Burden Of Breast Cancer Research Articles

Community and Research Perspectives on Cancer Disparities in Wisconsin.

IntroductionSignificant disparities are apparent in geographic areas and among racial/ethnic minority groups in Wisconsin. Cancer disparities are complex and multifactorial and require collaborative, multilevel efforts to reduce their impact. Our objective was to understand cancer disparities and identify opportunities to collaborate across community and research sectors to address them.MethodsFrom May 2017 through October 2018, we assembled groups of community members and researchers and conducted 10 listening sessions and 29 interviews with a total of 205 participants from diverse backgrounds. Listening sessions and interviews were scheduled on the basis of participant preference and consisted of a brief review of maps illustrating the breast and lung cancer burden across Wisconsin, and a semistructured set of questions regarding causes, solutions, and opportunities. Interviews followed the same structure as listening sessions, but were conducted between a facilitator and 1 or 2 individuals. Major themes were summarized from all sessions and coded. We used the Model for Analysis of Population Health and Health Disparities to identify areas for collaboration and to highlight differences in emphasis between community participants and researchers.ResultsParticipants identified the need to address individual behavioral risks and medical mistrust and to build equitable multilevel partnerships. Communities provided insights on the impact of environment and location on cancer disparities. Researchers shared thoughts about societal poverty and policy issues, biologic responses, genetic predisposition, and the mechanistic influence of lifestyle factors on cancer incidence and mortality.ConclusionListening sessions and interviews provided insight into contributors to cancer disparities, barriers to improving outcomes, and opportunities to improve health. The unique perspectives of each group underscored the need for multisector teams to tackle the complex issue of cancer disparities.

194 Poster - Endofascial axillary dissection – a novel method to reduce seroma formation

Background: The pathogenesis of seroma formation following axillary dissection is poorly understood. The greater the surgical disruption of the axilla, the higher the incidence of seroma and lymphedema. In view of the disease burden of breast cancer and also to refine the fast track approach to treatment; we looked at a method of dissection of the axilla which might reduce the seroma incidence and quantity thereby allowing early drain removal and reduced morbidity.

Evaluation of a novel strategy to implement exercise evidence into clinical practice in breast cancer care: protocol for the NEXT-BRCA randomised controlled trial

IntroductionThe burden of breast cancer in Canada is steadily growing. More women are surviving breast cancer, yet, survivors live with side effects for years after treatments have ended. The benefits...

A pan-Canadian prospective study of young women with breast cancer: the rationale and protocol design for the RUBY study.

The understanding of the biology and epidemiology of, and the optimal therapeutic strategies for, breast cancer (bca) in younger women is limited. We present the rationale, design, and initial recruitment of Reducing the Burden of Breast Cancer in Young Women (ruby), a unique national prospective cohort study designed to examine the diagnosis, treatment, quality of life, and outcomes from the time of diagnosis for young women with bca. Over a 4-year period at 33 sites across Canada, the ruby study will use a local and virtual recruitment model to enrol 1200 women with bca who are 40 years of age or younger at the time of diagnosis, before initiation of any treatment. At a minimum, comprehensive patient, tumour, and treatment data will be collected to evaluate recurrence and survival. Patients may opt to complete patient-reported questionnaires, to provide blood and tumour samples, and to be contacted for future research, forming the core dataset from which 4 subprojects evaluating genetics, lifestyle factors, fertility, and local management or delivery of care will be performed. The ruby study will be the most comprehensive repository of data, biospecimens, and patient-reported outcomes ever collected with respect to young women with bca from the time of diagnosis, enabling research unique to that population now and into the future. This research model could be used for other oncology settings in Canada.

8p11.23 Amplification in Breast Cancer: Molecular Characteristics, Prognosis and Targeted Therapy.

