Susan Kesmodel, MD

Exploring how an individual’s neighborhood environment impacts their breast cancer development and growth.

Impact

An individual’s neighborhood impacts many aspects of their life with disadvantaged neighborhoods experiencing limited access to healthcare, good food, clean air and water, and more. In fact, despite significant advances in breast cancer screening, diagnosis, and treatment, women living in disadvantaged compared to advantaged neighborhoods have higher breast cancer mortality rates. Drs. Kesmodel and Goel are conducting studies to examine precisely how neighborhood disadvantage influences breast cancer survival and how neighborhood disadvantages “gets under the skin” and impacts an aggressive tumor microenvironment (TME). They hope that her findings will enhance our understanding of the epidemiologic and genomic links between neighborhood disadvantages and an aggressive breast cancer TME. The team will also examine the connection between psychological stress in these neighborhoods and tumor aggressiveness. Their results may pave the way for future development of strategies to target modifiable factors and potentially level the playing field for those in disadvantaged neighborhoods.

Progress Thus Far

Drs Kesmodel and Goel and their colleagues are leveraging epidemiologic and genomic data from the ongoing Miami Breast Cancer Disparities Study, a prospective longitudinal cohort study with 280 breast cancer biospecimens and validated survey data on perceived neighborhood stress. Samples from this large and diverse cohort of patients (approximately 55 percent Hispanic, 20 percent Black, 21 percent White) are being utilized to map the cellular and molecular mechanisms by which neighborhood disadvantage leads to aggressive tumor biology, specifically tumor drivers correlated with disadvantaged neighborhoods. In the last year, the research team stained 108 samples for proteins associated with TME aggressiveness—CD31, CD68, and LYVE-1. Neighborhood surveys and clinical and long-term outcome data for these 108 patients were collected. Analysis is ongoing.

What’s next

They will continue to analyze the samples and correlate their findings with neighborhood level factors: The next steps will be to complete the gene expression analysis on the 108 samples and correlate with CD31, CD68, and LYVE-1 staining and outcome data. The team has identified the next 150 samples for staining to mark the TME. The results of these studies will improve our understanding of how the environment where people live impacts their breast cancer tumors and outcomes.