Research topics include the use of estrogen therapy in postmenopausal women, City of Hope’s Couples Coping With Cancer Together and genetic testing

City of Hope, one of the largest cancer research and treatment organizations in the United States, will present innovative research at this year’s San Antonio Breast Cancer Symposium (SABCS), taking place Dec. 5 to 9 in San Antonio, Texas.

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City of Hope's Joanne Mortimer, M.D., presented research at SABCS. (Photo: Business Wire)

Each year, about 10,000 physicians, scientists and other health care professionals attend the annual conference, which examines new breast cancer research and helps guide treatment of patients nationwide. It is the largest and most prestigious scientific gathering on breast cancer research.

Research presented by City of Hope doctors and scientists includes:

Study: Data shows that taking estrogen reduces breast cancer risk in postmenopausal women who had a hysterectomy

Data from the Women’s Health Initiative (WHI) in 2002 had this finding: Women without a uterus who took estrogen and progesterone, hormone replacement therapy that women took to help prevent health problems caused by menopause, had an increased risk of breast cancer compared to those women in the study who took a placebo. The use of hormone replacement therapy dropped drastically. Women who had a uterus and only took estrogen had a lower incidence of breast cancer compared to women who took the placebo, but those findings were challenged and have been debated since then.

City of Hope’s Joanne Mortimer, M.D., director of the Women’s Cancers Program, Baum Family Professor in Women’s Cancers and vice chair/professor, Department of Medical Oncology & Therapeutics Research, and other breast cancer doctors and scientists from other institutions decided to take a deeper dive into those findings. They gathered data from nine other smaller studies of women who had a hysterectomy and took estrogen to compare those results with WHI data, which now tracks breast cancer incidence after more than 20 years of data collection.

The analysis of 7,339 women showed a lower risk of developing breast cancer among the women with no uterus who took estrogen compared with those who took a placebo. However, hormone replacement therapy did not strongly protect women in the studies against such menopause-related health complications as cardiovascular disease and brain health.

“Postmenopausal women who took a combination of estrogen and progesterone have a higher risk for developing breast cancer,” said Mortimer, who will present the research at SABCS. “This study shows that single agent estrogen is safe in the population of women who have undergone hysterectomy and who desire hormone replacement therapy.”

The abstract titled “Randomized trials of estrogen-alone and breast cancer incidence: a meta-analysis” was presented Dec. 6 in an oral presentation spotlight.

Findings from City of Hope’s innovative Couples Coping With Cancer Together program

Research from City of Hope's innovative Couples Coping With Cancer Together program, started by the Department of Supportive Care Medicine, is one of the only programs of its kind nationwide, and is offered as part of the normal continuum of care provided to patients and families at City of Hope. It is tailored to the unique needs of English and Spanish-speaking couples facing a cancer diagnosis together, regardless of sexual orientation or relationship status.

As part of the supportive cancer care program, metastatic breast cancer patients and their partners completed a biopsychosocial screening, which asks each person about their perception of the patient’s prognosis. In addition, the couples were offered a standardized couples’ session before the medical consultation, individual couples’ counseling and a strengths-based group intervention.

The study included 241 patients and their partners. It found that patients were more realistic about their prognosis than their partners.

“Because open communication is important among women being treated for metastatic breast cancer and their partners, a prognosis question for both the patient and her partner should be included in standard of care,” said Mortimer, who presented the research at SABCS. “This will also help couples prepare for advanced care planning.”

The abstract titled “The ‘Couples Coping with Cancer Together Program’ provides insight into individual’s distress and an opportunity to discuss prognosis in a manner that is normalized as standard of care” was presented Dec. 7 in a poster session.

Testing for genetic mutations that can cause breast cancer

Because African American and Latina women have been less likely to undergo germline testing, which detects inherited genetic mutations that may cause cancer, it has been difficult to determine the prevalence of hereditary breast cancer predisposition in these populations.

Mortimer and team analyzed the prevalence of BRCA1/2 mutation in patients with a breast cancer diagnosis from City of Hope’s Implementing Next-generation Sequencing for Precision Intervention and Risk Evaluation (INSPIRE) study.

Patients with a history of any stage breast cancer were approached for their consent to undergo germline testing for 155 predisposition genes for cancer, which is performed at no cost to the patient.

From July 2020 to April 2023, 2,413 women underwent germline testing. Mutations in BRCA1 were identified in 3% of Hispanic women compared with 1.7% of non-Hispanic women. BRCA2 mutations were identified in 2.2% of Hispanics and 3% of non-Hispanics.

Hispanic women with breast cancer were 2.49 times as likely as non-Hispanics to carry a pathogenic germline BRCA1 mutations than BRCA2.

Women who have BRCA1 tend to have more aggressive breast cancers and the mutation can also cause ovarian cancer.

“What this study demonstrated is that regardless of your race, your ethnicity or age, everybody should have genetic testing,” Mortimer added. “Because knowing what your BRCA status is has implications for surgery, prognosis and treatment.”

“Prevalence of BRCA1/2 mutations in an underrepresented population of women with breast cancer: Observations from the City of Hope INSPIRE study” was part of a poster presentation on Dec. 7.

About City of Hope

City of Hope's mission is to deliver the cures of tomorrow to the people who need them today. Founded in 1913, City of Hope has grown into one of the largest cancer research and treatment organizations in the U.S. and one of the leading research centers for diabetes and other life-threatening illnesses. City of Hope research has been the basis for numerous breakthrough cancer medicines, as well as human synthetic insulin and monoclonal antibodies. With an independent, National Cancer Institute-designated comprehensive cancer center at its core, City of Hope brings a uniquely integrated model to patients spanning cancer care, research and development, academics and training, and innovation initiatives. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. City of Hope’s affiliated group of organizations includes Translational Genomics Research Institute and AccessHope^TM. For more information about City of Hope, follow us on Facebook, Twitter, YouTube, Instagram.

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