Background: Amplification of the locus 8p11.23 has been observed in cancer and genes of this locus, including ZNF703 (Zinc finger protein 703), NSD3 (Nuclear receptor binding SET domain protein 3) and FGFR1 (Fibroblast growth factor receptor 1), have been put forward as dominant oncogenes conferring pathophysiologic benefit in cancers with amplifications. However, there is no consensus on the importance of each of them or any other genes of the amplicon or even a consensus on which genes are part of the amplicon. Methods: Publicly available data were used to characterize the locus amplified at 8p11.23 and derive information on each of the genes and roles as oncogenes. The frequency of the amplifications in the locus was examined in the cBioportal platform, and expression levels of the amplicon genes in amplified cases were derived from genomic studies reported in the platform. Examination of the influence of mRNA expressions of each gene of the locus for Recurrence-free survival in breast cancer was performed using K-M plotter. Results: The 8p11.23 amplicon is present in higher frequency in squamous cell lung carcinomas, breast cancers and bladder carcinomas and is only rarely observed in other cancers. The most frequently amplified genes within the amplicon vary between different types of cancers. In breast cancer, amplified cases are most commonly of the luminal B type. Amplified genes are not always over-expressed and there is a low correlation of amplification with over-expression in amplicon genes with variation between genes. The presence of the amplicon does not influence the aneuploidy score or the tumor mutation burden of breast cancers. Regarding prognosis, the two genes of the amplicon whose mRNA hyper-expression portends adverse relapse-free survival in breast cancer are EIF4EBP1 (Eukaryotic transcription initiation factor 4E binding protein 1) and LSM1 (LSM1 homolog, mRNA degradation associated). Conclusion: Besides the previously proposed genes to play a role as dominant oncogenes in the 8p11.23 cancer amplified locus, other genes may also be important in breast cancer based on the high correlation of their amplification and mRNA expression and adverse prognosis conferred by over-expression, consistent with an oncogenic role.

Dynamic and subtype-specific interactions between tumour burden and prognosis in breast cancer

We investigated the relationship between the prognostic importance of anatomic tumour burden and subtypes of breast cancer using data from the Korean Breast Cancer Registry Database. In HR+/HER2+ and HR−/HER2−tumours, an increase in T stage profoundly increased the hazard of death, while the presence of lymph node metastasis was more important in HR+/HER2+ and HR−/HER2+ tumours among 131,178 patients with stage I–III breast cancer. The patterns of increasing mortality risk and tumour growth (per centimetre) and metastatic nodes (per node) were examined in 67,038 patients with a tumour diameter ≤ 7 cm and < 8 metastatic nodes. HR+/HER2− and HR−/HER2− tumours showed a persistent increase in mortality risk with an increase in tumour diameter, while the effect was modest in HER2+ tumours. Conversely, an increased number of metastatic nodes was accompanied by a persistently increased risk in HR−/HER2+ tumours, while the effect was minimal for HR−/HER2− tumours with > 3 or 4 nodes. The interactions between the prognostic significance of anatomic tumour burden and subtypes were significant. The prognostic relevance of the anatomic tumour burden was non-linear and highly dependent on the subtypes of breast cancer.

A case report of cancer patient

In India 25.8 per 10,000 women are suffering from Breast cancer as per the Ministry of Health &amp; Welfare, India. It is estimated by 2020 around 1.7 million women will be suffering from breast cancer. Awareness and early detection can curb the growing burden of Breast Cancer and are the first step in the battle against Breast Cancer. The aim of this qualitative study was to explore the awareness and perceived barriers concerning the early detection of Breast Cancer. According to the National Cancer Registry Programme of the India Council of Medical Research (ICMR), more than 1300 Indians die every day due to cancer. Breast cancer is now the most common cancer among women in India, accounting for 27% of all cancers among women. The WHO data says India will have 1.16 million new cancer cases this year i.e. 2020 and more than 50 per cent of these will be diagnosed in women.

