To understand how early life behaviors influence future breast cancer risk and to refine risk assessment methods. 

Impact

It is estimated that nearly a third of breast cancers could be prevented by lifestyle choices, particularly those that support and maintain a healthy weight, including diet and exercise. Dr. Colditz’s research has focused on how those choices (including diet, alcohol use, exercise, and sleep), when made during childhood and adolescence, impact a person's future risk of breast cancer. His findings showed that higher nut intake in adolescence (including peanut butter) was associated with lower subsequent risk of benign breast disease and this protection persisted among women who drank alcohol. Adolescents who drank alcohol in high school or had a low intake of fiber almost doubled their risk of benign breast disease. This risk, however, could be attenuated by consuming nuts. His studies may lead to strategies that promote a healthy lifestyle in young adults to reduce the risk of breast cancer. In his continued efforts to study the relationship between benign breast disease and risk of breast cancer, Dr. Colditz and his colleagues are analyzing mammograms accumulated from routine screening of large cohorts of patients over time and hope to develop refined models to predict when benign breast disease evolves to become breast cancer—these studies will improve risk management and inform personalized prevention strategies. 

Progress Thus Far

Dr. Colditz continues to examine how modifiable factors such as diet affect the rate of transition between breast cancer states such as the progression from benign breast disease to breast cancer. In the past year, his team has been evaluating how mammographic data can be used to monitor this progression. They have assembled over 9,000 mammograms obtained from screening of 954 women for over ten years, analyzed the images, and applied several sophisticated modeling techniques. They have demonstrated, for the first time, that analysis of repeated mammograms over 10 years can detect a divergence in breast density more than 6 months prior to a breast cancer diagnosis.  

What's next

Building on their findings, the team will expand their analysis and include a questionnaire and genetic marker assessment to further refine their risk prediction model, while also working to enhance the models to predict risk of ductal carcinoma in situ (DCIS) and triple-negative breast cancer. These studies may provide insight into the dynamic transition that occurs as normal breast tissue evolves to become breast cancer. Moreover, Dr. Colditz results will demonstrate that mammograms that are routinely available can be used to understand an individual’s personalized risk over time.