Dawn Hershman, MD, MS

Improving breast cancer outcomes by reducing the long-term side effects of treatment.

Impact

Women with breast cancer are living longer and many experience long-term toxicities from therapy and a diminished quality of life. Dr. Hershman is conducting interventional studies that aim to reduce adverse effects, control pain, improve treatment adherence, and improve quality of life for patients in all stages of breast cancer. Her current research focuses on understanding the long-term adherence to endocrine therapy, evaluating primary care use, cancer screening and imaging in people living with metastatic breast cancer.

Progress Thus Far

Through a series of studies, Dr. Hershman is seeking to improve the quality of care and survivorship, with a focus on women with advanced and metastatic breast cancer (MBC), who may remain on treatment indefinitely. In the past year, she and her team have published several key findings evaluating the financial and insurance-related barriers to breast cancer care.

Notable updates from her work include the development of a model to better understand the factors contributing to non-adherence to endocrine therapy. The team developed a tool to measure the likelihood that a patient will not adhere to endocrine therapy. These studies help identify patients whose adherence to endocrine therapy may be improved with interventions.

In other work, Dr. Hershman’s team found that over 15% of patients reported limited or uncertain access to food. Food insecurity was twice as high among patients with metastatic breast cancer and was associated with higher rates of emergency room visits. This has led to an ongoing study to evaluate the impact of reducing food insecurity on cancer care.

What’s next

Dr. Hershman will continue to investigate the impact of endocrine therapy non-adherence on cancer and non-cancer related outcomes. Additionally, she will focus on reducing unplanned emergency room visits in patients with MBC by developing a risk prediction model to inform personalized risk-based intervention strategies and resource allocation. These studies on patients with advanced and metastatic breast cancer will bring attention to the unique challenges they face, inform the design of future studies, and potentially change treatment guidelines.

Read more about Dr. Hershman’s work as part of BCRF’s Health Equity Initiative here.