Special studies within the BWHS
Mammogram Collection: examining breast density and other factors related to breast cancer risk
High breast density, which can be seen on a mammogram, is considered a well-established risk factor for breast cancer, but most previous studies have been based on women of European ancestry. Prior studies have suggested that the distribution of breast density could be very different among Black vs. White women. In addition, emerging evidence suggests that other breast tissue features identifiable on mammograms might also predict breast cancer risk.
The goal of this study is to collect copies of mammograms from 6,700 BWHS participants, including 700 who have reported being diagnosed with breast cancer. A random sample of BWHS participants will be contacted to request permission for BWHS investigators to contact their mammography clinics to obtain their records. This effort began in September 2017 and will continue until the full sample size is reached. Mammogram images will be analyzed using computer-assisted techniques that determine breast density and identify other features. Because these techniques were developed for research purposes, results of the mammogram assessment will not be returned to participants. The information obtained from the mammograms will be used, in conjunction with BWHS questionnaire data, to study predictors of high mammographic density and to assess associations of mammographic density and other breast features with breast cancer risk. Ultimately, findings from this study could be useful for improving risk prediction models for breast cancer in Black women.
Breast Cancer Tumor Tissue Collection
It has become increasingly clear that breast cancer is not a single disease but rather consists of two or more subtypes that may have different causes and require different treatments. A particularly aggressive form of breast cancer (the triple-negative subtype) occurs more often among African American women than U.S. women of other racial/ethnic groups, although it is still relatively uncommon (about 20% of all breast cancers in African American women). We can lessen our risk of developing the more common type of breast cancer – tumors responsive to estrogens – by avoiding use of menopausal hormones, reducing alcohol intake, and avoiding excess weight gain, but little is known about what factors play a role in triple negative breast cancer. Therefore, much of the current breast cancer research in the BWHS is focused on triple negative breast cancer.
It is very helpful to be able to include information from the tumor itself in our analyses. To do so, we need to obtain the breast tumor tissue samples that have been stored in laboratories at the hospitals in which women were originally treated for their breast cancers. We remove a very small section of the tumor tissue and then return the sample to the hospital. Part of the section is used for tests that identify specific subtypes and the rest will be used to look at the biology of the tumor itself. Before requesting samples from the hospitals, we obtain written informed consent from each participant.
We hope and expect that our current and future research using tumor tissue will help to identify ways to avoid developing triple negative breast cancer, as well as better treatments for the disease.
Urinary Incontinence: impact and treatment
The study will assess the barriers and facilitators to seeking care for urinary incontinence, the impact of urinary incontinence on daily life (ability to perform chores, physical activity, emotional health), and treatment received among participants in the Black Women’s Health Study.
On the 2011 and 2013 BWHS questionnaires, participants were asked some initial questions regarding urinary incontinence. Based on these questions, a subset of women will receive a questionnaire specifically about their urinary incontinence and any treatments they received.
Findings will provide important information regarding the risks associated with urinary incontinence, and have the potential to direct interventions and to ensure health equity and symptom-control among Black women.
Breast Cancer Survivorship
A diagnosis of breast cancer and breast cancer treatment can affect women for many years afterward, but little is known about how Black women’s lives may change after breast cancer. This project collects data from Black Women’s Health Study participants who have been diagnosed with breast cancer to learn about their breast cancer treatments and how their lives have been affected. The mortality rate from breast cancer, the most commonly occurring cancer among women in the U.S., is 39% higher in Black women than White women. The reasons for this difference are largely unknown, so the research will also study factors that affect death due to breast cancer and other cancer outcomes.