Titles and Affiliations

Professor of Epidemiology and Oncology
Johns Hopkins Bloomberg School of Public Health
Sidney Kimmel Comprehensive Cancer Center
Baltimore, Maryland

Research area

Evaluating new strategies to identify women and men at risk for developing a second cancer after breast cancer. 


While deaths from breast cancer have decreased significantly, the number of new diagnoses made each year has not. Even if women have been successfully treated for their cancer, their cancer may return or a second (non-breast) primary cancer may develop, sometimes long after their initial diagnosis. According to a national SEER (Surveillance, Epidemiology, and End Results) database, the cumulative incidence of developing any second cancer among breast cancer patients is between 15-20 percent at 25 years, including a seven percent incidence of developing a new primary breast cancer. Furthermore, the National Cancer institute has identified second cancers as an underexplored area of research. Dr. Visvanathan is focused on understanding the incidence and impact of second cancers in women and men initially diagnosed with breast cancer. Her research will address critical gaps in our current knowledge, inform clinical practice, and provide strategies to prevent the occurrence of second cancers.

Progress Thus Far

In the first of its kind, large population-based study, Dr. Visvanathan examined the mortality differences in breast cancer survivors with a second primary cancer (other than breast cancer) compared to those breast cancer survivors with no second cancer. Her results suggest that prior breast cancer history significantly impacts cancer prognosis in women diagnosed with a second cancer—these patients had a 30 percent increase in mortality compared to women who have a single primary cancer. 

What's next

In the coming year, Dr. Visvanathan and her colleagues will perform a similar analysis for male breast cancer survivors with second cancers. In addition, they will focus on understanding the impact of second cancers on breast and cardiovascular mortality in both women and men diagnosed with breast cancer. They hope to identify at-risk groups and strategies to improve outcomes. They will also test whether clinical tools used to evaluate first breast cancers can be applied to second cancers in men and women and to what extent adherence to hormonal treatment of first cancers impact second breast cancer. 


Kala Visvanathan is a Professor in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health and the Department of Medical Oncology at Johns Hopkins School of Medicine. Dr. Visvanathan is Director the Clinical Cancer Genetics and Prevention Service and the Cancer Epidemiology Track at Johns Hopkins.

She received her medical degree from the University of Sydney in Australia.  She subsequently went on to complete her training in Internal Medicine and Medical Oncology at Royal Prince Alfred Hospital, an academic teaching hospital of the University of Sydney in Australia and at the Sidney Kimmel Comprehensive Cancer Center Johns Hopkins School of Mediine. Dr. Visvanathan also completed training in clinical/cancer epidemiology at the Johns Hopkins Bloomberg School of Public Health.

Her research is focused on primary and secondary prevention of breast and ovarian cancer. Trained as a medical oncologist and cancer epidemiologist, a large part of her research is transdisciplinary and focused on translating results from the laboratory to populations, to identify at risk groups, preventable targets and to evaluate agents that have the potential to impact the natural history of breast and ovarian cancer. She conducts both observational studies and clinical prevention/early detection studies Specific exposures of interest include hormonal exposures, inflammation, genetic and epigenetic changes, DNA damage/repair, obesity and oxidative damage. She has recently co-chaired the American Society of Clinical Oncology national guideline on breast cancer risk reduction.

BCRF Investigator Since