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Joyce Slingerland, MD, PhD, FRCPC
Professor of Medicine and Biochemistry
Director, Braman Family Breast Cancer Institute
University of Miami Sylvester Comprehensive Cancer Center
Goal: To understand the relationship between obesity, inflammation and breast cancer risk after menopause.
Impact: Dr. Slingerland is studying how fat cells and breast cancer cells interact and promote the development and spread of ER-positive breast cancer. Her work may reveal new strategies for preventing the disease from developing and spreading beyond the breast (metastasis).
What’s next: Having identified a specific postmenopausal estrogen (estrone) that drives cancer development and spread, she and her team will now explore how it interferes with the ability of the immune system to kill cancer cells and whether combinations of immunotherapies and anti-estrogen drugs can oppose the hormone’s actions.
Women who are overweight or obese have an increased risk of breast cancer after menopause in spite of the fact that estrogen production–a major driver of breast cancer–decreases after menopause. One explanation may be the extra fat tissue, which is a source of estrogen. Dr. Slingerland has discovered that a specific estrogen produced after menopause may be a driver of obesity-related breast cancer.
Full Research Summary
Research area: Understanding the molecular underpinnings of obesity-associated breast cancer risk and poor outcomes.
Impact: Obesity increases the risk of breast cancer after menopause and is associated with a worse outcome in breast cancers diagnosed at any age. Weight loss and exercise can reduce the risk but adhering to these lifestyle changes is difficult. Dr. Slingerland aims to identify biological underpinnings of obesity-induced breast cancer risk and associated worse breast cancer outcomes. These studies could provide added incentive and support for clinical interventions that support a healthy weight.
Current research: Dr. Slingerland will continue ongoing studies to understand how post-menopausal estrogens drive breast cancer growth and metastasis.
What they’ve learned so far: In previous BCRF-supported work, Dr. Slingerland found that the interaction of fat cells with breast cancer cells promotes an inflammatory reaction that drives tumor progression. In the last year they found that estrone, the main estrogen produced after menopause, contributes to inflammation in the breast, suggesting that post-menopausal estrogens, produced largely in fat, promotes cancer development and drives metastatic progression.
What’s next: In the coming year, Dr. Slingerland’s team will continue to study the role of estrone on breast cancer risk and outcomes. Planned studies include comparing gene expression changes between pre- and post-menopausal ER-driven breast cancer which could define novel estrone-activated gene drivers of breast cancer in obesity. Additionally, they will determine if estrone interferes with the anti-tumor immune reaction and therefore if immunotherapies combined anti-hormone drugs may prevent metastasis.
Dr. Slingerland received her MD from the University of Toronto in 1983, followed by a Fellowship in Internal Medicine with the Royal College of Physicians and Surgeons in Canada. In 1987, she was certified by the American Board in Internal Medicine and in Medical Oncology by the Royal College of Physicians and Surgeons. In August of 2002, Dr. Slingerland came to the University of Miami School of Medicine as the Director of the Braman Breast Cancer Institute, Sylvester Comprehensive Cancer Center, where she is working to expand and coordinate research efforts on breast cancer from many disciplines.
Dr. Slingerland discovered the cell growth brakes molecule p27 and her research investigates how cancer cells lose growth restraints. Current work also investigates the causes underlying resistance to endocrine (also called anti-estrogen) therapies for breast cancer. Recent work is focused on why obesity increases breast cancer risk and worsens patient outcomes and is testing effects of a fatty environment on breast cancer stem cells.
Dr. Slingerland is also Professor of Medicine with a graduate appointment in the Department of Biochemistry and Molecular Biology at the University of Miami, as well as a member of the senior leadership of the UMSCCC and Co-Program Leader of the UMSCCC's Molecular Oncology and Experimental Therapeutics Program. She continues her medical practice devoted entirely to breast cancer patients at the Sylvester Comprehensive Cancer Center and the Jackson Memorial Hospital. She has published over 70 articles and reviews in addition to several book chapters and has received numerous awards.