Report from the California Breast Cancer Research Program
to the California Legislature: 2010–2015
December 2015
Report from the California Breast Cancer Research Program to the California Legislature December 2015
2
California Breast Cancer Research Program
Annual Report to the State of California Legislature 2015
Report prepared by the University of California, Office of the President pursuant to Article 1 of
Chapter 2 of Part 1 of Division 103 of the California Health and Safety Code
Marion H. E. Kavanaugh-Lynch, M.D., M.P.H.
Director, California Breast Cancer Research Program
Mary Croughan, Ph.D.
Executive Director, Research Grants Program Office
William Tucker, Ph.D.
Interim Vice President for Research and Graduate Studies
Aimée Dorr, Ph.D.
Provost and Executive Vice President
Janet Napolitano, J.D.
President
California Breast Cancer Research Program
University of California, Office of the President
300 Lakeside Drive, 6
th
Floor
Oakland, CA 94612-3550
Phone: (510) 987-9884
Toll-free: (888) 313-BCRP
Fax: (510) 587-6325
Email: [email protected]
Web: http://www.CABreastCancer.org
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Table of Contents
Executive Summary
4
About the California Breast Cancer Research Program
12
CBCRP’s Strategy for Allocating Research Funds 18
Relationship between Federal and State Funding for Breast
Cancer Research
25
Funding and Research Highlights, 2010–2015
Funding and Research Detail: The Special Research
Initiatives
Funding and Research Details: The Community Impact
of Breast Cancer
Funding and Research Details: Etiology and Prevention
Funding and Research Details: Detection, Prognosis and
Treatment
Funding and Research Details: Biology of the Breast
Cell
30
31
40
47
50
56
Program Highlights, 2010–2015
61
Activities to Increase Funding for Breast Cancer Research and
Awareness of Breast Cancer Research
69
Impact Beyond CBCRP 73
Looking Forward 76
Appendix 1: California Breast Cancer Research Program
Council (2010–2015)
Appendix 2: California Breast Cancer Research Program Staff
(2010–2015)
Appendix 3: CBCPI Steering Committee and Strategy Advisors
lists
Appendix 4: CBCRP 2010–2015 Research Review Committees
Appendix 5: Policy Research Advocacy Group
77
79
80
81
90
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Executive Summary
The California Breast Cancer Research Program (CBCRP) is an international leader in funding
breast cancer prevention research and innovative areas of investigation. CBCRP's mission is to
prevent and eliminate breast cancer by leading innovation in research, communication, and
collaboration in the California scientific and lay communities.
This report provides an overview of the investments and progress made by the Program for the
period of July 1, 2010, to June 30, 2015. It describes the strategies CBCRP used to determine the
research topics that will make an impact on breast cancer and to identify the research projects that
best address those topics. A summary of what was funded by priority area is summarized in
Table 1.
Table 1: Research Funded from July 1, 2010 to June 30, 2015 by Priority Area
Priority Area
No. of Projects
Funded Funding Dollars
% of Total
Funding
Etiology and Prevention 34 $25,581,118 49%
Detection, Prognosis, and Treatment 48 $12,874,384 25%
Community Impact of Breast Cancer 22 $9,975,783 19%
Biology of the Breast Cell 20 $3,402,556 7%
Grand Total 124 $51,833,841 100%
CBCRP celebrated its 20
th
anniversary in 2013. Established with passage of the 1993 Breast
Cancer Act, CBCRP was created because California breast cancer activists were impatient with
the slow pace of progress against the disease. Together with scientists, clinicians, state legislators,
and University of California officials, they wrote legislation that created a program to fund
cutting-edge breast cancer research in California. The California Breast Cancer Act increased the
tobacco tax by 2¢ per pack, with 45 percent of the revenue going to CBCRP. Today, funding
comes from diverse sources in addition to the tobacco tax. See Table 2 for details.
Table 2: CBCRP Income, 2010–2015
Fiscal Year 2010–2011 2011–2012 2012–2013 2013–2014 2014–2015
5-Year
Summary
Breast Cancer
Research Account
(007)
ALLOCATION
$8,303,000 $9,959,000 $9,959,000 $11,058,000 $10,563,000 $49,842,000
California Breast
Cancer Research
Fund (0945)
ALLOCATION
$434,000 $484,000 $484,000 $618,000 $421,000 $2,441,000
EXTERNAL
FUNDING*
$1,002,862 $10,000 $216,000 $1,228,862
PRIVATE
DONATIONS
$139,457 $111,286 $112,768 $112,207 $115,915 $591,633
TOTAL FUNDS
$9,879,319 $10,554,286 $10,565,768 $11,788,207 $11,315,915 $54,103,495
* 2010–2011, National Institute of Environmental Health Sciences (NIEHS) grant 1RC4ES019826-01 and
Avon Foundation for Women grant; 2012–2013, NIEHS and National Cancer Institute Conference
Award 1 R13 ES022921-01; 2014–2015, NIH grant 1R25CA188482-01
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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The need for CBCRP is as urgent today as when we began in 1993. Nearly 200,000 California
women are living with breast cancer. Breast cancer can affect women of all ages and races, and
approximately 80 percent of women who develop breast cancer have no family history of the
disease. In California alone, more than 4,200 women die of breast cancer every year—that is
more than 11 women every day who die from the disease.
