Titles and Affiliations
Professor, Department of Clinical Cancer Prevention
Director, MD Anderson Nellie B. Connally Breast Center
Research area
Improving the precision and personalization of breast cancer screening for high-risk women
Impact
Women may be considered at high-risk of developing breast cancer because of a strong family history, an inherited gene mutation such as BRCA1 or BRCA2, or a prior diagnosis of ductal carcinoma in situ (DCIS). Because of this elevated risk, they are often advised to undergo more intensive screening, typically both mammography and breast MRI. However, many women identified as high-risk will never actually develop breast cancer, meaning some may undergo more intensive screening than necessary, with added cost, time, and discomfort. New technology has emerged that analyzes features in a screening mammogram to help assess a woman’s risk of developing breast cancer. One such tool, called Mirai, has been studied in women at average risk, but not specifically in women considered high-risk. Dr. Brewster and her team hypothesize that Mirai, alone or combined with blood-based biomarkers, may do a better job than current tools at distinguishing which high-risk women will go on to develop breast cancer, with the goal of making screening recommendations more precise for this population.
Progress Thus Far
In prior work, Dr. Brewster’s team focused on women with DCIS who face an elevated risk of developing invasive breast cancer and often undergo additional screening, preventive therapy, and surgery, even though many never develop invasive disease. The team evaluated a test that analyzes activity of a specific set of genes in DCIS lesions and in the invasive breast cancers that some patients later developed. Comparing gene activity between the two helped the team better understand how DCIS changes over time and refine the test itself.
What’s next
Building on this foundation and the team’s experience developing blood-based biomarkers, Dr. Brewster will evaluate Mirai specifically in high-risk women, testing both how well it performs on its own and in combination with clinical factors and blood-based biomarkers to predict who will actually develop invasive breast cancer. If successful, this approach could be broadened for wider use and help identify which high-risk women can safely avoid intensive MRI screening, reducing unnecessary cost, time, and discomfort.
Biography
Abenaa Brewster MD, MHS is a tenured professor in the Department of Clinical Cancer Prevention at MD Anderson Cancer Center (MDACC) and has an adjunct appointment in the Department of Epidemiology. She is a Medical Oncologist, Director of the MD Anderson Nellie B. Connally Breast Center, and her clinical interest is in the management of breast cancer.
Her research team has developed a framework for investigating the decision-making process that women undergo in considering contralateral prophylactic mastectomy. Her research expertise involves using the tools of molecular epidemiology to investigate clinical, epidemiological, and biological factors that determine breast cancer risk and survival. She is particularly interested in understanding how tumor genomics, host genetic susceptibility, ethnicity, and obesity influence a woman’s risk and survival after a diagnosis of breast cancer. She has experience in the conduct and data management of hospital, population-based cohort studies, and is the principal investigator and director of a longitudinal cohort study of women at high risk of developing breast cancer.
Dr. Brewster is a Komen Scholar, an award given to individuals for their knowledge and leadership within the scientific, research, and advocacy communities and for their own contribution to breast cancer research. She completed her MD at Harvard Medical School and her Master of Health Science in Cancer Epidemiology at Johns Hopkins School of Hygiene & Public Health.
