Ancillary Studies

Over the years, numerous research studies have been built upon the Pathways Study of breast cancer survivors. Search our ancillary study table by key word or sort by column.

Name	Grant Identification	Principal Investigator/s	Institution	Description
Racial Disparities in the Initiation and Intensity of Adjuvant Therapy for Breast Cancer	DOD BC043120	Al Neugut	Columbia University	This grant, funded by the Breast Cancer Research Program of the Department of Defense, supported a Breast Cancer Center of Excellence examining factors contributing to disparities in receipt of adjuvant therapy, and consequences for prognosis and breast cancer care. Participants were recruited from the Pathways Study, New York-area hospitals, and the Henry Ford Health Systems in Detroit, MI. This study is also referred to as the B-QUAL Study
Natural History and Cost Analysis of Lymphedema Secondary to Breast Cancer	RSG-06-209-01-LR	Marilyn Kwan	Kaiser Permanente Northern California	Funded by the American Cancer Society, the objectives of this grant are to examine the predictors and sequelae of breast-cancer-related lymphedema and its severity. This is an ancillary study with additional data collection from Pathways Study participants.
Using Physiological Age to Predict Chemotherapy Toxicity	R01 CA124924	Jeanne Mandelblatt	Georgetown University	This grant, funded by the National Cancer Institute, is examining functional status and its relation to chemotherapy administration, effectiveness, and toxicity. Participants are recruited from the Pathways Study and Columbia Presbyterian Medical Center in New York.
Adjuvant Breast Cancer Therapies: Race, Variations in Care and Survival	RSGT-08-009-01-CPHPS	Dawn Hershman	Columbia University	This American Cancer Society Grant enabled analyses on adjuvant hormone therapy adherence, discontinuation, and survival.
Genetics of Tamoxifen Response	14OB-0166	Elad Ziv	University of California San Francisco	This grant, funded by the California Breast Cancer Research Program, investigated variations in CYP2D6 and related metabolism genes modulate effectiveness of tamoxifen in participants from the Pathways Study and other studies.
Molecular Profiles and Lifestyle Factors in Breast Cancer Prognosis	R01 CA129059	Bette Caan	Kaiser Permanente Northern California	This grant examined PAM50 molecular profiles in breast cancer, with participants from both the Pathways Study and Life After Cancer Epidemiology (LACE) Study.
American Reinvestment and Recovery Act (ARRA) Grand Opportunity supplement to the Pathways Study	3R01CA105274-06S1	Lawrence Kushi	Kaiser Permanente Northern California	This ARRA Grand Opportunity grant enabled assay of inflammatory and other biomarkers, and targeted genotyping, among Pathways Study participants who had been enrolled and contributed biospecimens at the time of assay.
Lifestyle and Molecular Factors of Bone Health in Breast Cancer Survivors	R01 CA166701	Marilyn Kwan, Song Yao	Kaiser Permanente Northern California	This project investigates the impact of modifiable lifestyle factors, germline genetic variations, and serum biomarkers on adverse skeletal outcomes among aromatase inhibitor (AI) users in the Pathways Study, as well as develops a prediction model for risk of fractures for postmenopausal breast cancer patients taking AIs.
Mammographic Density and Prognosis among Breast Cancer Intrinsic Subtypes	R01 CA168893	Laurel Habel	Kaiser Permanente Northern California	This project addresses whether breast density is associated with all or only some breast cancer subtypes, and whether density influences breast cancer prognosis and predicts response to hormonal therapy in a subset of LACE and Pathways participants included in the LACE competitive renewal
Germline and Tumor Genomic Analyses of Breast cancer in Latinas	R01 CA184585	Susan Neuhausen, Elad Ziv	City of Hope, University of California San Francisco	This grant aims to identify breast cancer susceptibility genetic loci in Latina women. The Pathways Study will contribute to replication of the top 1,000 candidate genes discovered in other populations from whole-exome and targeted sequencing and expression analysis in germline and somatic DNA.
Genome-wide Association Studies of Breast Cancer Prognosis & Treatment Outcomes	X01 HG008335; 268201200008I-0-26800077-1	Lawrence Kushi	Kaiser Permanente Northern California	This grant supported germline genome-wide assays through the NIH Center for Inherited Disease Research program, and was supported as a companion grant to U01 CA195565. Genotyping was conducted using the Illumina Multi-Ethnic Global Array, with additional custom content related to breast cancer from the Vanderbilt University Biobank (BioVU), for over 1.8 million genotyped SNPs. Genotype data are available through dbGaP (phs001534.v1.p1).
