University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
Professor, Epidemiology and Pathology & Lab Medicine
Director, Center for Environmental Health & Susceptibility
Co-leader, Cancer Epidemiology Program, Lineberger Comprehensive Cancer Center
Health Equity Initiative
Investigating the drivers of breast cancer in Black women.
In the last 30 years, deaths from breast cancer have declined by 43 percent. Yet, that tremendous progress has not been experienced equally and certain populations are at higher risk for worse breast cancer outcomes. Black women in particular face stark, sobering, and unacceptable disparities. They are diagnosed at younger ages and at more advanced stages of breast cancer, are diagnosed with triple-negative breast cancer at two times the incidence and—despite being diagnosed at similar rates—are 41 percent more likely to die from their breast cancer than non-Hispanic white women. Eliminating racial disparities in breast cancer incidence, diagnosis, and treatment is an urgent priority.
With generous support from the Estée Lauder Companies Charitable Foundation, BCRF launched the Health Equity Initiative—Breast Cancer Drivers in Black Women: Society to Biology—to address the existing breast cancer mortality gap between white women and Black women. In this era of personalized medicine, BCRF’s goal is to significantly reduce breast cancer disparities and improve outcomes among Black women by advancing personalized, evidence-based care.
One of the major barriers is that Black women are an understudied population, comprising less than 5 percent of patients enrolled in cancer clinical trials where their experience could inform treatment recommendations. Furthermore, single institution studies of Black women are too small in both size and scope to address the complex interactions between race, heredity, genetics, environment, socioeconomic and cultural factors that impact breast cancer risk, biology, and outcomes. As more women are diagnosed with breast cancer, even more are likely to experience the injustice of worse, and preventable, health outcomes. And this poses a significant challenge as the underlying causes of breast cancer disparities are complex and multifactorial. The Health Equity Initiative will address this unmet need and work to close the disparities gap.
BCRF has convened leading breast cancer investigators to participate in the Health Equity Initiative, including Dr. Troester who has considerable expertise in epidemiology and has led large clinical trials with a focus on Black women with breast cancer. These researchers are conducting a comprehensive study to examine the interaction of comorbidities, social determinants of health, and breast cancer genetics in Black women in a bold and novel way. This multi-center effort will enable researchers and clinical trialists across the U.S. to assemble a large database of contemporary SDoH and genetic profiles in Black women with breast cancer. Coupled with treatment and outcomes data this database will allow investigators to develop a comprehensive picture that captures the heterogeneity of breast cancer in Black women.
Melissa Troester, PhD, MPH is a Professor of Epidemiology with a joint appointment in Pathology & Laboratory Medicine at University of North Carolina (UNC) at Chapel Hill’s Lineberger Comprehensive Cancer Center. At Lineberger Comprehensive Cancer Center, Dr. Troester leads the Carolina Breast Cancer Study, co-leads Lineberger’s Program in Cancer Epidemiology, and is Director of the UNC Center for Environmental Health and Susceptibility.
Her research focuses on biomarker development and validation, genomic methods, epidemiologic methods, and breast cancer. Her long-term goal is to support multi-level approaches that integrate tumor biology with individual, community, and health services data to understand and eliminate barriers to health equity.
As Principal Investigator of the Carolina Breast Cancer Study, Dr. Troester has led studies investigating social factors contributing to health care access and treatment in breast cancer. This involved collection of quality of life, treatment delay and timeliness data, comorbidities, income, education, and other social factors. In another clinical study, her team utilized breast tissue samples to build an atlas of human breast tissue and develop digital algorithms to describe tissue morphology objectively and quantitatively.
Estée Lauder Companies Charitable Foundation
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