Despite the ongoing breast cancer crisis in California, there is reason for hope. CBCRP has
contributed to significant progress in its understanding of breast cancer through its program-
initiated research efforts designed specifically to push the field forward in new areas. Devoting 30
percent of its annual research funding over six years to program-initiated research, in 2004
CBCRP launched the Special Research Initiatives. In 2010, CBCRP decided to build on the
success of this approach with the California Breast Cancer Prevention Initiative and devoted
about half of its funding over five years to program-initiated research in some of the most
challenging and under-researched areas in breast cancer: the role of the environment in the
disease; the reasons why some groups of women—based on characteristics such as ethnicity or
race—bear a greater burden of breast cancer; and breast cancer prevention. In 2015, CBCRP
recommitted to maintaining about half of its funds over the next five years focused on prevention-
oriented, program-initiated research. This program-directed approach to research has yielded
significant breakthroughs in the field, some of which are documented throughout this report.
CBCRP has focused the other half of its research funding on investigator-initiated research,
allowing investigators to bring creative approaches and unique perspectives to bear on questions
that will improve breast cancer prevention, treatment and survivorship. CBCRP has significantly
helped advance the field of community based participatory research through the Community
Research Collaboration (CRC) awards. Innovative, Developmental and Exploratory (IDEA)
awards have supported speculative, exploratory, high-risk/high-reward projects. The
Translational Research awards support research that is on a critical path for practical application.
The combination of program and investigator initiated awards has created a robust portfolio of
breast cancer research.
Due in part to the cutting edge research CBCRP funds related to breast cancer prevention,
specifically around the role of environmental exposures and uncovering the causes driving the
unequal burden of breast cancer incidence, mortality and survivorship, several significant shifts
have happened in the field of breast cancer. The shift in the national prioritization of the research
agenda is evidenced by The Institute of Medicine release of Breast Cancer and the Environment:
A Life Course Approach (commissioned by Susan G. Komen for the Cure) and the federal
Interagency Breast Cancer & Environmental Research Coordinating Committee’s release of
Breast Cancer and the Environment: Prioritizing Prevention. CBCRP has also provided
leadership to the International Cancer Research Partnership (ICRP) to focus on environmental
links to cancer as well as to inform the agenda set by the American Cancer Society. The fact that
these prestigious, national and international leaders are prioritizing these issues speaks to the
impact CBCRP’s development work and funded research has had.
In recognition of the contributions that CBCRP has made, the program was recognized in 2011 at
the National Coalition for Cancer Survivorship’s 25
th
Annual Rays of Hope® Gala winning its
most prestigious award, the Catherine Logan Award for Service to Survivorship. In 2014,
CBCRP was recognized by Money Magazine for leadership in research quality, accountability,
and integrity. The magazine identified CBCRP as one of five charitable organizations that are
making the biggest impact against breast cancer.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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What is Covered in this Report
This report has been prepared by the University of California, pursuant to California Health and
Safety Code, Section 104145 and the Revenue and Taxation Code Sections 18791-18796 and
30461-30462.1. The following required reporting elements will be addressed in this report:
1. The number and dollar amounts of research grants, including the amount allocated
to indirect costs. From July 1, 2010, through June 30, 2015, CBCRP provided 124
single- and multiple-year research projects, totaling nearly $52 million in direct and
indirect costs, funded in the form of 166 grants at 46 California institutions.
2. The institutions and campuses receiving grant awards. All funded grants with
recipient institutions are listed in Section IV: Funding Highlights.
3. The subject of research projects. All of the projects funded by CBCRP involve key
questions in one or more of the following research areas:
Community Impact on Breast Cancer (sociocultural behavioral studies and health
policy);
Breast Cancer Cause and Prevention;
Earlier Detection, Diagnosis and Treatment of Breast Cancer; and
Basic Biology of the Breast (normal breast biology and breast cancer
pathogenesis).
4. The relationship between federal and state funding for breast cancer research.
CBCRP takes several steps to avoid duplication of funding at the individual research
project level and in the Program’s research priorities. CBCRP identifies and attempts to
fill important gaps in knowledge about breast cancer. At the start of each priority setting
process, CBCRP reviews priorities in light of changes in the research field, successes and
failures of previous funding initiatives, and the results of previous funding. Additionally,
as founding members of the International Cancer Research Partnership, CBCRP funding
complements, rather than duplicates, grants bestowed by other funding organizations.
CBCRP’s Breast Cancer Research Council sets the Program’s funding priorities, taking
into account:
Opinions from national breast cancer experts;
Opinions from California advocates and activists, healthcare providers, public
health practitioners, community leaders, biotechnology scientists, and academic
researchers;
Current literature on breast cancer and current gaps in knowledge;
Comparisons with portfolios and programmatic goals of other funding agencies;
and
In-house evaluations of the efficacy of CBCRP grant mechanisms and topic areas
in fulfilling program goals
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5. The relationship between each project and the overall strategy of the research
program. The following ten goals are used to set overall programmatic research
priorities and calls for applications:
California Specific: Fund research that utilizes resources particular to California
and/or addresses a breast cancer need that is specific, but not necessarily unique,
to the burden of breast cancer in California.
Capacity-building: Fund research that helps recruit, retain, and develop high
quality California-based investigators who engage in breast cancer research.
Collaboration: Fund research that uses multi-disciplinary approaches and helps
foster collaboration among California scientists, clinicians, advocates,
community members, patients, survivors, and others.
Disparities and Underserved: Fund research that addresses disparities,
inequalities, and/or underserved populations in California.
Innovation: Fund innovative research (e.g., new drugs, new strategies, new
paradigms, new technologies, new applications of tested strategies in new
populations and contexts).