Predictors of CVD among breast cancer survivors in an integrated health system	R01 CA214057	Marilyn Kwan, Heather Greenlee	Kaiser Permanente Northern California	This grant examines risks of cardiovascular disease risk factors and outcomes in the Pathways Study cohort, with comparisons to CVD risk in a non-breast cancer cohort from KPNC.
The Impact of Racial/Ethnic Discrimination and Segregation on Cancer Survivorship		Salma Shariff-Marco	Cancer Prevention Institute of California	Within the Pathways cohort, we project examined associations with racial/ethnic discrimination, quality of life (QoL) and residential segregation
Race Disparities in Social Networks, and Breast Cancer Treatment, Prognosis	RSG-16-167-01-CPPB	Candyce Kroenke	Kaiser Permanente Northern California	The project examines social network factors by race and treatment status, and social network effects on treatment and outcomes after breast cancer.
Obesity, Chemotherapy Dosing, and Breast Cancer Outcomes	R37 CA222793	Elizabeth Kantor	Memorial Sloan Kettering Cancer Center	This grant examines associations between body size and chemotherapy dosing in breast cancer cases from KPNC and KP Washington. This grant was initially awarded as R01 CA222793.
Relationships between parity, breastfeeding and ER- breast cancer in African American women: Elucidating the biologic underpinnings at the molecular and cellular level	R01 CA225947	Christine Ambrosone, Michael Higgins, Julie Palmer	Roswell Park Comprehensive Cancer Center	This study is examining tumor DNA methylation characteristics in African American women diagnosed with breast cancer, including participants from the Women's Circle of Health and Black Women's Cohort Studies, as well as the Pathways Study. Tumor DNA methylation assays have been conducted by CIDR.
Neighborhood and Allostatic Load Among Breast Cancer Survivors	Administrative Supplement to U01CA195565	Salma Shariff-Marco	University of California San Francisco	This study leverages the Pathways Study and novel machine learning methods to assess allostatic load from EHRs records, explore whether neighborhood factors impact survivorship outcomes through a stress pathway.
Cardiovascular Risk in Breast Cancer Survivors: An Integrated Analysis of Neighborhood, Behavioral, and Clinical Data	R01 CA214057-S1	Salma Shariff-Marco	University of California San Francisco	This is an administrative supplement to the Pathways Heart Study, studying neighborhood factors and CVD outcomes.
Social Networks and Disparities in Health Behaviors and Breast Cancer Outcomes in Immigrant Women	R01 CA230440	Candyce Kroenke	Kaiser Permanente Northern California	This grant is investigating immigrant status, social networks, and neighborhood characteristics in breast cancer outcomes in three prospective cohorts, including participants from the Pathways Study, the LACE Study, and the CHI Study.
Healthful Dietary Patterns, Intermediate Biomarkers and Long-Term Breast Cancer Prognosis	632996	Elizabeth Feliciano	Kaiser Permanente Northern California	This grant examines plant-based dietary patterns and dietary inflammatory indices in relation to breast cancer outcomes in the Pathways Study.
NCI Confluence Project		Peter Kraft, Montserrat Garcia-Closas	Division of Cancer Epidemiology & Genetics, National Cancer Institute	The NCI Confluence Project is assembling the largest and most diverse study of genetics and breast cancer risk and prognosis, bringing together data and biospecimens for new genotyping if necessary, from numerous studies, including the Pathways Study.
Latin American Genomics Breast Cancer Consortium (LAGENO-BC)	R01 CA286650	Laura Fejerman, Julie Dutil	University of California, Davis	LAGENO-BC is a consortium of research studies conducted in the US and countries in Central America and South America to examine genetic factors in breast cancer risk and prognosis. The Pathways Study is contributing data related to our Latina participants. LAGENO-BC is also participating in the NCI Confluence Project.
Breast White Adipose Tissue Inflammation and Breast Cancer Outcomes	R01 CA241409	Lawrence Kushi, Neil Iyengar	Kaiser Permanente Northern California	This study is investigating whether breast adipose tissue inflammation is associated with breast cancer outcomes, using Pathways Study surgical specimens.
Tumor Immune Contexture and Breast Cancer Disparities: A Multi-Disciplinary Study in Women of African and European Ancestry	R01 CA247281	Christine Ambrosone, Scott Abrams, Song Yao	Roswell Park Comprehensive Cancer Center	This project is investigating whether breast tumor immune profiles differ between American women with genetic similarity to African populations (AA) differ from those with genetic similarity to European populations (EA), and whether these differences are associated with risk factors, tumor aggressiveness, and survival. Contributing studies include the Women's Circle of Health Study and the Pathways Study.
