Titles and Affiliations
Professor of Internal Medicine
Director, Breast Cancer Prevention and Survivorship Centers
Morris Family Endowed Chair in Cancer Prevention
Research area
To develop strategies to prevent breast cancer in moderate- to high-risk women that also improve their overall health and quality of life.
Impact
Breast cancer prevention drugs such as tamoxifen or aromatase inhibitors dramatically reduce the risk of developing breast cancer, but many women will discontinue their use due to side effects that can initiate or worsen menopausal symptoms. Dr. Fabian is focusing on finding prevention strategies that women are more likely to adopt, ones that not only lower breast cancer risk but also help with common health issues like menopause symptoms, weight management, or high cholesterol.
Progress Thus Far
Dr. Fabian and her team completed enrollment in two prevention trials: one testing bazedoxifene and conjugated estrogens (Duavee®) in postmenopausal women with hot flashes, and one testing the diabetes drug tirzepatide (Mounjaro®/Zepbound®) in women with obesity. A third trial, comparing acolbifene, an experimental anti-estrogen drug with potentially fewer side effects, to low-dose tamoxifen in younger women, is nearly halfway enrolled. In the tirzepatide trial, the team found that the target receptor for one of the drug’s actions is present in breast tissue, suggesting tirzepatide may act directly on breast cells, offering a possible explanation for how it could reduce cancer risk beyond its benefits related to weight and metabolism. They also used advanced techniques to detect molecular changes in tissue and blood and found substantial shifts in these markers among women who lost more than 10 percent of their body weight and 20 percent of their body fat.
What’s next
Dr. Fabian and her team will complete final analyses of the tirzepatide and Duavee® trials. They plan to add an artificial intelligence tool to analyze mammographic patterns to improve breast density measurements and more precisely detect changes. They will also expand their use of advanced measurement techniques across trials, with the goal of eventually using blood-based markers to track changes in breast cancer risk without requiring a breast biopsy. Together, these efforts will allow the team to refine biomarkers, compare different prevention strategies, and move closer to offering women safer and more acceptable options for lowering breast cancer risk.
Biography
Carol Fabian received her MD, internal medicine and oncology training from the University of Kansas School of Medicine in Kansas City, Kansas. Dr. Fabian joined the faculty at the University of Kansas Medical Center in 1977 and currently holds the rank of Professor. She serves as the Director of the Breast Cancer Prevention and Survivorship Centers. These centers are heavily involved in translational research in addition to providing clinical services. She leads the Cancer Prevention Research Program within the University of Kansas Cancer Center and holds the Morris Family Endowed Chair in Cancer Prevention.
Dr. Fabian pioneered the use of random peri areolar fine needle aspiration to acquire breast epithelial cells for refinement of breast cancer risk assessment. The technique is also used for evaluation of biomarkers to monitor response in early phase breast cancer prevention clinical trials: 1) weight loss in combination with omega-3 fatty acid supplementation; 2) a flaxseed lignin derivative; and 3) an aromatase inhibitor in postmenopausal women taking hormone replacement. She is also involved in clinical studies to promote health and quality of life for breast cancer survivors and serves as a Co-Chair for the Cancer Survivorship Committee of SWOG.