Analysis on long-term trend of mortality and years of life lost of breast cancer in women in Tianjin, 1999-2017

Objective: To analyze the trends of mortality and years of life lost (YLL) of breast cancer in women in Tianjin and provide references for the development of intervention strategies. Methods: The crude mortality rate, standard mortality rate, cumulative rate (0-74 years old) and truncated rate (35-64 years old) of breast cancer in women in Tianjin from 1999 to 2017 were calculated. The annual percentage change of the mortality rate and YLL rate were analyzed by Joinpoint regression. Results: From 1999 to 2017, a total of 8 356 deaths of breast cancer were reported in Tianjin, resulting in a YLL of 262 835.53 person-years. The average crude mortality rate was 9.15/100 000. The average age standardized rate(ASR) (World) was 6.14/100 000. The ratio of ASR (World) between urban and rural areas was 1.73∶1. The peak mortality ratio of age groups between urban area and rural area was 3.13∶1. From 1999 to 2017, both the crude mortality rate and ASR of breast cancer in Tianjin had rising trends. In 2017, the crude mortality rate and the ASR of breast cancer increased by 113.7% and 44.4% respectively compared with 1999. The increase of urban mortality mainly came from elderly group aged ≥75 years, and the mortality of young age groups in rural area showed an fast increases, which was most obvious in age group 45-59 years (average annual percentage change=3.6%, P<0.01). Conclusions: The mortality rate of breast cancer and disease burden in women in Tianjin are still in rapid increase. We should continue to implement the prevention and control strategies such as lifestyle intervention and screening of key groups. More attention need to be paid to the increase of breast cancer incidence in rural area.

Inequalities in the burden of female breast cancer in Brazil, 1990\u20132017

BackgroundBreast cancer is the most frequently diagnosed cancer in women and the leading cause of cancer death among females worldwide. In recent decades, breast cancer death rates have been stable or decreasing in more developed regions; however, this has not been observed in less developed regions. This study aims to evaluate inequalities in the burden of female breast cancer in Brazil including an analysis of interregional and interstate patterns in incidence, mortality and disability-adjusted life years (DALYs) rates from 1990 to 2017, and mortality-to-incidence ratio (MIR), and their association with the Socio-demographic Index (SDI).MethodsUsing estimates from the global burden of disease (GBD) study, we applied a spatial exploratory analysis technique to obtain measurements of global and local spatial correlation. Percentage changes of breast cancer incidence, mortality, and DALYs rates between 1990 and 2017 were calculated, and maps were developed to show the spatial distribution of the variables. Spatial panel models were adjusted to investigate the association between rates and SDI in Brazilian states.ResultsIn Brazil, while breast cancer mortality rate have had modest reduction (−4.45%; 95% UI: −6.97; −1.76) between 1990 and 2017, the incidence rate increased substantially (+39.99%; 95% UI: 34.90; 45.39). Breast cancer incidence and mortality rates in 1990 and 2017 were higher in regions with higher SDI, i.e., the most developed ones. While SDI increased in all Brazilian states between 1990 and 2017, notably in less developed regions, MIR decreased, more notably in more developed regions. The SDI had a positive association with incidence rate and a negative association with MIR.ConclusionSuch findings suggest an improvement in breast cancer survival in the period, which may be related to a broader access to diagnostic methods and treatment. This study also revealed the inequality in breast cancer outcomes among Brazilian states and may guide public policy priorities for disease control in the country.

