Titles and Affiliations
Professor
Associate Director and Attending Clinical Geneticist
Vanderbilt-Ingram Cancer Center
Research Area
Examining the intersection of social drivers of health and tumor biology to impact breast cancer in Black women.
Impact
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 about 40 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 five 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.
What’s Next
BCRF has convened leading breast cancer investigators to participate in the Health Equity Initiative, including Dr. Pal who has considerable expertise in breast cancer genomics and outcomes. She leads multiple studies focused on genomics, etiology, outcomes, and care delivery among underserved and/or inherited cancer populations, including clinical work to refine the evaluation of patients with a family history of cancer. She and colleagues at Vanderbilt University, including fellow BCRF-investigator Dr. Sonya Reid, have established a database of over 800 younger Black women with breast cancer. This adds a unique perspective to the HEI particularly since the incidence of breast cancer in this population is on the rise.
Dr. Pal lends her expertise to the HEI where researchers are conducting a comprehensive study to examine the interaction of social drivers of health (SDOH) and breast cancer genetics in Black women in a bold and novel way. This multi-center effort has led to the assembly of a large database of Black women with breast cancer and the corresponding SDOH, genetic profiles, and treatment and outcomes data. Ongoing research is diving into the individual-level, area-level, and genomic factors that contribute to overall disparities in this population.
Biography
Tuya Pal, MD is a tenured professor at Vanderbilt University Medical Center and clinical geneticist based at Vanderbilt-Ingram Cancer Center. She obtained her medical degree from McGill University School of Medicine in Montreal, Canada. Her residency at Washington University, School of Medicine was followed by two fellowships at the University of Toronto, Ontario, Canada: in clinical genetics at the Hospital for Sick Children and in cancer genetics at the Centre for Research in Women’s Health.
Dr. Pal’s research focuses on genomics, spanning both risk characterization and delivery of services, in those with inherited cancer predisposition and underserved populations. Over her career, she has led multiple studies to evaluate risk and outcomes based on patient and tumor genomics, including a cancer registry-based study of younger Black women with breast cancer. To date, over 800 participants have been enrolled, and the study data will be incorporated into BCRF’s Health Equity initiative. She has also developed a registry of high-risk patients—the Inherited Cancer Registry (ICARE)–which includes about 8000 individuals across the U.S. and beyond. Dr. Pal is leading the efforts across populations of younger women with breast cancer to educate and enhance awareness about inherited breast cancer.
