Kristen Brantley, Ph.D., a new Susan G. Komen® research investigator at Dana-Farber Cancer Institute, is hoping to reveal some of the underlying biological factors that lead to worse breast cancer outcomes and survival for young women.
Breast cancer among young women is an increasing concern in the U.S., with the most recent report from the American Cancer Society showing breast cancer diagnoses for women under 50 have increased by 1.4% from 2012-2021. Breast cancer is currently the leading cause of cancer death for women in the U.S. ages 20-49.
Research has already shown that women under the age of 40 who are diagnosed with breast cancer are more likely to have genetic factors that may put them at higher risk to develop more aggressive tumors and to experience worse outcomes than older women. And while more research is still needed to understand the underlying causes, young women are often not included in breast cancer studies and clinical trials.
“Because breast cancer is much less common among younger women, there’s very little research on it,” Dr. Brantley says. “There’s a significant gap that we do need to fill and given that breast cancer cases are rising in this age group, the importance is just compounded.”
Young Women Face Unique Challenges
Breast cancer is generally seen as a disease in older women, as most breast cancer cases occur in women in the U.S. over the age of 50. As a result, most people assume that young women cannot have breast cancer or write off new pain or lumps in the breast as hormonal changes. Tragically, these early signs can be overlooked by doctors, causing young women to be diagnosed at later stages.
Young women diagnosed with breast cancer often face additional challenges that older women do not, such as early menopause and fertility decisions. If they wish to have a child after breast cancer treatment, they must make decisions about preserving their fertility, such as freezing their eggs, prior to starting their treatment. These decisions can be emotionally and financially taxing during an already stressful time.
As Dr. Brantley observes, young women also face a longer road ahead of survival and risk of long-term health challenges, including contralateral breast cancer, or cancer that occurs in the other breast. “Given that they’re diagnosed young and are alive a long time afterward, that means they remain at risk of recurrence and contralateral events for a much longer time than older women,” she explains.
“Finding what causes breast cancer is what really fuels me as I continue in this research, especially because there are so many incredibly intelligent scientists working to better understand breast cancer, but the cause remains super elusive.”
Understanding the Role of Biological Precursors
Dr. Brantley was recently awarded a Komen Career Transition Award for her project “Evaluating Germline Genetics and Tumor Genomics of Young-Onset Breast Cancer.” Through this study, she will explore how different hereditary (genetic) mutations in young women can be linked to higher breast cancer risk and poorer outcomes, including the risk of recurrence. By better understanding the relationship between these mutations and tumor progression, Dr. Brantley hopes to improve treatment options for these patients.
“I’m really interested in connecting risk with progression to target areas for specific intervention,” she explains. “If we can understand the pathways that are at work here, maybe we can get closer to understanding the underlying cause and then find a way to prevent this from occurring.”
First, Dr. Brantley will collect and analyze DNA from a large study group of women under the age of 40 and evaluate how certain genetic mutations may influence breast cancer outcomes, like recurrence. Next, she will examine the connection between the genetic mutations and mutations in tumor cells that may be driving these risks in young women.
“If someone has a BRCA1 mutation, I want to explore how that mutation directly or indirectly influences changes in the breast tumor itself, causing the tumor to mutate and grow,” Dr. Brantley says. “And how that will drive the severity of disease.”
Finally, she will compare tumor genetics between women with metastatic disease under the age of 40 and women with metastatic disease over the age of 40. Dr. Brantley hopes that any differences found in the tumor profiles of younger women will explain differences in breast cancer survival and help identify possible therapeutic targets for these patients.
“Expanding our knowledge about the biology behind breast cancer is going to give us tools to improve early identification of high-risk patients,” Dr. Brantley says. “Ultimately, this knowledge will lead to more effective therapies that can be used in the clinic.”
Looking Ahead with Komen
With support from Komen through this award, Dr. Brantley hopes to build a multidisciplinary team in her lab and continue her career as an independent breast cancer epidemiologist. Her ultimate career goal is to help make significant contributions to the prevention, early detection and treatment of breast cancer, especially for those diagnosed at a young age.
“Finding what causes breast cancer is what really fuels me as I continue in this research, especially because there are so many incredibly intelligent scientists working to better understand breast cancer, but the cause remains super elusive.”
