Grant: Operating Grant - Priority Announcement: Breast Cancer

When a patient is diagnosed with early breast cancer, the treatment plan is aimed at reducing the risk of the cancer coming back (recurrence). Chemotherapy, targeted therapy, radiation therapy, and hormonal therapy given before or after surgery are all used to lower the risk of recurrence. Better ways to determine the risk of recurrence would allow doctors to create treatment plans tailored to each woman's individual recurrence risk. So if there were a test that told the doctor that a patient's recurrence risk was very low, him and the patient might decide to skip chemotherapy after surgery. Right now, some breast cancer characteristics, such as grade and stage, offer a rough estimate of overall recurrence risk, but it is virtually useless in predicting the late recurrence. Breast cancer that comes back more than 5 years after diagnosis and initial treatment is called "late recurrence". We propose a study that may eventually be able to estimate anyone's risk of recurrence with more precision, allowing treatment to be tailored to individual risk. We suspect that if there are certain normal cells, called breast stem cells, in the tumor microenvironment before surgery, the risk of late recurrence is high. If breast stem cells are not in the tumor, the risk of recurrence is low. We propose to develop a test to give "late recurrence scores" to early breast cancers patients.