Where Do BCRF Dollars Go?

The following is the first in a series of articles describing the impact on breast cancer research and treatment that your donations to BCRF have made.

In the early 1990s, the cancer research community was ablaze with great excitement. Several breakthroughs in cancer genetics occurred closely together. First, the gene for breast and ovarian cancer (BReast CAncer gene one, or BRCA1) was mapped. Then, in the same year, a group at Dana-Farber found that the tumor suppressor gene p53 was instrumental in the development of the Li-Fraumeni syndrome, a rare hereditary disorder that greatly increases a person's susceptibility to developing cancer. Then mapping of the second breast cancer gene, BRCA2, quickly followed.

It was in this environment of great anticipation and expectation that BCRF was founded. The advances mentioned above were by scientists who are now BCRF grantees - Mary-Claire King, PhD (University of Washington), Judy Garber, MD, MPH (Dana-Farber Cancer Institute and Harvard Medical School) and Alan Ashworth, BSc, PhD, FRS (The Institute of Cancer Research, UK) respectively. While significant progress was being made, each new insight led to more questions. It was clear that there was a lot of work to do and the talent to do it; however, funding sources for breast cancer researchers were scarce. This motivated Evelyn H. Lauder to found The Breast Cancer Research Foundation in 1993.

Since inception, BCRF has steadily grown from a small organization funding eight grantees totaling $159,000 in its first year, to a widely respected grantmaker contributing $33 million towards breast cancer research worldwide in 2010-2011. In view of the fact that breast cancer is not a single disease but a complicated set of diseases, BCRF-funded projects take a multi-faceted approach to solving the breast cancer enigma so that prevention and cure(s) can be achieved in our lifetime.

BCRF research can be broadly organized into two categories: "Finding the Cause" (understanding why breast cancer happens, and how it can be stopped) and "Finding the Cure" (designing better and more effective treatments that will cure breast cancer and stop it from coming back). These insights and progress are possible only because of the tens of thousands of contributors from all walks of life, ranging in age from 5 years to 85 years-plus, who generously donate their time and resources to fund the lifesaving research that will ultimately eliminate breast cancer.

Finding the Cause

Breast cancer, by definition, is an uncontrolled growth of breast cells. These cells have changed, or mutated, in a way that the green light to divide and replicate is always on. Furthermore, some of these mutated cells have gained the ability to invade healthy tissues, even in other parts of the body, causing metastasis, making them more dangerous than ever. For BCRF-supported researchers working on "Finding the Cause" of breast cancer, the key questions they ask are: what factors are responsible for regulating the growth of cells? What causes or triggers a cell to mutate? And how do these mutated cells move around the body and affect healthy cells?

BCRF-funded researchers are leading the foray into answering these questions. The ways that investigators are approaching their search into the origins of breast cancer can be divided into three categories: inherited susceptibility to breast cancer, external factors, and irregular cellular activities. All of these mechanisms are associated with changes in breast cells that turn them cancerous.

The first category, inherited susceptibility, addresses the "inheritability" of cancer. BCRF investigators have elucidated what we know about the BRCA1 and BRCA2 genes, as well as identified additional inheritable mutations. They have created the most comprehensive database of breast cancer genes ever assembled. In addition, they are studying the varied forms of breast cancer that occur in different populations. Furthermore, they have identified evolutionary protection against diseases, such as malaria, that seem to bring on the development of aggressive forms of breast cancer. Ultimately, BCRF-funded investigators intend to be able to use genetic information of individuals to help them prevent the development of breast cancer, as well as shed light on what physicians can do to prevent the disease�s onset.

The second category of inquiry, external effects, examines non-genetic factors that contribute to breast cancer occurrence. BCRF scientists are looking at human behavior and environment and their impact on breast cancer. The concept behind these studies is that some factors outside of a person's DNA, such as diet, childbirth, breast-feeding, and exercise, have caused a disruption in normal cellular processes leading to breast cancer. Investigators are focusing on how a person lives, rather than where she lives, and the relationship to breast cancer development.

The final group of inquiries focuses on irregular cellular activities, or "when good cells go bad," a phenomenon that seems to occur randomly. Researchers have determined that only 5-10% of breast cancers are due to an abnormality inherited from a parent, so there is considerable uncertainty over what causes breast cancer. BCRF researchers have contributed significantly to our understanding in this area. Thanks to their advances, most breast cancer cases are manageable or even "curable."

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The second article in this series will appear in the next issue of the BCRF E-Press.