New Paradigm of Breast Cancer Causation and Prevention

Institution: University of California, San Francisco
Investigator(s): Robert  Hiatt , M.D., Ph.D. -
Award Cycle: 2009 (Cycle 15) Grant #: 15QB-8301 Award: $229,732
Award Type: SRI Request for Qualifications-RFQ
Research Priorities
Prevention & Risk Reduction>The intersection of environment and disparities



Initial Award Abstract (2009)

Breast cancer involves many complex, dynamic properties that are best understood as an ecological disorder. This means that within the individual there are likely to be multiple determinants of breast cancer risk, and within populations the causes of breast cancer are heterogeneous. Women with different genetic inheritance and gene expression may develop the same disease through a different initial contributing nexus of factors. Conversely, women with similar exposures may experience different disease outcomes. The search for a single causal framework to explain the changing incidence of breast cancer may be futile.

This team will conduct research and create a conceptual framework that extends complexity theory to the study of breast cancer. We are including the perspectives of multiple disciplines to examine the web of relationships among the many variables operating on susceptibility, induction, and development of breast cancer.

Specific questions to be answered include:
1. What risk and protective factors should be included in a new, complex conceptual framework (e.g. gene expression, multiple contaminant exposures across the life course, fetal programming, the timing and pace of sexual maturation, personal experience of racism, neighborhood cohesion, etc.)
2. How can dynamics of these factors be accounted for, including interactions, timing, dose, and other properties?

An multi-disciplinary expert panel will assist the team in exploring alternative modeling approaches and generating a graphic display of the model that contains the necessary complexity and is transparent and understandable to the lay public. These will be tested to ensure effectiveness and disseminated for further use and potential development and to inform research and prevention efforts.