Breast Cancer Care and Research Fund

Abstract Introduction In 2019, Invasive Lobular Cancer (ILC) Patient Advocates attended the 3rd meeting of the European Lobular Breast Cancer Consortium (ELBCC), a scientific community focused on lobular research and treatment. European Lobular Breast Cancer Advocates (ELBCA) now have a network of ILC patient advocates across Europe. ILC is classified by the World Health Organisation as the most common Special Type of Breast Cancer. In 2022 there were 576,300 diagnoses of breast cancer in Europe, 15% ~86,500 were ILC. ILC is a histologically distinct breast cancer with diverse presentations including a tendency to metastasize to unique locations. Current endocrine therapies may have different effectiveness for ILC making treatment challenging. Current imaging tools are often unreliable with up to 30% of ILC tumours not identified on mammograms and detection is often delayed. Challenges There are no standardised European diagnostic or treatment protocols for ILC. ELBCA addresses this with collaborative efforts between ILC medical professionals and researchers. It’s a major challenge because each European country has a different health care system and economic policy structure. It’s also a challenge to streamline the translation of clinically accurate information to European patients in their own language. Not all European countries are members of the EU, there are a minimum of 24 official European languages. Established European breast cancer patient organizations often don’t distinguish between different histological subtypes. Current European policy and administrative processes have hindered the formation of a not-for-profit Advocacy Organization. Without such an organization, fundraising and collaborative efforts with others is difficult. Conclusions ELBCA has made significant progress towards raising awareness and increasing knowledge of ILC across Europe. Our poster will expand on these accomplishments as well as the following goals: Work with European and International ILC research and patient communities to better understand this unique histological subtype. Elevate ILC research priorities and inform European policy to recognize ILC as a distinct disease. Enhance education of ILC among primary HCP’s and patients. Establish a recognized European ILC Advocacy Organization and collaborate with established BC organizations. Attend major BC research and clinical conferences. Lobby to achieve increased funding for ILC research and clinical trials. Citation Format: Siobhan Freeney, Helene Bonval, Esther Geven, Lori Petitti, Rian Terveer, Claire Turner, Cathrin Brisken, Patrick Derksen, Christine Desmedt, Thijs Koorman, ADRIAN LEE, Steffi Oesterreich, Anne Salomon, George Sflomos, Karen Van Baelen, Tone Lien, Damir Vareslija, Sabine Linn. European Lobular Breast Cancer Advocates: Bridging the Geographical Gaps in Lobular Breast Cancer Education and Awareness [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-11-09.

Abstract Background: Engaging diverse community members in research is vital to communicate and disseminate information to their communities. Co-design is a participatory approach to design solutions to problems and can be used to develop materials by bringing together individuals from diverse backgrounds. There is currently a gap in research of health education materials (i.e., Infographics) being created that employ a community co-design approach. We describe use of the co-design process to develop an infographic on breast cancer risk factors for broad community dissemination. Methods: The Community Leadership Committee (CLC) that represents the demographics of the Greater Los Angeles area was formed in 2015 and members were drawn from community and advocacy organizations, representing the four largest racial/ethnic groups (African American, Chinese, Latina, and Non-Hispanic White). The primary role of the CLC was to help create teachable, culturally-responsive materials on breast cancer and the environment. To address their communities’ informational needs about breast cancer and the environment, the CLC determined elected to develop infographics. Focus groups were held in summer of 2017 to evaluate the initial drafts of the infographics for clarity, utility, cultural and linguistic appropriateness and effectiveness. Focus group participants were recruited by the CLC members to and were conducted in English, Spanish, or Mandarin Chinese. Results: CLC members (N=18) informed the design and development of the infographic. Members of the CLC member ages ranged from 49 to 79. All members were female, 42%% were foreign-born, 34%% spoke Spanish, 20% spoke Chinese, and 75% were breast cancer survivors. A total of 6 focus groups were conducted with 53 women. The groups consisted of 4 groups in the English language [African American (N=12), non-Hispanic White (N=7), Chinese (N=9), and Hispanic/Latina (6)], one in Spanish (N=7), and Mandarin Chinese (N=12). The infographic went through 6 versions before being finalized, translated into Spanish and Chinese, and printed. Focus groups occurred between initial draft and draft #3. Some of the common themes included the importance of representation, readability, and visualization. CLC members preferred materials that included less text and more graphics to make it faster and easier to read. Collaboration with the CLC and findings from the focus groups led to the development and refinement of the final infographics Discussion: We have described the development of health education materials through a co-design process to increase the awareness of breast cancer risk. These findings emphasize the importance of involving people with lived experience and end users. Co-design is vital to ensuring the health education materials were appropriate, engaging, culturally and linguistically competent. Health education materials that resonate with their intended audience have the potential to influence health behaviors resulting in risk reduction. Citation Format: Michele Rakoff, Mayra Serrano, Susan Neuhausen. Using co-design to develop culturally and linguistically appropriate breast cancer education materials [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-08-11.