Insights from Asian Populations into Disparities in Breast Cancer Prognosis and Outcomes	R01 CA241125	Scarlett Lin Gomez, Lawrence Kushi, Song Yao	University of California San Francisco	This study is investigating multilevel factors (tumor genetics, treatment adherence, health behaviors and neighborhood factors) in relation to overall and breast cancer-specific mortality across several studies with Asian American breast cancer cases, including the Pathways Study.
Dietary Supplements and Breast Cancer Therapy Interactions in a Well-Characterized Cohort of Breast Cancer Patients	3U01 CA195565-05S1; Administrative supplement with funding from the NIH Office of Dietary Supplements	Heather Greenlee	Fred Hutchinson Cancer Center	This study is examining the use of dietary supplements and its effects on chemotherapy.
Long noncoding RNA regulations in breast cancer among African-American women	R01 CA246688	Zhihong Gong	Roswell Park Comprehensive Cancer Center	This study is examining whether long noncoding RNA, a novel class of regulatory molecules, may be associated with tumor aggressiveness in African American women. Contributing studies include the Women's Circle of Health Study and the Pathways Study.
An Electronic Health Record-Based Tool to Identify Newly Diagnosed Breast Cancer Patients at Risk of Low Social Support	R01 CA253028	Candyce Kroenke	Kaiser Permanente Northern California	This study is developing and testing an EHR-based algorithm to identify women with high risk of low social support, among those diagnosed with breast cancer; the Pathways Study will be a validation cohort.
Energy Balance, mTOR Pathway Signaling, and Breast Cancer Prognosis	R37 CA248371	Ting-Yuan (David) Cheng	The Ohio State University	This study is examining expression of proteins in the mTOR signaling pathway in tumor tissue on breast cancer prognosis, using TMAs created under Pathways Study infrastructure funding. This grant was initially awarded as R01 CA248371.
Assess Inflammatory Potential of Diet Among Breast Cancer Patients: Novel Index and Short-Form Questionnaire		En Cheng, Isaac Ergas	Kaiser Permanente Northern California	This study will develop a dietary inflammatory index for breast cancer patients based on existing Pathways Study data, and will examine associations of the index with breast cancer outcomes. Based on the index, a brief inflammatory dietary screener will be developed and tested in breast cancer patients.
Aging, DNA methylation, and incident cardiovascular disease in breast cancer survivors	R37 CA299472	Jacob Kresovich	Moffitt Cancer Center	This study examines DNA methylation patterns from blood samples collected soon after cancer diagnosis in the Pathways Study to develop methylation-based measures of biological aging.  We will investigate the relationships among biological aging, immune system characteristics, and cardiovascular disease risk.  This research will advance our understanding of cardiovascular disease etiology of breast cancer patients, identify biological markers that may personalize cardiac monitoring and treatment decisions, and ultimately improve long-term cardiovascular health of breast cancer survivors.
Developing CVD prediction models for women with early stage breast cancer	U01 CA214057	Heather Greenlee	Fred Hutchinson Cancer Center	In this continuation of the Pathways Heart Study, we will leverage existing resources to develop, test, and validate two CVD risk prediction models that will identify early-stage breast cancer patients at high risk of developing serious, life-threatening CVD who need increased surveillance and management. The models will use readily available clinical and biomarker data that are easy to collect with the long-term goal of developing a freely available online CVD risk prediction tool to use in the breast oncology clinical setting.
Prevention of liver metastasis by defining regulators of tumor dormancy, how they are disrupted, and how to reverse it	BC240948P1	Lawrence Kushi, Cyrus Ghajar	Kaiser Permanente Northern California	This real-world data study examines predictors of liver metastases in women diagnosed with breast cancer. Factors of interest include liver function tests, liver conditions, and associated risk factors. This is a collaboration with laboratory scientists at the Fred Hutch Cancer Center.
Vision-Language Models with Explainability for Breast Cancer Prognosis using Image and Clinical Data	R01 CA299626	Joann Elmore, Thaer Khoury, Linda Shapiro	University of California, Los Angeles	This study will develop a deep learning model that uses both clinical variables and breast biopsy microscopy image features to improve prediction of recurrence and mortality. We also will develop an explainability component that will provide physicians a text description of image features relevant to and explaining the prediction, thus providing insight and explainability. Our models will be evaluated by expert breast pathologists, working in a feedback loop, to improve model trustworthiness and clinical relevance.
Post-Recurrence Survival in Patients with Recurrent Breast Cancer: Identifying Key Predictors and Standardizing Assessments	R01 CA303112	Jennifer Plichta	Duke University	This project will develop a risk prediction model to identify key variables associated with post-recurrence survival and will develop the first prognostic classification system for patients with recurrent breast cancer. The Pathways Study will be one of six data collection sites or studies that are participating in this project.