Burden of breast cancer in Serbia 2007-2017

Abstract Background Breast cancer is the third highest incidence of cancer globally. It is the leading cause of cancer-associated mortality among females in the world. In Serbia, the incidence rate of breast cancer in 2015 was 61.0/100000 and breast cancer attributed to 18.9% of total cancer mortality among females. The aim of this study was to examine the incidence rate, years lived with disability (YLD) and disability-adjusted life-years (DALY) in Serbia in the ten-year period, from 2007 to 2017. Methods We analyzed data from the global burden of disease study (GBD) 2017. The data for the breast cancer incidence, prevalence, YLD, DALY counts and DALY rates per 100,000 were used for analyses. Results The prevalence of breast cancer in Serbia (in thousands) in 2017 was 44.6 (95% CI: 39.9-50.6), the incidence (in thousands) was 5.6 (95% CI: 5.0-6.4), YLD (in thousands) in 2017 was 3.5 (95% CI: 2.5-4.9). In the period between 2007 and 2017, YLD counts increased by 11.7%, while the age-standardized rates increased by 5.8%. Total all age DALY counts for both sexes were 51.8 (95% CI: 49- 55.3) in 2007 and 51.5 (95% CI: 45.7-58.3) in 2017. Age-standardized DALY rates per 100,000 decreased from 388.8 (95% CI: 368.3-415.7) in 2007 to 366.3 (95% CI: 323.8-415.4) in 2017. Conclusions The data from the GBD study show that the total YLD counts in Serbia increased by more than 10% in the past decade. However, the total DALY counts did not change significantly and the age-standardized DALY rate per 100,000 decreased in the period between 2007 and 2017. Key messages The total years-lived with disability as a consequence of the breast cancer increased for 10% in Serbia between 2007 and 2017. The decrease in age-standardized DALYs may reflect aging and depopulation effects in Serbia.

PCN45 Disease Burden of Breast Cancer UNDER the Current Treatment Pattern in China

To estimate the disease burden of breast cancer (BC) under the current treatment pattern in China. A decision-analytic model was constructed to simulate the Chinese patients with BC and the age and gender-matched Chinese general population over lifetime time horizon for the differences in overall survival, quality-adjusted life years (QALY), and lifetime direct medical costs. A literature search was conducted to estimate the model variables. Base case analysis and sensitivity analysis were conducted for the point estimations and uncertainty of the disease burden of BC. The Chinese BC patients were associated with reduced average overall survival by 7.054 years (20.933 years vs. 27.987 years), reduced average QALY by 9.651 QALY (14.727 QALY vs. 24.378 QALY), and increased average lifetime direct medical costs by ¥534,867 (¥692,056 vs. ¥157,189). The reduced QALY associated with BC was sensitive to utility of stage I (change: 0.482 QALY) and stage II BC (change: 0.947 QALY), risk of disease recurrence after radical mastectomy (change: -0.886 QALY), proportions of stage I (change: 0.870 QALY) and stage IV BC at diagnosis (change: -0.857 QALY). The increased lifetime direct medical costs associated with BC was sensitive to medical costs of progressive disease (change: ¥172,362), treatment response to exemestane (change: ¥-91,035), and the mortality of progressive disease (change: ¥-51,827). The probabilistic sensitivity analysis with 5,000 Monte Carlo simulations estimated the median and 95% credible interval of reduced QALY (-9.881 QALY; -11.306 to -8.386 QALY ) and increased lifetime direct medical costs (¥548,992, ¥464,895 to ¥650,181). The disease burden of BC in Chinese patients was characterized by reduced overall survival, reduced QALY, and increased medical costs that were sensitive to disease stage distribution at diagnosis, utility of early-stage BC, exemestane treatment, and the mortality and medical costs of progressive disease.

Breast cancer risk factors, prevention and patients empowerment

Breast cancer was the most common cancer in women worldwide in 2018, contributing 25.4% of the total number of cases diagnosed. Evidence says that less than 10% (between 6% and 7%) of the total is due to genetic missfailiures. Some mutations, particularly in BRCA1, BRCA2 and p53 might induce an increase of breast cancer. However, these mutations are rare and account for a small portion of the total breast cancer burden. (1) Risk factors Lifestyle is also determinant when it comes to cancer. Several researches have proven that unhealty diets, obesity (2), smoking (3), alchool intake (4) and a sedentary life style (5) might translate in an increase of all types of cancer risk, including breast cancer (6) Breast cancer prevention According to reserch there are several things that patients can do to prevent all types of cancer, including breast cancer (7),(8), (9) Patient empowerment Research has shown that a healthy lifestyle increases chances to overcome breast cancer. Passing this information on to patients is crucial for them to take an active part in their illness and improve their quality of live as well as their chances to recover health. (10)