Non-Duplicative: Fund research that complements, builds on, and/or feeds into,
but is not duplicative of other research programs.
Policy: Fund research and evaluation that will have policy implications for breast
cancer in California.
Public Health Outcomes: Fund research that will improve public health
outcomes (e.g., preventing breast cancer, identifying environmental links to
breast cancer, detection of breast cancer, effective treatments, and quality of life).
Responsive: Fund research that is responsive to the perceived breast cancer
research needs, opportunities, and expectations of CBCRP as identified by
scientists and the public in California.
Translation and Dissemination: Fund research that is on a critical path for
practical application and leads to more effective products, technologies,
interventions, or policies and their application and delivery to Californians.
The review of each individual grant application is also designed to ensure that the
research projects funded by CBCRP have both high scientific merit and programmatic
interest. Each individual application is evaluated by external scientific review committees
for specific aspects of scientific merit including, but not limited to, impact on breast
cancer, innovation, feasibility, and approach. All applications of sufficient scientific merit
undergo a programmatic review by our Breast Cancer Research Council for
responsiveness to program priorities, including whether it fits the goals of the award type,
integrates advocacy issues, and addresses an under-funded research field.
6. A summary of research findings including discussion of promising new areas.
Highlights of funded research that has concluded during this period are included in the
body of this report. Listed below are a few of the findings:
Toward an Ecological Model of Breast Cancer Causation and Prevention: In
the quest to identify the cause of breast cancer, scientists often investigate one
factor at a time—but it is becoming increasingly clear that many factors interact
with one another to contribute to the disease. It can be hard for decision makers,
scientists and the public to sort through the research to fully understand the causal
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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context of breast cancer. Through the New Paradigm of Breast Cancer Causation
and Prevention research initiative, Robert Hiatt at UCSF led a team in the
creation of a breast cancer causation model that reflects the complexity of these
interactions. The model was developed through a collaboration of scientists who
synthesized evidence from scientific literature to offer their expert understanding
of the relationships important to new cases of post-menopausal breast cancer
causation. This model is interactive, allowing decision makers, researchers and
members of the public to explore connections and develop a conceptual
framework for research (http://www.cbcrp.org/research-topics/causal-
model.html). This model has proved successful and compelling enough that a
second phase of research was funded.
Environmental Causes of Breast Cancer across Generations: The Three
Generations Study is a follow-up study of women whose mothers enrolled in the
Child Health and Development Studies between 1959 and 1967. The study looks
at causes of breast cancer and other diseases affecting women that may pass from
one generation to the next or be caused by things in the environment. Barbara
Cohn and her team at the Public Health Institute tested the idea that prenatal
exposure to environmental chemicals increases the risk of breast cancer by
evaluating 54 years of data from women. Cohn assessed data from 9,300 women
who had been tracked prior to birth and identified 118 women diagnosed with
breast cancer. For the first time researchers were able to show: 1) there is direct
evidence that daughters who had been exposed to significant levels of DDT
(dichlorodiphenyltrichloroethane) during pregnancy were four times as likely to
have had breast cancer as their counterparts who had been exposed to a smaller
quantity of the pesticide; and 2) that exposure to environmental toxins in utero
affect adult breast cancer risk. These findings were publicized in numerous
influential publications.
Making Chemical Testing Relevant to Breast Cancer: Through this initiative,
the City of Hope developed a screening test that can analyze 16 times as many
chemicals as conventional means. The test—called AroER tri-screen™—can
quickly analyze up to 1,536 compounds' effect on estrogen and aromatase, an
enzyme that converts androgen to estrogen. The research team, led by
Shiuan Chen, discovered that the antidepressant paroxetine (Paxil) acts as an
estrogen promoter. This is especially important because women are commonly
prescribed anti-depressants when they have been diagnosed with breast cancer.
Based on its excellent technical and biological performance characteristics,
AroER tri-screen assay has been selected by the US Environmental Protection
Agency for screening the Tox21 10K compound library for identification of
aromatase inhibitors-like Endocrine Disrupting Chemicals.
Cost-effectiveness Analysis to Inform BC Screening Policy: Over the last five
years, Every Woman Counts (EWC), a California breast cancer screening
program, faced challenging budget cutbacks and policy choices. Breast cancer
health programs for underserved women are faced with increasing need for
services and declining budgets. Making effective policy choices can have
significant impacts on how many women are served and how well they are served.
Carefully constructed computer modeling can be useful in projecting potential
outcomes of policy and budgetary choices. Joy Melnikow of UC Davis has
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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developed a computer interface to enable breast cancer policy makers, advocates,
and researchers to choose program parameters and receive immediate feedback on
the costs and outcomes of policy alternatives they are considering. This project is
aimed at creating a user-friendly tool that will help to integrate research evidence
into health policy making. Using this model, researchers were able to find that for
the EWC program, biennial screening mammography starting at age 50 years was
the most cost-effective strategy.
Light at Night and Breast Cancer Risk among California Teachers: There has
been convincing evidence that exposure to light at night (LAN) promotes
mammary carcinogenesis in rodents for some time; however, the role that light at
night plays in increasing human breast cancer risk has been less understood.
Peggy Reynolds at Cancer Prevention Institute of California analyzed data
from the California Teachers Study participants to determine that women living in
the areas with very high levels of outdoor LAN had about a 10 percent increased
risk of breast cancer compared to women who lived in areas with the lowest levels
of indoor LAN. Findings like these can have significant implications for people
who work night shifts or who live in urban areas.
