Yale University New Haven, Connecticut
Fellow, Hematology and Oncology Yale New Haven Hospital
Conquer Cancer, the ASCO Foundation
Assessing precision treatment strategies in managing breast cancer in South Africa
Breast cancer patients in South Africa face significantly different outcomes compared to those in resource-abundant countries, including lower survival rates and higher rates of recurrence of cancer. One promising approach to improve these outcomes is implementing de-escalation strategies in patients with early-stage, low-risk breast cancer. De-escalation, or appropriately reducing the amount of treatment that patients receive, has been shown to be safe and effective in high-income countries. The benefits are two-fold: de-escalation can minimize patients’ exposure to unnecessary treatment-related side effects and free up medical resources that are needed for more critical interventions needed for those who have more aggressive cancer.
For her Conquer Cancer research supported by BCRF, Dr. Kwaramba and her team will analyze data from the South Africa Breast Cancer and HIV Outcomes (SABCHO) cohort to determine how many patients are eligible for de-escalation strategies. These include omitting radiation therapy in older patients with early-stage, HR-positive breast cancer who undergo breast-conserving surgery and omitting chemotherapy after surgery in patients with early breast cancer who are at low risk for recurrence. The study will also assess current treatment patterns, recurrence rates, survival rates, and side effects experienced by patients to inform the decision-making process regarding de-escalation strategies. This comprehensive approach aims to determine the potential for safely and effectively implementing such strategies in South Africa, ultimately improving patient outcomes and optimizing resource use.
Tendai Kwaramba, MSc, MD is a hematology/oncology fellow at Yale New Haven Hospital. She is originally from Zimbabwe and moved to the United States to obtain an undergraduate degree at Southwestern College where she majored in Biology and Biochemistry and graduated summa cum laude in 2013. She proceeded to Duke University to attain a Master of Science in Global Health in 2015, and her thesis explored the epidemiologic profile and underreporting patterns of intimate partner violence experienced by women in Brazil using a unique mixed methods model. Dr. Kwaramba received an MD at the University of North Carolina in Chapel Hill in 2019.
In medical school, she chose oncology as a future career focus and started exploring global oncology at this early stage. This led her back to Brazil to explore disparate outcomes in cancer, particularly racial disparities in the surveillance and epidemiology of cervical cancer, as well as HPV vaccine acceptability among at-risk women. She did her internal medicine residency at Tulane University where she was selected as a global health scholar and, in this capacity, travelled to Bugando Medical Center in Mwanza Tanzania for a clinical rotation to better explore cancer care in a resource-constrained setting. Her productivity at every stage is evidenced by her leading or co-authoring several presentations, abstracts, and publications.
2024
The Anne Douglas Young Investigator Award
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