Titles and Affiliations
Rob and Karen Hale Distinguished Chair in Surgical Oncology
Research area
Understanding how stress on the immune system influences response to treatments and to guide care and improve outcomes.
Impact
Some patients with breast cancer respond well to preoperative (before surgery) chemotherapy and targeted therapy or immunotherapy, while others do not, and it is not fully understood why. One possible explanation is that stress, especially when experienced over a lifetime, may influence how the immune system responds to cancer and its treatment. The overarching goal of Dr. Mittendorf’s project is to determine whether a patient’s peripheral immune profile, or “immunotype,” is shaped by lifetime or recent stress, and whether that immune state is linked to treatment response. This may help to identify which patients are most likely to benefit from specific preoperative therapies, and whether stress management could improve outcomes.
What’s next
During the upcoming year, Dr. Mittendorf and her team will enroll 100 patients with HER2-positive or triple-negative breast cancer, two types of breast cancer typically treated with chemotherapy and targeted therapy or immunotherapy before surgery. Patients will complete two surveys: the STRAIN (Stress and Adversity Inventory), which measures lifelong exposure to stressors such as trauma, discrimination, or financial hardship; and the NCCN Distress Thermometer, which assesses recent emotional distress. At the same time, the team will collect blood samples before and during treatment to analyze immune cell patterns, or “immunotypes.” This project builds on prior research showing that distinct immunotypes exist among breast cancer patients and may be associated with treatment response. Ultimately, Dr. Mittendorf’s goal is to better understand how the immune system, shaped in part by stress, may influence cancer outcomes—and to use that knowledge to guide more personalized and holistic care for patients facing breast cancer.
Biography
Elizabeth Mittendorf, MD, PhD is the Robert and Karen Hale Distinguished Chair in Surgical Oncology and Associate Chair for Research in the Department of Surgery at Brigham and Women’s Hospital. She is also the Director of the Breast Immuno-Oncology program and Co-Director of the Breast Cancer Clinical Research Program at Dana-Farber/Brigham and Women’s Cancer Center. Dr. Mittendorf received her medical degree from Case Western Reserve University School of Medicine where she also completed residency in General Surgery. She then served on active duty in the United States military before completing a fellowship in Surgical Oncology at the University of Texas MD Anderson Cancer Center. Dr. Mittendorf also holds a PhD in Immunology from the University of Texas Graduate School of Biomedical Sciences at Houston. She is board certified by the American Board of Surgery.