Combating Breast Cancer with the Wellderly Immune Repertoire: What can
healthy, older adults teach us about breast cancer? Brunhilde Felding of the
Scripps Research Institute took a unique approach to explore this question by
examining blood samples of the “wellderly” —healthy adults over 80 years of
age—to understand the reasons for their long life. By studying antibodies, she was
able to identify footprints, or memories of past victories against cancer,
specifically triple negative breast cancer, which currently lacks effective treatment
options. Understanding how the wellderly have naturally fought off the disease
provides important opportunities to developing effective therapies to treat this
aggressive form of breast cancer.
Stratifying DCIS Biopsies for Risk of Future Tumor Formation: Thea Tlsty
and her team at UCSF have discovered a way to predict whether women with
ductal carcinoma in situ (DCIS) —the most common form of non-invasive breast
cancer—are at risk for developing more invasive tumors in later years.
Historically, women diagnosed with DCIS have often received aggressive
treatments such as chemotherapy, radiation or mastectomy, though it is becoming
increasingly clear that this may not be necessary for everyone. Not all cases of
DCIS develop into life-threatening breast cancer. However, without a reliable
screen for the risk each person’s DCIS poses, doctors and patients have often
opted for interventions. It is hoped that these findings will give women with DCIS
the opportunity to be more selective about their treatment. Findings were
published in the Journal of the National Cancer Institute in May 2010, Cancer
Prevention Research in May 2010, Cancer Prevention Research in February 2010
and Breast Cancer Research in December 2009.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Fiscal Overview
The program operates below a 5 percent administrative cap. For funding allocations distributed
between July 1, 2010 and June 30, 2015, CBCRP devoted 4 percent to administration, 10 percent
to program activities and 86 percent to grants. Tables 3 and 4 provide specific details of how
moneys have been spent from funds allocated in the past five years.
Table 3: Grants and Initiatives Funded
Fiscal Year 2010–2011 2011–2012 2012–2013 2013–2014 2014–2015
5-Year
Summary
CYCLE
17 18 19 20 21
CORE GRANTS
AWARDED
20 projects 19 projects 17 projects 14 projects 2 projects 72 projects
Direct Cost Total
$3,965,367 $4,713,936 $3,361,980 $3,249,696 $36,299 $15,327,278
Indirect Cost Total
$1,909,380 $608,016 $1,266,915 $1,139,795 $0 $4,924,106
Pending Grants
(funding decisions
made before
7/1/2015)
$5,131,717
Total Grant Costs
$5,874,747 $5,321,952 $4,628,895 $4,389,491 $36,299 $20,251,384
PROGRAM
INITIATIVES
Special Research
Initiatives
Awarded/
Contracts
6 projects 6 projects
Direct Cost Total
$4,230,972 $4,230,972
Indirect Cost Total
$1,598,279 $1,598,279
Total Grant Costs
$5,829,251 $5,829,251
California Breast
Cancer Prevention
Initiatives
Awarded/
Contracts
1 project 1 project 5 projects 7 projects
Direct Cost Total
$717,640 $791,936 $4,027,070 $5,536,646
Indirect Cost Total
$116,305 $67,495 1,268,479 $1,452,279
Total Grant Costs
$833,945 $859,431 $5,295,549 $6,988,925
Pending Initiative
Grants (RFPs
released in 2015)
$11,091,500
TOTAL GRANT
FUNDS
Disbursed* $11,703,998 $5,321,952 $5,462,840 $5,248,922 $5,331,848 $33,069,560
*Totals do not include grants that were funded in 2010 from fiscal allocations made prior to July 1, 2010.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Table 4: Administrative and Program Expenditures
Fiscal Year 2010–2011 2011–2012 2012–2013 2013–2014 2014–2015
5-Year
Summary
CYCLE
17 18 19 20 21
Administration
$405,658 $374,900 $357,741 $517,552 $472,005 $2,127,856
% Total Funds
4.1% 3.6% 3.4% 4.4% 4.2% 4.0%
Research Support
and Evaluation
$950,748 $1,139,738 $1,630,129 $1,172,162 $1,222,708 $5,757,744
% Total Funds
10.7% 10.8% 12.1% 9.9% 10.8% 10.1%
Summary
This report gives an in-depth description of the many ways that CBCRP has advanced the field of
breast cancer research. With more than 20 years of experience, its work has empowered
community groups to engage in research that directly affects their lives, helped identify several
specific and controllable factors that increase risk for breast cancer (allowing for meaningful
interventions to protect women), and advanced understanding of how breast cancer develops and
new ways to detect the disease. The work is far from over, but this report provides important
insight into just how much has been accomplished.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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I. About the California Breast Cancer Research Program
Nearly 200,000 California women are living with breast cancer. Breast cancer can affect women
of all ages and races, and approximately 80 percent of women who develop breast cancer have no
family history of the disease. In California alone, more than 4,200 women die of breast cancer
every year—that's more than 11 women every day who die from the disease. See Figure 1 and 2
for details.
The California Breast Cancer Research Program’s (CBCRP) mission is to prevent and eliminate
breast cancer by leading innovation in research, communication, and collaboration in the
California scientific and lay communities. Established by the California Legislature with passage
of the 1993 Breast Cancer Act, CBCRP was created because California breast cancer activists
were impatient with the slow pace of progress against the disease. Together with scientists,
clinicians, state legislators, and University of California officials, they wrote legislation that
created a program to fund cutting-edge breast cancer research in California. The California Breast
Cancer Act increased the tobacco tax by 2¢ per pack, with 45 percent of the revenue going to
CBCRP.
