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Julie R. Gralow, MD

Jill D. Bennett Professor of Breast Cancer
University of Washington School of Medicine
Director, Breast Medical Oncology
Seattle Cancer Care Alliance
Member, Clinical Research Division
Fred Hutchinson Cancer Center
Seattle, Washington

Current Research

Goal: To increase awareness and improve treatment of breast cancer.

Impact: Bisphosphonates have been shown to both reduce the risk of breast cancer recurring in the bone and the number of deaths due to breast cancer. Dr. Gralow has been following patients to determine who is mostly likely to benefit from bisphosphonate treatment. 

What’s next: She plans to conduct further analyses to determine which patients and tumors respond to bisphosphonates. In addition, she is also testing an assay that may help determine which patients benefit from post-mastectomy radiation in Latin America, where access to this therapy is limited. 

Bone is often the first site of recurrence of metastatic breast cancer (MBC). Studies have shown that a class of drugs called bisphosphonates can reduce the risk of breast cancer recurring in the bone and lower the number deaths due to breast cancer. Dr. Gralow is conducting studies to identify which patients are at risk for developing bone metastasis and might benefit most by receiving a bisphosphonate agent. She and her team are also conducting a study in breast cancer patients in Latin America that will help identify patients who can safely forgo post-mastectomy radiation, an important advance in a region where radiotherapy is difficult to access.

Full Research Summary

Research area: Identifying methods of decreasing the risk of bone metastases and determining which young Latin American breast cancer patients can safely avoid post-mastectomy radiotherapy.

Impact: Work by Dr. Gralow and others has shown that bisphosphonates—drugs used to treat osteoporosis—can reduce the risk that breast cancer will recur in the bone and thereby lower the number of deaths due to breast cancer. Dr. Gralow has been studying the effectiveness of three bisphosphonate drugs in postmenopausal patients who are receiving other forms of anti-cancer therapy to help reduce the risk of recurrence. Findings from her studies could help reduce the rate of breast cancer recurrence and improve outcomes.

Current Investigation: In addition to her ongoing work on bisphosphonate use for prevention of bone metastasis, Dr. Gralow is part of the SWOG Latin American Network, which is conducting a clinical trial in Mexico and Latin America. The mean age of breast cancer diagnosis in this region is 50 years, approximately a decade earlier than in women living in Europe and North America. Most breast cancer patients undergo mastectomy, but radiotherapy, which is known to improve outcomes is not widely available. To help determine which patients may be able to safely forego radiation therapy, Dr. Gralow and her international colleagues are evaluating the association between no post-mastectomy radiation and 10-year recurrence rates in young women with early-stage estrogen receptor (ER)-positive breast cancer. 

What she’s learned so far: In her bisphosphonate study conducted by the SWOG clinical trial consortium, Dr. Gralow is comparing 3 bisphosphonate drugs given for 3 years to determine if they differed in their ability to reduce recurrence or in side effects. Study results did not find evidence that there was a difference in recurrence or death based on which bisphosphonate was given to patients.

What’s next: She will continue to follow patients on the bisphosphonate study for 10 years and will also conduct further studies to determine which patients and tumors benefit the most from bisphosphonates.


Julie R. Gralow, MD, is the Jill Bennett Endowed Professor of Breast Cancer at the University of Washington (UW) School of Medicine, Director of Breast Medical Oncology at the Seattle Cancer Care Alliance, and Member of the Clinical Research Division at Fred Hutchinson Cancer Center (FHCRC).

As a clinician-researcher, Dr. Gralow has developed and implemented numerous clinical trials that study new regimens for breast cancer prevention and treatment. She promotes exercise and a healthy diet for improving quality of life among breast cancer patients. She also has an interest in international breast cancer education. Dr. Gralow’s primary research expertise is in the field of breast cancer bone metastases and bisphosphonates (drugs that slow bone cell turnover, leading to a decreased risk of developing bone metastases).

Dr. Gralow is PI for the clinical core of the FHCRC/UW Breast Cancer Specialized Program of Research Excellence (SPORE) grant. She currently serves as an Executive Officer for SWOG overseeing breast and lung cancer efforts. She has served as an alternate member of the NCI Breast Cancer Steering Committee since its inception, and co-chaired an NCI State of the Science conference on preoperative therapy in breast cancer in 2007. She also serves as a member of the Leadership Team of the FHCRC’s application to NCI as a Network Lead Academic Participating Site (LAPS) in the National Clinical Trials Network.

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BCRF Investigator Since


Donor Recognition

The Play for P.I.N.K. Award