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Study Description

Goals of the study

The Pathways Study is one of the pre-eminent studies focused on understanding and improving the lives and experience of women diagnosed with breast cancer. Funded by the National Cancer Institute and with support through the NCI's cancer epidemiology cohort program, the Pathways Study is examining multi-level factors and outcomes in breast cancer survivorship and prognosis.

Who are the participants?

Women were invited to participate in the Pathways Study if they were recently diagnosed with breast cancer and were enrolled in the Kaiser Permanente Northern California health plan. Recruitment into the cohort began in January, 2006, and ended in May, 2013, and a total of 4,504 women diagnosed with invasive breast cancer consented to participate in the study. Women were age 21 years or older at the time of diagnosis, and had a primary language of English, Spanish, Cantonese, or Mandarin. The women enrolled in the Pathways Study are generally similar to the overall population of KPNC women diagnosed with breast cancer.

Description of the study

The Pathways Study is a prospective cohort study of women diagnosed with breast cancer. The cohort of women who are participants in the study have provided information through questionnaires at various times throughout their breast cancer experience. This includes at baseline, or study entry, which was on average about two months after breast cancer diagnosis, and then at 6 months, 12 months, and 24 months after that, and periodically thereafter. Questionnaire items include information on food intake, physical activity, dietary supplements, and use of alternative therapies; psychosocial measures describing quality of life and social support; breast cancer risk factors including reproductive history; and a number of other areas. Study participants also provided blood and saliva samples, enabling research into genetic and molecular factors in breast cancer prognosis, and also provided access to their tumor specimens for research related to novel tumor characteristics.

As members of the Kaiser Permanente Northern California health plan, clinical information available from electronic health records provide details on diagnosis, treatment, and other health conditions. We have also have incorporated neighborhood factors related to the social and built environment, using databases such as from the US Census, and measures of air and water quality. This study thus provides the ability to examine multiple factors and their effects on the breast cancer experience.

The following two grants have provided core support to establish and follow the Pathways Study cohort:

  1. Prospective Study of Breast Cancer Survivorship (R01 CA105274), Lawrence Kushi, Kaiser Permanente Northern California (9/20/2004-6/30/2017): This National Cancer Institute grant established the Pathways Study, including recruitment, informed consent, enrollment, survey and in-person research data and biospecimen collection.
  2. Infrastructure for Pathways, a Prospective Study of Breast Cancer Survivorship (U01 CA195565), Lawrence Kushi, Christine Ambrosone, Kaiser Permanente Northern California (Kushi); Roswell Park Comprehensive Cancer Center (Ambrosone) (6/1/2016-5/31/2026): This National Cancer Institute cancer epidemiology cohort infrastructure cooperative agreement continues follow-up and support of the Pathways Study.

Over the years, numerous research studies have been built upon the Pathways Study of breast cancer survivors. To see a list of these studies, please visit our ancillary studies documentation.