Abstract Background: In spite of aromatase inhibitors reducing risk of recurrence and mortality, painful side effects often cause women to discontinue use of the drug. Side effects of aromatase inhibitors include joint and muscle pain, loss of bone mineral density, and impairment of heart functioning. Discontinuation of aromatase inhibitors due to these side effects occur in up to 40% of breast cancer survivors, and consequently risks of recurrence and mortality increase. Objective: We developed two interventions designed to reduce inflammation, alleviate pain and stabilize bone mineral density. Methods: We are currently conducting a pilot parallel intervention trial that is targeted toward alleviating side effects from aromatase inhibitors through dietary and exercise controlled interventions lasting for three months. The dietary intervention is an anti-inflammatory Mediterranean diet designed to decrease inflammation and lessen joint and muscle pain. Participants randomized to the Mediterranean dietary intervention are exclusively consuming food provided by Territory Foods®, an outside food preparation and delivery service, local to Los Angeles. Our exercise intervention is designed to mobilize the joints, and strengthen and reduce bone loss. Participants are visiting the UCLA Kinross gym for three days per week and are undergoing tailored exercise sessions delivered from personal trainers following our bone strengthening intervention protocol. Anthropometric measures, muscle strength, DXA scanning of bone mineral density, peripheral arterial tonometry, pulse wave velocity and biomarkers of inflammation, bone turnover and heart functioning are conducted at baseline, mid- and end of intervention. Results: Our trial is targeted to accrue 20 participants. Thus far we enrolled six participants, with three participants completing the trial. Analysis is ongoing and preliminary results will be presented at the San Antonio Breast Cancer Symposium in December, 2022. Post intervention reports from participants have noted a reduction in pain symptoms, moderate weight loss and increase in muscle strength. Citation Format: Catherine L. Carpenter, Aashini K. Master, Olivia Julian, Dina Ben-Nissan, Michele Rakoff, Gail Thames, Zhaoping Li. Improving the health of women on Aromatase Inhibitors: A pilot controlled dietary and exercise intervention trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-06-01.

PurposeWe quantified cytotoxic T cells in nonmalignant breast tissues from women with and without subsequent breast cancer to assess evidence of whether immunosurveillance may be suppressed prior to tumor development.MethodsWe used an age-matched set of breast tissues from women with benign breast disease (BBD) who subsequently developed breast cancer (BBD with later BC), women with BBD who remained cancer free (BBD cancer-free), and normal Komen Tissue Bank (KTB) tissue donors (KTB controls). We evaluated terminal duct lobular units (lobules) for degree of epithelial abnormality and density of dual-positive CD8/CD103 T cells, as CD103+ cells are thought to be a subset of CD8+ cytotoxic T cells located primarily in the intraepithelial compartment.ResultsIn 10 sets of age-matched women, 256 breast lobules were studied: 85 in BBD women with later BC, 85 in BBD cancer-free women, and 86 in KTB donors. The majority of all lobules were histologically normal (N = 143, 56%), with 65 (25%) nonproliferative fibrocystic change, and 48 (19%) proliferative epithelial change (with or without atypia). In BBD women with later BC, median CD8+/CD103+ cell density was 39.6, 31.7, and 10.5 cells/mm2 (p = 0.002) for normal, nonproliferative, and proliferative lobules. In BBD cancer-free women, median CD8+/CD103+ cell density values were 46.7, 14.3, and 0 cells/mm2 (p = 0.004) respectively. In KTB donors, CD8+/CD103+ cell density was not significantly different across the lobule types (medians 0, 5.8, 10.7, p = 0.43).ConclusionIn women with BBD, breast lobules with increasing epithelial abnormality show significant decreases in cytotoxic T cells as measured by CD8/CD103 staining, suggesting that impaired immunosurveillance may be a component of the earliest stages of breast cancer development.

e19586^ Background: The POM-DEX combination is an effective treatment for RRMM patients (pts), even those refractory to lenalidomide (LEN). We investigated the combination of POM-DEX-PLD using a mo...