specimens from approximately 1,900 Pathways Study participants to examine associations of various factors with B-WAT inflammation incidence and severity at the time of breast cancer surgery, and to examine whether B-WAT inflammation impacts breast cancer recurrence, second primary breast cancer, and breast cancer progression-free survival. We will also investigate the associations of inflammatory blood biomarkers, body composition, and lifestyle factors such as diet and physical activity with B-WAT inflammation and severity. This collaborative project includes investigators at the Fred Hutchinson Cancer Research Center, Memorial Sloan Kettering Cancer Center, Roswell Park Comprehensive Cancer Center, and Weill Cornell Medical College, where Dr. Andrew Dannenberg, who co-leads this project, is located. 

Investigator: Kushi, Lawrence

Funder: National Cancer Institute

Healthful dietary patterns, intermediate biomarkers and long-term breast cancer prognosis

To strengthen the dietary guidelines for breast cancer survivors, we examine whether at-diagnosis concordance with healthful dietary patterns is associated with recurrence or breast cancer death, or with prognostic biomarkers (i.e., body composition, inflammation or metabolic syndrome). Secondarily, we will examine whether improving diet quality (or maintaining high diet quality) after diagnosis reduces risk of recurrence or breast cancer death.

Investigator: Feliciano, Elizabeth

Funder: American Institute for Cancer Research

Geospatial, Multilevel, and Contextual Approaches in Cancer Control and Population Sciences

This funding expands on neighborhood resources developed under the U01 grant (geocoded residential histories, linkage to census and area databases, virtual neighborhood audits). Aim 1: Develop methods to use remote sensing data and machine learning techniques to characterize neighborhood attributes (e.g., green space, proximity to blue space, night-time light) and enhance the neighborhood infrastructure of the Pathways Study cohort. Aim 2: Demonstrate their applicability by examining the impact of social and built environment attributes on allostatic load among the Pathways cohort of breast cancer survivors. This work provides an opportunity to apply a comprehensive suite of neighborhood attributes to better understand multilevel factors and outcomes in breast cancer survivors.

Investigator: Kushi, Lawrence

Funder: National Cancer Institute

Germline and Tumor Genomic Analyses of Breast Cancer in Latinas

​This project expands a consortium of studies examining germline genetic mutations in breast cancer risk in Latinas. It builds on a study that will include approximately 550 Latina women with breast cancer in the Pathways Study; genetic data from Latina women without breast cancer will be contributed from Kaiser Permanente Northern California’s Research Program on Genes, Environment and Health. Led by Susan Neuhausen, PhD, of City of Hope, and Elad Ziv, MD, of UC San Francisco, this project further incorporates Latina cases and controls from studies led by Dr. Neuhausen. While this project includes investigation of tumor DNA, Pathways Study and Kaiser Permanente Northern California participants will not be included in that aspect.

Investigator: Kushi, Lawrence

Funder: National Cancer Institute

Infrastructure for Pathways, a Prospective Study of Breast Cancer Survivorship

This grant provides core infrastructure support for the Pathways Study (Kushi, PI), a prospective cohort study of breast cancer survivorship and prognosis. Since 2006, the study enrolled 4,505 women diagnosed with invasive breast cancer in KPNC. Activities (Ambrosone, Christine, Roswell Park Cancer Institute, Co-PI) include ongoing follow-up of participants, active and passive ascertainment of outcomes, collection of tumor specimens, linkage to KPNC electronic records, enhancement of area-level data from contextual databases through virtual neighborhood audits, provision of genotypic data from genome-wide assays, and establishment of a community and participant advisory board. These activities enhance the Pathways Study to make it an unparalleled, outstanding resource for studies of breast cancer prognosis.

Investigator: Kushi, Lawrence

Funder: National Cancer Institute

Back To Top