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Chi-Chen Hong, PhD
Department of Cancer Prevention and Control
Roswell Park Comprehensive Cancer Center
Buffalo, New York
Goal: To understand the molecular drivers of aggressive breast cancer in African American women and how these are different in Caucasian women.
Impact: African American women are 40 percent more likely to die of their breast cancer white women. Those diagnosed with breast cancer are more likely to be younger than newly diagnosed white women and more likely to be diagnosed with aggressive disease. While these disparate outcomes are complex and multifactorial, the work of Drs. Hong and Ambrosone is shedding light on molecular factors that contribute to worse mortality rates in Black women compared to white women.
What’s next: Drs. Hong and Ambrosone are investigating the types of immune cells that are in and around breast tumors from African American and white women and whether immune cell populations affect tumor aggressiveness. Recent findings suggest these immune cells in the tumors of African American women are defective in their ability to kill cancer cells. To further validate their pilot findings, the team will increase the enrollment of Black women in the Women’s Circle of Health Study (WCHS) to match the same number of white women to Black women for a more in-depth analysis.
TNBC is an aggressive disease that disproportionately affects women of African ancestry. Why this disparity exists is not well understood. Drs. Hong and Ambrosone are studying breast tumor tissues from both African American and Caucasian women to identify factors that may influence the incidence of TNBC in African American women.
Full Research Summary
Research area: Identifying factors that influence the incidence of triple negative breast cancer (TNBC) in African American women, who are more likely to be diagnosed with this aggressive subtype of breast cancer than Caucasian women.
Impact: While TNBC accounts for less than 20 percent of breast cancer diagnosed in the US, women of African American descent are two times more likely to be diagnosed with TNBC than Caucasian women. Currently, it is not clear what accounts for this disparity. Drs. Hong and Ambrosone are investigating several biological and lifestyle factors that may influence the incidence of TNBC in African American women. This work may provide new insights at the population level into why some women develop more aggressive breast tumors, so that personalized prevention and treatment may be designed.
Current investigation: The team is conduting a series of studies to delineate some of the underlying biological factors of more aggressive breast cancers in African Amerinca women compared to Caucasian women. Current studies include characterizing immune cells in and around breast tumors and the effect of breast feeding on the development of triple negative breast cancer, an aggressive breast cancer that disproportionately affect Black women.
What they’ve learned so far: Drs. Hong and Ambrosone found that tumors from African American women have higher levels of exhausted T cells for all subtypes of breast cancer, and that this is associated with poorer survival. Results from their study on breast feeding has shown that FOXA1—a developmental protein involved in cell differentiation—is supppressed in TNBC breast cancer and in breast cells of women who do not breast feed after childbirth.
What’s next: In the coming year, the researchers plan to expand the immune cell study with a larger cohort of white women to confirm their initial findings of a prevalence of dysfunctional T-cells in the tumors of Black women comparted to white women. With this larger sample size, they will measure a comprehensive panel of proteins in tumors that characterize exhausted immune cells to determine if they are, in fact, more prevalent in tumors from African-American women than Caucasian women and if they are related to poorer survival outcomes in African-American women.
Dr. Chi-Chen Hong is an Associate Member in the Department of Cancer Prevention and Control within the Division of Cancer Prevention and Population Sciences at Roswell Park. Dr. Hong's research is focused on breast cancer etiology, survivorship, and prognosis. Specifically, her interests are on the influence of lifestyle, comorbidity, genetics, and immune factors. She has an ongoing prospective cohort study of early stage breast cancer patients to examine issues in breast cancer survivorship, and with colleagues at the Rutgers Cancer Institute of New Jersey and Rutgers University is principal investigator of a study examining the role of obesity and related comorbidities, including asthma and type 2 diabetes, and their management on quality-of-life and breast cancer survival outcomes among African American women, and to elucidate key pathways mediating these associations.