Abstract 4638: Associations of fecal microbial profiles with non-malignant breast disease and breast cancer in the Ghana Breast Health Study

Abstract Background and objective: Breast cancer burden is rising in Africa; however, breast cancer risk factors remain largely understudied in this population. The gut microbiome may play a role in the etiology of breast cancer through the regulation of estrogen homeostasis and other metabolic or immunologic pathways. We investigated the association of fecal bacteria with breast neoplasms in a case-control study conducted in Accra and Kumasi, Ghana, comprising 102 non-malignant breast disease cases, 379 invasive breast cancer cases, and 414 population-based controls nested within the Ghana Breast Health Study. Methods: We used the MO-BIO PowerMag kit for DNA extraction and sequenced the V4 region of 16S rRNA gene to characterize bacteria in fecal samples. We used DADA2 to process sequencing data. We calculated estimates of alpha diversity (observed sequence variants, Shannon index, and Faith's phylogenetic diversity), beta diversity (Bray Curtis and unweighted/weighted UniFrac), and presence/absence and relative abundance of select taxa. We then estimated the associations of the microbial metrics with non-malignant breast disease and malignant breast cancer using multivariable unconditional logistic regression. Results: Odds of malignant breast cancer were statistically significantly lower with increasing alpha diversity (all Ptrends &amp;lt;0.0001). For example, comparing those in the highest vs. lowest tertile of observed sequence variants, the odds ratio and 95% confidence interval was 0.22 (0.13-0.36). Alpha diversity estimates were also lower for non-malignant breast disease cases compared to controls but were similar to malignant cases. Likewise, based on the multivariable MiRKAT test, which compares kernel similarity matrices based on beta diversity metrics, overall microbiota composition was similar between non-malignant and malignant cases (all p's &amp;gt; 0.1) but was statistically significantly different for both case groups compared controls (all p's &amp;lt;0.001). After correction for multiple testing, 49 taxa were significantly differentially prevalent among non-malignant and malignant cases compared to controls. Cases tended to have a lower prevalence of the Families Lachnospiraceae, Ruminococcaceae, and Prevotellaceae, and the genera Bifidobacterium, Collinsella, Coprococcus, and Mitsuokella. Notably, previous evidence suggests that some of these differentially prevalent taxa encode the enzymes ß-glucuronidase and/or ß-galactosidase, which are involved in estrogen metabolism. Conclusions: Our findings suggest lower fecal alpha diversity, differences in overall microbial composition, and prevalence of certain taxa involved in estrogen metabolism may be associated with both non-malignant breast disease and invasive breast cancer. Given that the gut bacteria are potentially modifiable and targetable, our findings warrant further investigation into the role of the gut microbiota in hormone regulation and etiology of breast cancer in integrative, prospective studies. Citation Format: Doratha Byrd, Emily Vogtmann, Zeni Wu, Autumn Hullings, Xing Hua, Thomas Ahearn, James J. Goedert, Jianxin Shi, Jonine Figueroa, Louise Brinton, Montserrat Garcia-Closas, Rashmi Sinha. Associations of fecal microbial profiles with non-malignant breast disease and breast cancer in the Ghana Breast Health Study [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4638.

Global disparities in breast cancer outcomes: new perspectives, widening inequities, unanswered questions

Breast cancer is the most common neoplastic disease and leading cause of cancer mortality in women.1 Global estimates have recorded regional variations in the burden of breast cancer, but none have been disaggregated by menopausal status.1 In The Lancet Global Health, Emily Heer and colleagues2 contribute to the body of evidence on global disparities in outcomes, with particular reference to breast cancer incidence and survival by menopausal status and by a country's human development index (HDI).

Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study

Breast cancer has distinct causes, prognoses, and outcomes and effects in patients at premenopausal and postmenopausal ages. We sought to assess the global burden and trends in breast cancer by menopausal status. We did a population-based analysis of global breast cancer incidence and mortality among premenopausal and postmenopausal women. Menopausal status was defined using age as a proxy, whereby breast cancer cases or deaths at age 50 years or older were regarded as postmenopausal. Age-standardised breast cancer incidence and mortality in 2018 were calculated using GLOBOCAN data. Incidence trends for 1998-2012 were assessed in 44 populations from 41 countries using the Cancer in Five Continents plus database, by calculating the annual average percent change. Approximately 645 000 premenopausal and 1·4 million postmenopausal breast cancer cases were diagnosed worldwide in 2018, with more than 130 000 and 490 000 deaths occurring in each menopausal group, respectively. Proportionally, countries with a low UNDP human development index (HDI) faced a greater burden of premenopausal breast cancer for both new cases and deaths compared with higher income countries. Countries with a very high HDI had the highest premenopausal and postmenopausal breast cancer incidence (30·6 and 253·6 cases per 100 000, respectively), whereas countries with low and medium HDI had the highest premenopausal and postmenopausal mortality, respectively (8·5 and 53·3 deaths per 100 000, respectively). When examining breast cancer trends, we noted significantly increasing age-standardised incidence rates (ASIRs) for premenopausal breast cancer in 20 of 44 populations and significantly increasing ASIRs for postmenopausal breast cancer in 24 of 44 populations. The growth exclusively at premenopausal ages largely occurred in high-income countries, whereas the increasing postmenopausal breast cancer burden was most notable in countries under transition. We provide evidence of a rising burden of both premenopausal and postmenopausal breast cancer worldwide. Although early diagnosis and access to treatment remain crucial in low-income and middle-income countries, primary prevention efforts seeking to decrease exposure to known breast cancer risk factors are warranted in all world regions to curb the future breast cancer burden. None.

Breast cancer burden in Africa: evidence from GLOBOCAN 2018.

Breast cancer is the leading malignancy in African females. This study aims to examine the breast cancer burden in Africa using recently released GLOBOCAN 2018 estimates. The incidence and mortality estimates of age- and country-wise burden of breast cancer in 54 African countries were obtained from GLOBOCAN 2018. In Africa, breast cancer caused 74 072 deaths, and 168 690 cases were estimated to have occurred in 2018. The age-standardized incidence rate stood at 37.9/100 000 in Africa, varying from 6.9/100 000 in the Gambia to 69.6/100 000 in Mauritius. The age-standardized mortality rate stood at 17.2/100 000 in 2018, ranging from 4/100 000 in the Gambia to 29.1/100 000 in Somalia in 2018. Nigeria was the leading country in terms of absolute burden with 26 310 cases and 11 564 deaths, followed by Egypt with 23 081 new cases and 9254 deaths. The mortality-to-incidence ratio for Africa stood at 0.44, varying from 0.24 in Libya to 0.68 in the Central African Republic. To tackle breast cancer burden in Africa, the main challenges are late-stage disease presentation, lack of screening and therapeutic infrastructure, lack of awareness and limited resources.

Earlier Breast Cancer Detection in Peru: Establishing a Comprehensive Program in an Underserved Region.

Rising breast cancer incidence and mortality rates in low- and middle-income countries are largely attributed to changing lifestyle, economic factors, and late-stage diagnosis. In Peruvian women, it is the second most common cancer diagnosis (16%) behind cervical cancer (24%) and is the second leading cause of cancer hospitalizations [1]. The breast cancer burden is expected to rise and cause more premature deaths unless early detection programs are established.

