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. People living in neighborhoods with limited access to healthcare, good food, clean air and water, etc., are more likely to experience poor health outcomes. 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 it impacts the tumor microenvironment (TME). Their findings will enhance our understanding of the epidemiologic and genomic links between neighborhood disadvantage and aggressive breast cancer. The team will also examine the connection between psychological stress in these neighborhoods and tumor biology. Drs. Kesmodel and Goel hope their results may pave the way for future strategies to target modifiable factors and potentially reduce the disparity in breast cancer outcomes.

Progress Thus Far

Drs. Kesmodel, 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. They are utilizing samples from this large and diverse cohort of patients (approximately 55 percent Hispanic, 20 percent Black, 21 percent White) to map the cellular and molecular mechanisms by which neighborhood disadvantage leads to aggressive tumor biology. In the last year, they evaluated 150 samples, specifically focusing on two proteins—CD-34 and LYVE-1—that are associated with TME aggressiveness. In addition, clinical and long-term outcome data have been collected for these 150 patients.

What’s next

Drs. Kesmodel and Goel will continue to analyze the samples, focusing on specific tumor drivers correlated with disadvantaged neighborhoods. On the patient level, distribution of neighborhood surveys will be expanded to assess if higher levels of perceived stress are also associated with an aggressive TME.