The University of Texas MD Anderson Cancer Center Houston, Texas
Professor, Department of Clinical Cancer Prevention Director, MD Anderson Nellie B. Connally Breast Center
Improving the precision and personalization of breast cancer screening
Annual breast cancer screening is an important component of preventive healthcare for women. Mammograms, the gold standard for breast cancer screening, are imperfect and less helpful for fast-growing breast cancers, like the estrogen receptor (ER)-negative subtypes. To improve the precision of breast cancer screening, and increase capacity for detecting breast cancer early, Dr. Brewster and her team are working to develop a new liquid biopsy technique to detect cancer with a simple blood-based test. Ideally, this test would allow for more personalized screening, where someone with a positive blood test can be offered more frequent screening—including breast MRI—while someone with a negative blood test would be safely advised to have less frequent screening mammograms or no screening at all. Further, her team is evaluating patients’ perceptions and preferences for this new method of breast cancer detection to evaluate potential barriers.
Dr. Brewster’s team developed a unique liquid biopsy test to detect exosomes, which are small particles secreted by cancer cells into the blood. Preliminary results have shown that the new technology has a few limitations in specificity and sensitivity, compared to standard mammography. They are designing new protocols to optimize the use of the test.
The team will refocus their research efforts this year on screening in women with DCIS, who have an elevated risk of developing invasive breast cancer. As a result of the elevated risk, women with DCIS undergo additional screening, preventive therapy, and often surgical intervention. Many are overtreated and never develop invasive breast cancer. A recent study by the Human Tumor Atlas Network (HTN) identified several hundred genes that can predict recurrence and disease progression in patients with DCIS. Dr. Brewster plans to build upon this landmark study by investigating genomic similarities between DCIS and subsequent invasive breast cancer vis á vis the identified genes. Her team will also investigate gene expression changes by patients’ race and ethnicity to determine if these factors contribute to a higher risk of invasive breast cancer. The results from these studies may help explain why some women with DCIS develop invasive breast cancer and others do not, equipping patients and their doctors with more information to inform personalized decision-making for patients with DCIS.
Abenaa Brewster MD, MHS is a tenured professor in the Department of Clinical Cancer Prevention at MD Anderson Cancer Center (MDACC) and has an adjunct appointment in the Department of Epidemiology. She is a Medical Oncologist, Director of the MD Anderson Nellie B. Connally Breast Center, and her clinical interest is in the management of breast cancer.
Her research team has developed a framework for investigating the decision-making process that women undergo in considering contralateral prophylactic mastectomy. Her research expertise involves using the tools of molecular epidemiology to investigate clinical, epidemiological, and biological factors that determine breast cancer risk and survival. She is particularly interested in understanding how tumor genomics, host genetic susceptibility, ethnicity, and obesity influence a woman’s risk and survival after a diagnosis of breast cancer. She has experience in the conduct and data management of hospital, population-based cohort studies, and is the principal investigator and director of a longitudinal cohort study of women at high risk of developing breast cancer.
Dr. Brewster is a Komen Scholar, an award given to individuals for their knowledge and leadership within the scientific, research, and advocacy communities and for their own contribution to breast cancer research. She completed her MD at Harvard Medical School and her Master of Health Science in Cancer Epidemiology at Johns Hopkins School of Hygiene & Public Health.
2022
The Delta Air Lines Award
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