Since then, CBCRP has made California a leader among states for breast cancer research. The
Program is the largest, most stable state-funded breast cancer research effort in the nation. Since
1993, CBCRP has awarded over 1000 grants to 108 scientific institutions and community entities,
totaling more than $260 million for research in California to prevent, treat, and cure breast cancer.
From July 1, 2010, through June 30, 2015, CBCRP awarded nearly $52 million for 124 single-
and multiple-year research projects at 46 California institutions. Ninety-five percent of our
revenue goes directly to funding research and education efforts.
CBCRP is administered as a public service by the University of California. CBCRP's staff
manages the solicitation, review, award, and oversight of grants and dissemination of research
results, working under the administration of the University of California, Office of the President,
in Oakland. By being housed in the Office of the President Research Grants Program Office,
CBCRP shares grant making and financial management resources and personnel with the
Tobacco-Related Disease Research Program, California HIV/AIDS Research Program and the
UC Research Initiatives programs. This allows CBCRP to leverage administrative support in the
form of financial, grant management, and legal services. It is part of the reason that CBCRP is
able to keep its administrative costs low.
Funding for CBCRP comes primarily from a state tax on tobacco, a steadily declining source of
revenue due to decreasing consumption of tobacco products. This funding is supplemented with
taxpayer donations contributed through state income tax forms and by private contributions.
Ninety-five percent of our revenue goes directly to funding research and education efforts.
Administration is under 5 percent and other activities (programmatic, educational) are under 10
percent. See Table 5 for an overview of income and administrative and program expenditures.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Table 5: Income and Administrative and Program Expenditures
Fiscal Year 2010–2011 2011–2012 2012–2013 2013–2014 2014–2015
5-Year
Summary
CYCLE
17 18 19 20 21
TOTAL INCOME
$9,879,319 $10,554,286 $10,565,768 $11,788,207 $11,315,915 $54,103,495
Administration
$405,658 $374,900 $357,741 $517,552 $472,005 $2,127,856
% Total Funds
4.1% 3.6% 3.4% 4.4% 4.2% 4.0%
Research Support
and Evaluation
$950,748 $1,139,738 $1,630,129 $1,172,162 $1,222,708 $5,757,744
% Total Funds
10.7% 10.8% 12.1% 9.9% 10.8% 10.1%
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Figure 1: CA Breast Cancer Incidence Rates, All Races (Including Hispanic), Female,
All Ages, 2008–2012
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Figure 2: CA Breast Cancer Age-adjusted Death Rates, All Races (Including Hispanic),
Female, 2008–2012
Funding Philosophy
During its 22-year history, CBCRP has established a track record for funding innovative research
ideas that have led to successes. These successes include a CBCRP-funded researcher winning a
Nobel Prize, investing in capacity to build research collaborations between members of
California's diverse communities and scientific researchers to conduct research, informing
national policy, and serving as a model for other funding agencies.
While CBCRP is not as large as some of the national breast cancer research funders, its impact is
significant in California and around the world. As Janet Napolitano, president of the University of
California, has said: “As California goes, so often goes the world. It's also true that as the
University of California goes, so goes California… We teach for California, and research for the
world….” CBCRP is proud of the global impact it has had in promoting a breast cancer research
agenda that prioritizes the disease’s prevention more than any other funder in the world.
CBCRP remains committed to advancing cutting-edge research focused on the prevention of
breast cancer. CBCRP plans to be an innovator in breast cancer research until breast cancer is a
thing of the past.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Commitment to Incorporating Diverse Input
From the beginning, CBCRP has been structured to welcome and encourage input from a broad
range of constituents, including community members. Breast cancer advocates, who sparked the
creation of the Program, continue to play a critical role in every aspect of CBCRP’s work, from
setting research priorities to recommending research projects for funding and getting out the word
about research results (see Figure 3). The Program's structure has inspired other research funding
agencies around the nation to follow CBCRP's example. Other agencies are now more likely to
include community advocates in the review of research proposals and to involve community
members in the design and conduct of research.
Any Californian concerned about breast cancer has opportunities to help set the strategic direction
of CBCRP’s work via several avenues of engagement and feedback:
Breast Cancer Research Council: CBCRP’s Breast Cancer Research Council (Research
Council) includes scientists, clinicians, representatives of industry and nonprofit health
organizations, and breast cancer advocates serving overlapping three-year terms. The
Research Council provides vision, sets research priorities, and makes decisions on how
CBCRP invests funds in research. The Research Council also conducts one of the two
reviews that every proposal must pass to receive funding. Research Council members
review research proposals for relevance to CBCRP’s goals, while teams of research
scientists and breast cancer advocates from outside California review all proposals for
scientific merit.
Advocate involvement: CBCRP requires that breast cancer or other appropriate
community advocates be actively involved in funded research. Grant applicants are
required to collaborate with advocates affiliated with an organization, regardless of the
specific topic of their research. Advocates from outside California participate in the peer
review of every application, and California-based advocates represent one-third of
CBCRP Research Council membership.
Community-engaged research: CBCRP funds the Community Research Collaboration
Awards, which support research conducted as an equal partnership between community
groups and scientists. Community members and researchers work together to identify the
research questions, conduct the study and disseminate the results. See Section IV:
Funding Highlights 2010–2015 for details.
