Virginia Borges, MD

Improving outcomes for women with postpartum breast cancer.

Impact

Postpartum breast cancer (PPBC) is diagnosed within 5-10 years of childbirth. Rates of PPBC are rising as women delay childbearing, and it is associated with higher risk for metastasis and death compared to breast cancer in younger women before or during pregnancy. Prior research has identified biological events such as breast tissue remodeling that occurs after lactation or pregnancy without nursing as inciting events that promote aggressive breast cancer. Biological mechanisms such as a change in normal proteins that regulate signaling in the breast, new lymphatic vessels forming from pre-existing ones, an increase in inflammation, and the expression of a gene called SEMA7A have also been found to contribute to poorer outcomes. Dr. Borges seeks to understand the biology of PPBC and improve outcomes for this population.

Progress Thus Far

Dr. Borges and her team have made progress this year expanding their work on young women’s breast cancer (YWBC) and pregnancy-associated breast cancer (PPBC). Through the team’s expanded Colorado cohort, in partnership with Denver Health, they are enriching the study population with Latina women, which will continue this year. They plan to recruit an additional 150 participants, bringing the total to 300, and will use these samples for ongoing analyses to better understand tumor biology. Using data from the long-running I-SPY clinical trial, they are also working to confirm biomarkers that may predict outcomes, including responses to immunotherapy. Early results suggest PPBC tumors may carry aggressive genomic features. The team is helping to build one of the largest, most detailed cohorts of YWBC and PPBC patients through the Oncology Research and Information Exchange Network (ORIEN), linking clinical, genetic, and long-term outcome data across a consortium of 19 cancer centers. To support this effort, Dr. Borges established a new Breast Cancer Research Interest Group that meets monthly to share research interests across the consortium. The team now has data on more than 700 young women with breast cancer ready for analysis.

What’s next

In the upcoming year, Dr. Borges’ goal is to continue the construction of the novel resources she and her team are building to study PPBC. National-level collaborative databases are needed to answer the detailed questions remaining in understanding and treating PPBC. The team plans to recruit another 150 participants for a total of 300 participants through their collaboration with Denver Health. In addition to ongoing analysis, the team will add participant surveys for social determinants of health and patient reported outcomes, as the impact of social determinants of health on PPBC has not been explored. The team plans to expand the PPBC database, to potentially include data from over 4,000 women diagnosed under age 45. This data set will provide the strongest potential to study PPBC and validate predictive factors for PPBC outcomes and, importantly, include PPBC cases across races, geographical locations, and up to age 45, as women are electing to delay childbearing and are diagnosed in their early 40s. Overall, this work will generate large-scale, real-world evidence to improve outcomes for women with this high-risk form of breast cancer.