Abstract C031: NanoString nCounter-based gene expression assay for evaluation of breast cancer molecular subtypes in Ethiopian patients

Abstract Introduction: The burden of breast cancer is escalating across the globe and becoming a major public health problem in Ethiopia. Considering the fact that breast cancer is a heterogeneous disease in its nature, it demands a coordinated multimeric approach for diagnosis, treatment and management. Therefore, NanoString nCounter-based gene expression analysis might be employed for breast cancer intrinsic molecular subtyping, since it is a robust, highly reproducible tool and allows to simultaneously explore the expression of hundreds of genes in a single reaction tube. The aim of the study was to determine the intrinsic molecular subtypes of breast cancer samples from Ethiopian patients using a tailored NanoString nCounter gene expression assay for formalin-fixed, paraffin-embedded (FFPE) material. Methods: The present study was carried out to determine the molecular subtypes of breast cancer in Ethiopian patients. Archived FFPE tumor samples from public hospitals in Ethiopia were retrieved and blocks with clinical and pathologic data were used. From each sample total RNA was extracted by miRNeasy kit, then total RNA concentration and quality were determined and high-quality RNA was subjected to NanoString-based nCounter gene expression analysis using a tailored assay consisting of molecular and immunologic markers. For each gene, gene-fold change expression is given when compared to the reference cut-off value. The study focused on the analyses of estrogen receptor 1(ESR1), progestrone receptor (PGR), erythroblastic oncogene B (ERBB2) genes expression and the intrinsic molecular subtypes done using PAM 50 assay. Statistical analysis was carried out using SPSS software. Results: A total of 164 FFPE breast cancer blocks were analyzed for protein (ER, PR and Her2) expression status and mRNA expression levels. 86/164 (52.4%) breast cancer patients were tumor grade 3. More than 50% of tumor samples were ER and PR positive. In contrast to hormone receptors, only 20 (12.2%) breast tumor samples were found to be positive for HER-2. With regard to the mRNA expression levels of the respective genes, 106 (64.6%), 43 (26.2%) and 143 (87.2%) of breast cancer lesions analyzed showed an upregulation of ESR-1, PGR and ERBB2 genes, respectively. The samples with ER and PR positive results demonstrated by immunohistochemistry (IHC) showed nCounter levels from -60 to 124 (median=7) and -379 to 9 (median= -2), respectively. Samples with HER-2 positive results by IHC showed nCounter levels from -1 to 60 (median=17.5). Using PAM50 algorithm, we found 32 (19.5%) luminal A, 33 (20.1%) luminal B, 24 (14.6%) HER-2 enriched, 29 (17.7%) basal and 17 (10.4%) normal type breast cancer. Conclusion: According to the RNA expression assay, the majority of breast cancer subtypes were luminal A and luminal B and the lowest was normal type. In addition, the large majority of the cases analyzed were hormone receptor positive. Thus, hormonal therapy is of high importance for breast cancer care in Ethiopia. Citation Format: Zelalem Desalegn Woldesonbet, Martina Vetter, Meron Yohannes Nigussie, Tamrat Abebe Zeleke, Yonas Bekuretsion, Mahlet Arayselassie, Mathewos Assefa, Abebe Bekele, Endale Anberber, Claudia Wickenhauser, Eva J. Kantelhardt, Jürgen Bukur, Barbara Seliger. NanoString nCounter-based gene expression assay for evaluation of breast cancer molecular subtypes in Ethiopian patients [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C031.

Abstract C100: Identification and functional characterization of a novel GLI1 splice variant in breast cancer