Community input in strategic planning: CBCRP goes through regular planning
processes to guide funding strategies. CBCRP invites feedback from the broader
community into the planning process.
By bringing the research, advocacy, and treatment communities into closer collaboration, CBCRP
pushes the boundaries of research, mobilizing greater creativity and resources toward decreasing—
and ending—the suffering and death caused by breast cancer.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Figure 3: Involvement of Breast Cancer Advocates in CBCRP
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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II. CBCRP’s Strategy for Allocating Research Funds
As a Program committed to innovation and addressing unmet needs in the field of breast cancer
research, CBCRP Research Council and staff regularly evaluate breast cancer research gaps and
achievements and undertake strategic planning to ensure that CBCRP is stimulating meaningful
and unique research. See Appendix 1 and 2 for Research Council and staff lists, respectively.
To date, CBCRP has undergone three thorough strategic planning processes: in 2002, 2010 and
2015. Each planning process has both affirmed CBCRP’s investment and worked toward ongoing
evaluation and improvement. These processes shape CBCRP’s strategic approach and allow it to
ensure that research effectively progresses in all four areas that CBCRP was founded to address:
1. The Community Impact of Breast Cancer
2. Etiology and Prevention
3. Detection, Prognosis and Treatment
4. Biology of the Breast Cell
Planning allows CBCRP to identify areas where it is effective in supporting investigators to
advance the field of breast cancer research as well as determine research topics that are not being
sufficiently supported by other funding organizations. Additionally, the planning process allows
CBCRP to identify areas to reduce or eliminate funding if other funders are supporting them
sufficiently.
Each strategic planning process follows five major steps:
1. Review the CBCRP mission statement and reaffirm the program’s foundation of long-
term outcomes;
2. Review and revise the priority criteria (see Figure 4) and, if necessary, the data questions
that will be used to determine how well each criterion is being addressed by the funding
strategy;
3. Gather and analyze pertinent data as indicated by the priority criteria and data collection
questions;
4. Identify and make decisions on long-term (5 year) priorities through a data-driven, group
decision-making process; and
5. Incorporate priority decisions into CBCRP operational plans and award cycles.
The first evaluation and planning process in 2002 resulted in significant shifts in how CBCRP
prioritized funding. There were two pressing concerns that needed to be addressed:
Declining income into the future due to reduced cigarette purchases, which required in
part the identification of ways to have impact with fewer resources; and
Per stakeholder feedback, insufficient research dedicated to the causes and prevention of
breast cancer as well as disparities in mortality among different ethnic and racial groups –
at that time it was the smallest portion of CBCRP’s portfolio.
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Figure 4: CBCRP’s Funding Priority Criteria (listed alphabetically)
CBCRP uses the following criteria to determine which award types (described later in the
report) to offer for research funding. These criteria are set by the CBCRP Research Council.
While not all efforts funded by CBCRP will meet every one of these criteria, evaluation and
planning helps ensure that the complete body of work funded by CBCRP collectively
addresses these criteria.
California Specific: Fund research that utilizes resources particular to California
and/or addresses a breast cancer need that is specific but not necessarily unique to the
burden of breast cancer in California.
Capacity-building: Fund research that helps recruit, retain, and develop high quality
California-based investigators who engage in research that advances CBCRP
initiatives.
Collaboration: Fund research that uses multi-disciplinary approaches and helps
foster collaboration among California scientists, clinicians, advocates, community
members, patients, survivors, and others.
Disparities and Underserved: fund research that addresses disparities, inequalities,
and/or underserved populations in California.
Innovation: Fund innovative research (e.g., new drugs, new strategies, new
paradigms, new technologies, new applications of tested strategies in new
populations and contexts).
Non-Duplicative: Fund research that complements, builds on, and/or feeds into, but
is not duplicative of other research programs.
Policy: Fund research and evaluation that will have policy implications for breast
cancer in California.
Public Health Outcomes: Fund research that will improve public health outcomes
(e.g., preventing breast cancer, identifying environmental links to breast cancer,
detection of breast cancer, effective treatments, and quality of life) focusing on
population interventions.
Responsive: Fund research that is responsive to the perceived breast cancer research
needs, opportunities, and expectations of CBCRP as identified by scientists and the
public in California.
Translation and Dissemination: Fund research that is on a critical path for practical
application and leads to more effective products, technologies, interventions, or
policies and their application and delivery to Californians.
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To address these concerns, CBCRP decided to reduce funds for investigator-initiated awards by
30 percent in order to establish its program-initiated funding stream, called the Special Research
Initiatives (SRIs). SRIs addressed two research areas:
1. The effects of the environment on the development of breast cancer; and
2. Disparities in breast cancer, i.e., the reasons why some groups of women are more likely
to get breast cancer or to die from the disease.
The research funded through SRIs was completed during the period this report covers and is
detailed below in Section IV: Funding Highlights 2010–2015.
The second evaluation and planning process in 2010 confirmed the effectiveness of program-
initiated awards and increased the commitment from 30 to 50 percent of the available funding.
The most recent planning process in 2015 affirmed the 2010 strategy and CBCRP’s commitment
to allocating 50 percent of its funding to program-initiated research.
An overview of the new strategic directions for both investigator-initiated and program-initiated
research is described below.
Investigator-initiated Research
Investigator-initiated research funds are awarded through a range of award types. In the 2002,
2010 and 2015 planning processes, CBCRP evaluated the effectiveness of each award type.
