Breast Cancer

Ongoing and Upcoming Studies

Establishment of a novel breast cancer cohort at Kamuzu Central Hospital in Malawi

Summary

(PI, Dr.Tamiwe Tomoka, active, enrolling)

In sub-Saharan Africa, breast cancer is the second most common cancer among women. In 2008 breast cancer was responsible for 64,620 new cases and 35,427 deaths. Breast cancer and cervical cancer comprise one-quarter of all cancers occurring in the region. In addition, the burden of both cancers is expected to increase by 80-90% by the year 2030. Our breast cancer study is one of the first to thoroughly examine the etiology and biology of breast cancer in Malawi, and one of the first such studies in sub-Saharan Africa. Importantly, studying breast cancer in this setting presents several unique opportunities. The high prevalence of potentially genotoxic environmental exposures, such as indoor air pollution from cooking smoke, will enable us to study gene-environment interactions that have not been seen in the U.S [9]. This study will establish procedures and infrastructure for molecular and genomic characterization of tumors, which has not been performed in African populations. Finally, it applies methods from the highly successful Carolina Breast Cancer Study, which will facilitate future cross-national comparisons of breast cancer risk and patient-reported outcomes.

The primary objective of the study is to develop a prospective cohort of Malawian breast cancer patients, who are comprehensively characterized with respect to clinical, laboratory, and histopathologic features, while receiving care according to local standards. Secondary objectives include: to assess if the clinical characteristics of breast cancer at KCH differ by HIV status, to assess the feasibility and acceptability of interviewing patients for risk factors and treatment outcomes, and to evaluate tumor blocks for histologic, molecular, and genomic characterization.