Graham A. Colditz, MD, Dr.PH

2007-2008 BCRF Project:
Benign breast disease and mammographic density are both strong predictors of breast cancer risk. Using data from the Nurses' Health Study benign breast disease nested case control study, Dr. Colditz and his team have identified factors that predict the pathologic category of benign lesion. These categories have important implications for subsequent risk of breast cancer.

They are now applying this information to their larger cohort through imputation. These statistical models will allow the researchers to improve upon previous methods and refine the clinical prediction of breast cancer risk associated with a diagnosis of benign breast disease. They have completed the construction of tissue microarrays from benign breast disease lesions of women who went on to develop breast cancer (cases) and those who did not (controls), and they also have completed staining for a number of markers and have begun scoring these slides. Expression of these molecular markers in benign breast tissue may be clinically important in predicting a woman's subsequent risk of breast cancer.

In the Nurses' Health Study, the researchers found that common genetic variation in IGFI, but not IGFBPI or IGFBP3, is associated with mammographic density. Because breast density varies by race and ethnicity they have initiated the Boston Mammography Cohort Pilot Study: an ethnically diverse group of healthy women undergoing routine mammography. They are enrolling women one day a week through the Bell Mammography Center at Brigham and Women's Hospital. To date, they have enrolled over 90 women into the study. The initiation of this cohort will create resources for future studies of biomarkers and breast cancer across the full spectrum of disease progression and will allow the integration of studying both benign breast disease and mammographic density in the same population of women.

Mid-Year Progress Report:
Using data from the Nurses' Health Study and statistical methods developed by their group, Dr. Colditz’s team has refined a tool for the clinical prediction of breast cancer risk associated with a diagnosis of benign breast disease. They will now add mammographic density to this prediction and apply the tool in a clinical screening mammography service to determine its acceptability for women and providers. Early life factors are likely to play an important role in breast cancer, and perhaps, breast density. The researchers will examine adolescent diet and growth velocity in relation to risk of benign breast disease in the cohort of over 8,000 young girls.

Based on preliminary data from their 3-month pilot study to initiate an ethnically diverse cohort of women undergoing routing mammographic screening at Brigham and Women's Hospital (BWH), they will implement changes to the study protocol and begin a second phase of pilot studies that include blood collection for future studies. The cohort will create resources for future studies of biomarkers and breast cancer across the full spectrum of disease progression and will provide an ideal setting for the integration of studying both benign breast disease and mammographic density in the same population of women. Finally, using breast cancer tissue from the Nurses' Health Study they will evaluate COX-2 status and risk of recurrence for breast cancer.

Bio:
Graham A. Colditz, MD, Dr.PH, is Professor of Medicine at Harvard Medical School, a Professor of Epidemiology at the Harvard School of Public Health, and a Senior Epidemiologist in the Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, and Head of the Chronic Disease Epidemiology Group at Channing Laboratory. He received his BSc. and MB, BS, and MD from the University of Queensland and his Doctorate in Public Health from Harvard University School of Public Health. He is the 2003 recipient of the American Cancer Society-Cissy Hornung Clinical Research Professorship, and the AACR-Dewitt Goodman Memorial Lectureship, and was recently awarded the 2005 American Society of Preventive Oncology Distinguished Achievement Award.

He is the Principal Investigator on the Nurses' Health Study, a cohort study of 121,701 Nurses and Principal Investigator on the Growing Up Today Study (GUTS) which focuses on the diet and lifestyle of 16,883 adolescents between the ages of 13 years to 17 years of age. As Director of the Harvard Center for Cancer Prevention, Dr. Colditz leads the effort to bring the growing body of knowledge on cancer prevention to the public. His work at the Center includes the Harvard Cancer Risk Index (a compilation of interactive tools designed to assess individual cancer risk and encourage healthy lifestyle choices) and a Breast Health compendium. Under his leadership, the Center has become actively involved with the Massachusetts Colorectal Cancer Working Group, Massachusetts Skin Cancer Prevention Collaborative, and Boston's Crusade Against Cancer, three local cancer prevention efforts with potential for replication on a nationwide scale. His research focuses on breast cancer incidence, breast cancer prevention, and screening evaluation for breast and colon cancer. He recently led a collaborative effort to promote colorectal cancer screening in primary care practices.