University of Texas MD Anderson Cancer Center Houston, Texas
Endowed Professor and Chair, Department of Breast Radiation Oncology Executive Director, Morgan Welch Inflammatory Breast Cancer Clinic and Research Program Professor, Department of Radiation Oncology
On behalf of the National Surgical Adjuvant Breast and Bowel Project
Maximizing the effectiveness of breast cancer radiation treatments while avoiding an increased risk of heart disease.
The benefit of breast cancer radiation therapy can be diminished by the risk of radiation-induced heart disease (RIHD). Numerous studies have described the occurrence of RIHD by examining breast cancer populations treated decades ago and estimating the radiation dose delivered. While research has provided important information on the potential for RIHD risk, it has not supplied the critical knowledge needed to optimize radiation dose to avoid RIHD in diverse populations. To improve personalized assessment and modification of RIHD risk from breast cancer radiotherapy, much work must be done to assess the impact of modern radiation therapy methods on risk of RIHD, including understanding what part of the heart is most vulnerable to radiation and routinely screening patients for known heart disease risk factors prior to radiotherapy.
Dr. Woodward and her team will examine computed tomography (CT) scan data from a phase III trial that enrolled 2,350 patients with breast cancer from 2010-2013. The trial population has been followed for an average of 7 years and information was collected on the occurrence of any heart disease. The archived CT scans will undergo delineation of the different parts of the heart, known as its substructures, and the specific radiation dose received by each substructure will be calculated. They will analyze heart disease events reported in the clinical trial in relation to the radiation dose to the heart and its substructures and compare this to the patient’s baseline cardiac risk calculated from the initial CT scan. This will provide the data needed to identify a more reliable predictor of RIHD that can be implemented into breast cancer radiation treatment planning and individualized to a patient’s baseline risk of heart disease. This research aims to maximize the effectiveness of radiation therapy to reduce breast cancer recurrence while avoiding complications in other organs.
Wendy Woodward, MD PhD is Professor and ad interim Chair of the Department of Breast Radiation Oncology at The University of Texas M. D. Anderson Cancer Center (MDACC) with a dual appointment in the Department of Experimental Radiation Oncology. She is the Executive Director ad interim of the Morgan Welch Inflammatory Breast Cancer (IBC) Clinic and Research Program which treats > 100 IBC patients per year and manages the largest prospective IBC tissue bank in the world. She is an MD-PhD trained physician scientist, who has led three multi-PI R01 projects (two multi-institutional). She has published extensively on breast cancer with work in clinical, translational, and basic science realms and is also an adept clinical trialist and is the national translational PI on NRG BR002, National PI on SWOG 1706. She is a well-established leader in breast translational and correlative science. Nationally, she has been the co-chair of the translational science breast committee at NRG Oncology for over a decade and works closely with BCRF investigator, Vered Stearns, and Julia White (University of Kansas Medical Center) on this proposed project to study radiation dose to cardiac substructures on NRG trials. Across these leadership roles, Dr. Woodward has completed over 250 hours of formal leadership training and has extensive experience in planning, vision casting, team science management, mentoring, collaborating, communicating across large organizations, budget management, and timeline setting.
2023
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