Based on this analysis, some award types were modified to maximize their ability to address
priority criteria, while others were discontinued. For example, in the 2010 planning process,
CBCRP decided to eliminate career development awards (postdoctoral fellowships and
dissertation support) and IDEA renewal awards (which allow researchers to expand on data
developed in their initial IDEA award, described below) because they could be funded through
other agencies.
CBCRP solicits applications from researchers (and in the case of Community Research
Collaboration awards (CRC), community-scientist member teams) based in California for five
different types of investigator-initiator research. Below is a description of the types of
investigator-initiated funding mechanisms CBCRP used during this reporting period and the
rationale for ongoing support. Actual funding outcomes are detailed in Section IV: Funding
Highlights 2010–2015.
Community Research Collaborations: CBCRP allocates $2 million annually to support
community-based participatory research (CBPR) that enables community groups and
academically-trained scientists to jointly answer important breast cancer questions. It
found that CRC awards effectively help address underserved populations and address
issues that are often missing in research. This is likely due to the involvement of
communities in the research and a requirement for projects to address issues important to
them.
Innovative, Developmental, and Exploratory Awards (IDEAs): The IDEA grants are
used to fund the beginning stages of novel projects (e.g., new drugs, new strategies, new
paradigms, new technologies, new applications of tested strategies in new populations
and contexts), establish new collaborations, develop new technologies, or adapt
technologies from other fields to breast cancer research. Applicants must show how their
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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project is part of a longer-term research process that will lead to practical applications,
such as breast cancer diagnosis, treatment, or prevention. Through June 2015, the
Program had invested over $37 million for 228 IDEAs, which comprises almost one-
quarter of all grants funded to date and 16 percent of all funds invested. In a survey
conducted of IDEA grantees in 2013, 10 of 13 responding investigators produced
publications from their funded studies. Additionally, IDEA awards create opportunities
for newer researchers by focusing the peer review on the innovation of the idea rather
than the track record of the investigator, which gives junior investigators and established
researchers an equal playing field. In the 2015 strategic planning process, CBCRP
committed to maintain funding for IDEAs at $100,000 to $150,000 (animal and human
participants) with an18-month duration. Looking ahead, IDEA award recipients will be
required to describe the public health outcomes of their research.
Translational Research Awards: These awards fund research that is on a critical path
for practical application and leads to more effective products, technologies, interventions,
or policies and their application and delivery to Californians. This research takes basic
science findings and applies them quickly toward treatment, diagnosis, prevention or
another application that can directly impact breast cancer, either in a medical clinic
setting or through a public health measure. Areas of focus include:
o Prevention, detection, diagnosis or treatment of breast cancer;
o Improved quality of life for survivors;
o Reduction in the social burden caused by the disease in California; and
o Advances in medical practices, health systems changes, health policies or
environmental modifications.
To ensure that these studies are truly translational, CBCRP requires applicants to present
a critical path that maps how the project fits along a defined research continuum leading
to practical applications. To date, the Program has funded 12 Translational awards. Eight
are complete and two more will be completed in the coming year. Preliminary assessment
of completed Translational awards indicates the funding mechanism is meeting many of
the expected outcomes. The most promising area of translational research supported by
CBCRP has been projects that seek to stratify and accurately predict outcomes for
women diagnosed with ductal carcinoma in situ (DCIS). Moving forward, a greater
emphasis will be placed on describing the public health outcomes of these awards.
Conferences: CBCRP conference awards are designed to support events that bring
together people with different perspectives who do not usually meet and exchange views
with the expectation that the experience will lead to new research projects and new
collaborations. CBCRP funds up to $50,000 per year in conferences/events that address
issues related to breast cancer and that do one or more of the following:
o Highlight resources particular to California,
o Encourage new collaborations,
o Recruit high quality researchers to the field,
o Examine and create solutions for disparities/inequities,
o Inspire paradigm-shifting research,
o Inform policy,
o Promote translational and/or outcome driven research, or
o Create tools for educating members of the public about breast cancer.
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Program-initiated Research
CBCRP began distributing program-initiated awards in 2009 (through SRIs). Based on the
success of SRIs we re-confirmed this strategic direction in the 2010 planning process and
established the California Breast Cancer Prevention Initiative (CBCPI). The planning process we
just completed in early 2015 further demonstrated the success of issuing program-initiated funds,
and led to the establishment of a third round of program-initiated research. These are described in
further detail below.
California Breast Cancer Prevention Initiative (2010–2015)
Evaluation of SRIs pointed to both the success of SRIs and two ways to strengthen CBCRP’s
program-initiated research:
Increasing available funds from 30 to 50 percent would allow for greater impact; and
Expanding focus to include breast cancer prevention, specifically the following areas:
o Identifying and eliminating environmental causes of breast cancer;
o Identifying and eliminating disparities/inequities in the burden of breast cancer in
California;
o Population-level interventions (including policy research) on known or suspected
breast cancer risk factors and protective measures; and
o Targeted interventions for high-risk individuals, including new methods for
identifying or assessing risk.
Additionally, the Research Council decided that the development of CBCPI should be
coordinated by an external researcher. After a competitive application process, Tracey Woodruff,
Professor and Director of the UCSF Program on Reproductive Health and the Environment
(PRHE) was chosen to lead the effort.