Abstract The purpose of this study is to investigate the biologic significance of novel GLI1 splice variants in breast cancer. African American (AA) women suffer a disproportionately high burden of basal-like breast cancer, an aggressive subtype that has no targeted therapy (1). About 15-20% of breast cancers are triple-negative/basal-like, are associated with poor clinical outcomes and show disproportionately higher prevalence in younger women of African descent (2-4). The Hedgehog (Hh)/GLI1 developmental pathway has emerged as a therapeutic target in many cancers, including breast cancer studies from our lab (5, 6). Overexpression of the main Hh transcriptional mediator GLI1, correlates with poor patient prognosis and relapse. The human GLI1 transcript undergoes alternative splicing producing two shorter isoforms, an N-terminal deletion variant (GLI1ΔN) (7) and a truncated GLI1 (tGLI1) (8), which have been reported to have different patterns of tissue expression and function. tGLI1 has been identified as being highly expressed in several cancers, including in breast cancer (9). We performed in silico analysis of the NCBI database for evidence of additional human GLI1 transcripts and identified a novel GLI1 splice variant, GLI1-X2, that has an in-frame deletion of the entire exon 10-zinc finger 5 domain of the GLI1 gene. Our preliminary data show that GLI1-X2 is expressed in basal-like breast cancers at substantially higher levels than GLI1, tGLI1, or GLI1ΔN. To our knowledge, we are the first to demonstrate expression of GLI1-X2 in any model and our findings expand the GLI1 family of zinc finger transcription factors. Our objectives are to examine the expression differences of the GLI1 splice variants in basal-like and luminal breast cancer cell models, AA and White patient samples and to investigate the biologic function of GLI1-X2 in breast cancer. Previous studies report that GLI1ΔN and tGLI1 proteins retain intact functional zinc finger domains. Thus, we hypothesize that the loss of zinc-finger 5 is critical for GLI1-X2's functional role and regulation of downstream target genes in breast cancer. As the biologic significance of GLI1-X2 in normal and cancer biology is unknown, this proposed work is the first to characterize its function and potential role in cancer. Citation Format: Maria S. Dixon, Lhoucine Chdid, David R. Lamson, Michael T. Tarpley, Helen O. Oladapo, Jodie M. Fleming, Jennifer A. Freedman, Gayathri R. Devi, Kevin P. Williams. Identification and functional characterization of a novel GLI1 splice variant in breast cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C100.

Abstract B015: Community and research perspectives regarding cancer disparities: A comparative analysis of listening sessions with diverse stakeholders

Abstract Background: Wisconsin’s cancer disparities affect both urban minority and rural communities. A team of academic researchers and community stakeholders convened to understand the complexity of these disparities by analyzing relevant data and community and academic perspectives. Through this analysis, the team identified opportunities for multi-sector collaboration and develop an integrated and collaborative action plan. Methods: Listening sessions and interviews were conducted with more than 200 individuals representing diverse “cells to community” backgrounds. Sessions included a brief review of maps illustrating the breast and lung cancer burden across Wisconsin, and a semi-structured set of questions regarding causes, solutions, and opportunities. A leader with cancer disparities knowledge, public health expertise, and qualitative data collection experience facilitated listening sessions. Whenever possible, facilitators were representative of the cultural and racial/ethnic identities or research backgrounds of the majority of participants. ATLAS.ti was used to codify themes from field notes by two independent coders. Rules for summarizing data, coding, and organizing results were discussed iteratively, and a third qualitative researcher resolved discrepancies. Emerging themes strongly aligned with The Model for Analysis of Population Health and Health Disparities by the National Institutes of Health, and thus, themes were integrated into this framework. Results: Coding themes using The Model for Analysis of Population Health and Health Disparities highlighted areas for potential collaboration as well as specific gaps in knowledge or awareness between researchers and community stakeholders. Communities had unique insights regarding the physical context of cancer disparities including environmental and social factors. Researchers, on the other hand, reflected specialized expertise on biologic and genetic pathways and biological responses such as genetic predisposition and the influence of reproductive and gynecologic factors. Participants from all sectors recognized the need to address individual behavioral risks, patient support, and the need for multi-level partnerships. Conclusions: The Model for Analysis of Population Health and Health Disparities is an effective tool for understanding results from broad based, transdisciplinary perspectives. Using this framework to analyze listening sessions reveal that stakeholders in both community and research settings had unique expertise and perspectives that enhanced the team’s collective understanding of cancer disparities in Wisconsin. Citation Format: Jessica Olson, Tobi Cawthra, Kirsten Beyer, David Frazer, Lyle Ignace, Cheryl Maurana, Sandra Millon-Underwood, Laura Pinsoneault, Jose Salazar, Alonzo Walker, Carol Williams, Melinda Stolley. Community and research perspectives regarding cancer disparities: A comparative analysis of listening sessions with diverse stakeholders [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B015.