The Project to End Post Partum Breast Cancer
If you’ve never heard of Postpartum Breast Cancer (PPBC) – well, you are not alone. This episode is a personal one for many on our podcast team – it is all about this little-known subset of breast cancer called Postpartum Breast Cancer (Postpartum means “following childbirth”) – how it happens, and why it creates a higher risk for metastatic spread and death. The doctors we interview here have proven that Postpartum Breast Cancer is a distinct category of breast cancer diagnosed in women within 10 years of having a baby. It affects 18,000 women in the US a year (that’s almost the same as ovarian cancer diagnoses in the US), and can happen across all subtypes, like hormone +/-, HER2+/-, or triple negative disease. *50%* of women diagnosed with breast cancer under age 45 in the US are actually diagnosed within a 10-year Postpartum window – 50%! Postpartum breast cancer also carries a higher risk for metastasis and death than breast cancer diagnosed outside this 10-year window. Now, Dr. Virginia Borges & Dr. Pepper Schedin are ready to move all their lab findings into the clinic by launching the first-in-human clinical trial to prevent Postpartum Breast Cancer – by giving healthy moms ibuprofen – yes, ibuprofen, for a brief period of time as they wean their babies from nursing. This is a groundbreaking clinical trial idea, with huge potential global impact, and they need the public’s help to make it happen.
To learn more, about this project and the fundraising efforts, you can visit The Project to End Post Partum Breast Cancer Fundraising Page.
Episode Notes
Citations:
The Lancet Oncology
Comment Volume 22, Issue 6 p753-754 June 2021
The Definition of Pregnancy-Associated Breast Cancer (PABC) is Outdated and should no longer be used
Frédéric Amant, Virginia F Borges, et. al.
Summary:
“The definition of pregnancy-associated breast cancer (PABC) is inconsistently given as either breast cancer diagnosed exclusively during pregnancy, or combined with cases diagnosed within 6 months to 1 year after the birth.1 Although pregnancy and the postpartum period are intertwined, evolving evidence supports considering breast cancer that occurs during pregnancy (PrBC) as a separate and distinct entity from breast cancer that occurs during the postpartum period (PPBC)—which, according to newer data, can extend to 5–10 years after the birth—because each type has unique biological attributes and prognosis.
JAMA Open Network
January 11, 2019
Erica T. Goddard, PhD1, et. al.
Key Points
Question Is there an increased risk for metastasis of breast cancers that are diagnosed in young women post partum that extends beyond 5 years from the last childbirth, and what association do standard clinical prognostic factors have with metastatic risk in these young women when categorized by parity?
Findings In a cohort study of 701 women 45 years or younger with breast cancer, those with stage I or II cancer diagnosed up to 10 years post partum had an increased risk for distant metastasis, with both estrogen receptor–positive and estrogen receptor–negative disease significantly affected.
Meaning Postpartum status may be a prognostic indicator in young women with breast cancer and should be routinely identified, as up to 45% of women 45 years or younger with breast cancer fall into this category and could be at increased risk for metastasis.
Nature
October 16, 2020
npj Breast Cancer volume 6, Article number: 55 (2020)
https://rdcu.be/dZWBf
Abstract
In rodents, weaning-induced mammary gland involution supports increased mammary tumor incidence, growth, and progression to metastasis. Further, the protumor attributes of gland involution are COX-2 dependent and mitigated by short-duration non-steroidal anti-inflammatory drugs (NSAIDs), suggesting a potential prevention strategy. However, the transition from lactation to postweaning breast involution has not been rigorously evaluated in healthy women. Here we queried breast biopsies from healthy women (n = 112) obtained at nulliparity, lactation, and multiple postweaning time points using quantitative immunohistochemistry. We found that mammary remodeling programs observed in rodents are mirrored in the human breast. Specifically, lactation associates with the expansion of large, secretory mammary lobules and weaning associates with lobule loss concurrent with epithelial cell death and stromal hallmarks of wound healing, including COX-2 upregulation. Altogether, our data demonstrate that weaning-induced breast involution occurs rapidly, concurrent with protumor-like attributes, and is a potential target for NSAID-based breast cancer prevention.
Meet the Guests of the Episode
Virginia Borges, Ph.D.
Dr. Borges is a Professor of Medicine with Tenure at the University of Colorado Denver and holds the Robert C. and Patricia Young-Connor endowed Chair in Young Women’s Breast Cancer. Dr. Borges is the Deputy-Head of the Division of Medical Oncology, the Director of the Breast Cancer Research Program and the Director for the Young Women’s Breast Cancer Translational Program. Dr. Borges focuses on research in Young Women’s breast cancer, the interaction of breast cancer and pregnancy and the development of novel drugs for breast cancer.
Pepper J Schedin, Ph.D.
Dr. Schedin is Professor of Cell, Developmental and Cancer Biology, and the Leonard Schnitzer Chair in Breast Cancer, at Oregon Health & Science University (OHSU). Dr. Schedin’s research is focused on understanding the biology behind the high rates of metastasis observed in young women with breast cancer (YOBC). Her research has led to the recognition of postpartum breast cancer (PPBC) as a new subtype of highly metastatic disease. Current research efforts are focused on the prevention and improved treatment of PPBC.
Dr. Schedin is founder and co-director of the Early Career Advancement Program for OHSU Research Faculty, as well as founding member of the OHSU CIMER Mentoring Academy for Graduate Faculty. As co-director for the Cancer Prevention and Control Program, Dr. Schedin facilitated the transition leading to Comprehensive Cancer Center status for the Knight Cancer Institute. Prior to joining OHSU in 2014, Dr. Schedin was Professor in the Division of Medical Oncology at the University of Colorado Anschutz, where she co-founded the Young Women’s Breast Cancer Translational Program with Dr. Virginia Borges, a first-of-its-kind program combining a YOBC clinic with translational research. Originally trained as a molecular developmental biologist at the University of Colorado Boulder, followed by training in dietary breast cancer prevention at the AMC Cancer Research Institute in Denver, Colorado, Dr. Schedin collaborates widely with epidemiologists, oncologists, endocrinologists, chemists, immunologists, and tumor microenvironment to advance our understanding of YOBC.
