Abstract A46: Breast cancers come out of nowhere: A two part Durham Community/Duke partnership to identify signaling pathways during the initiation of triple-negative breast cancer in African American women
Authors: Sistrunk Christopher , Robertson Stephaine , Ambrose Adrian , Drendall Catherine Ibarra , Seewaldt Victoria 
Published: May 2015

Abstract
Background: The current trend of increased survivability of women with breast cancer has been linked to increased awareness, early detection and better treatment. In fact the American Cancer Society estimate that there are more than 2.5 million breast cancer survivors living in America today. However the trends of these overall numbers are expressed quiet differently in the African American community. African American women have a 77% five-year survival rate while survival rates for European American are at 90%. It is clear that lack of access plays a role in poor survival of African American women. Other factors are hypothesized to be aggressive biology and lack of early detection strategies for triple-negative breast cancer.
Methods and Results: Phase I: We developed a community outreach partnership with the African American community in Durham, NC. One of the concerns of the community was that aggressive breast cancers “appeared to come out of nowhere” and seemed to defy the conventional model of stepwise breast cancer progression. This alliance allowed the development of a partnership to use breast Magnetic Resonance Imaging (MRI) screening to evaluate the onset of breast cancer occurring in over 300 African American high-risk women (&gt;48 month observation, 12 cancers). The results of this study corroborated the concerns of the community, that incidence of breast cancer could indeed occur in less than 6 months in women who had previously had a normal MRI. The results suggested that these aggressive breast cancers displayed an accelerated initiation and development within the patients of the local African American community, validating community observations.
Phase II: The second concern raised by our community partners was the lack of prevention agents for these aggressive breast cancers. In partnership with Durham community members, our current study investigated signaling pathways activated during the initiation of triple-negative breast cancer in African American women. For our study 10 African American women who were at highest risk for breast cancer (either known or suspected BRCA1 mutation carriers) donated mastectomy tissue. Women either underwent prophylactic mastectomy or had mastectomy after a cancer diagnosis.
Donated mastectomy specimens were serial sliced into 2.5 centimeter slices and 2 to 3 cubic centimeter samples were excised from specified section of each slice of breast tissue. Breast tissues were snap frozen, formalin-fixed and OCT embedded to preserve samples for further analysis. Thus far tissue tensile forces, collagen composition, metabolic and proteomic profiles have been characterized for this cohort. In addition biomarkers for stem cell, proliferation, apoptosis and senescence have been established.
Conclusion: Our Durham Community/Duke Partnership has allowed us to study a unique phenotype displayed in pre- malignant breast lesion found in rapid onset breast cancers displayed in high-risk African American women. Our study highlights the power of investigators working in collaboration and partnership with the community.
Citation Format: Christopher Sistrunk, Stephaine Robertson, Adrian Ambrose, Catherine Ibarra Drendall, Victoria Seewaldt. Breast cancers come out of nowhere: A two part Durham Community/Duke partnership to identify signaling pathways during the initiation of triple-negative breast cancer in African American women. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A46. doi:10.1158/1538-7755.DISP13-A46