The planning process took four years to complete (2010–2014) and was informed by a diverse set
of stakeholders and experts, including CBCRP staff and the Research Council, PRHE staff, an
eight-person steering committee that contributed heavily to defining the research concepts and
providing significant input into their development, as well as 15 strategy advisors who were
consulted based on their relevant expertise. Names of Strategy Advisors and Steering Committee
members are available in Appendix 3.
The process was guided by focused literature reviews and input on prioritized research questions
from a broad audience, including Strategy Advisors, stakeholders and Steering Committee
members. Once topics had been chosen, PRHE and CBCRP staff and consultants worked with
Strategic Advisors and Steering Committee members to develop full concept proposals
(descriptions of research topics with background, rationale and funds available). Once the
Steering Committee approved the concept proposals, they were submitted to the Research
Council for approval. The CBCPI process is documented in the July 15, 2015, issue of
Reproductive Toxicology in an article titled “California Breast Cancer Prevention Initiatives:
Setting a research agenda for prevention.”
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In total, 15 concept proposals with a combined allocation of $24 million were approved by the
Research Council to be developed into competitive Requests for Submissions offered through
2017. See Table 6 for details of concept proposals approved through CBCPI.
Table 6: Approved Concept Proposals Developed through CBCPI (numbers in parenthesis
indicate maximum potential project numbers and allocation for the topic)
Research Area
Concept Proposal Topics
Identify and eliminate
environmental causes of
breast cancer.
1. Examining Hormone Concentrations of Interest to Breast Cancer
Risk in California’s Beef (1 project, $310,200)
2. Testing for Potential Breast Toxins in California’s Drinking
Water (1 project, $846,000)
3. Women Firefighters Biomonitoring Collaborative Study (1 project,
$833,945)*
4. Occupational Chemical Exposures in California and Breast Cancer
Risk (1 project, $1,551,000)
5. Chemical Safety Testing to Reduce Breast Cancer Risk (5 projects,
$5,436,671)*
6. New Paradigm Model for Breast Cancer: Phase II (1 project,
$859,431)*
Identify and eliminate
disparities/inequities in the
burden of breast cancer in
California.
7. Early Life Adversity and Risk of Breast Cancer (1 project,
$846,000)
8. Multigenerational Study on Behavioral, Biological, Social and
Environmental Factors Influencing Breast Cancer Risk in
California’s Immigrants (1 project, $3,384,000)
9. Animal Models for Concurrent Effects of Environment and Stress
Factors on Mammary Cancer (2 projects, $1,762,500)
10. Community-Driven Studies of Racial/Ethnic Disparities in
Consumer Product Availability, Access, and Use (2 projects,
$846,000)
Population-level
interventions (including
policy research) on known
or suspected breast cancer
risk factors and protective
measures.
11. The Impact of Chemical Policy to Reduce or Eliminate Exposures
Linked to Breast Cancer (4 projects; $1,692,000)
12. California's Comprehensive Breast Cancer Primary Prevention Plan
(1 project, $423,000)
13. Preventing Developmental Exposure to Ionizing Radiation from
Medical Imaging (3 pilots, $634,500) – (full funding of one full-
scale project – $4,230,000 depending on outcome of pilots and if
funding is available)
Targeted interventions for
high-risk individuals,
including new methods for
identifying or assessing risk.
14. Improve Breast Cancer Risk Assessment to Identify High-Risk
Individuals (4 projects, $3,384,000)
15. Identify Novel Biological Markers of Breast Cancer Risk Related to
Environmental Chemical Exposures (3 projects, $4,230,000)
* Indicates that funds have already been distributed for these research topics.
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Program Initiative 3 (PI3) (2016–2022)
The planning process completed in March 2015 re-confirmed CBCRP’s commitment to allocate
50 percent of its funding to program-initiated research. The research areas of priority are
consistent with CBCPI, though with slight revisions to include:
Identification and elimination of environmental contributors to breast cancer,
Identification and elimination of fundamental causes of health disparities with a focus on
breast cancer in California, and
Development and testing of population-level interventions intended to prevent breast
cancer.
The multi-year planning process will be directed by program staff with input from a steering
committee, national experts, a community advisory board and CBCRP’s Research Council.
CBCRP’s Overall Portfolio
The combination of program-initiated and investigator-initiated awards results in unique, high
impact research that advances understanding in basic breast cancer biology, possible prevention
interventions and the social and human impact of the disease. Table 7 gives an overview of the
total annual allocations of funding distributed by CBCRP by award type.
Table 7: CBCRP Annual Allocations by Funding Mechanisms
Award Type
Annual
Allocation
Initiator Funding Focus
Community
Research
Collaboration
Awards
Approx.
$2 million
Investigator
initiated
Supports community-scientific
partnerships in conducting research.
Translational
Research Awards
Approx.
$2 million
shared
between
mechanisms
Investigator
initiated
Supports practical applications of
research, such as clinical applications,
policy, support for survivors, etc.
Innovative,
Developmental &
Exploratory Awards
Investigator
initiated
Supports challenging existing paradigms,
represents a new direction for the
Principal Investigator and encourages
innovation by the incorporation of
techniques and approaches not yet well
represented in mainstream breast cancer
research.
Conference Awards Approx.
$50,000
Investigator
initiated
Supports conferences that further the field
of breast cancer prevention and care.
California Breast
Cancer Prevention
Initiative Awards
Approx.
$4 million
Program
Initiated
Supports research focused on priorities set
by a panel of experts to move the field of
breast cancer prevention forward.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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III. Relationship between Federal and State Funding for Breast Cancer Research
CBCRP is distinct from research programs funded by the federal government in both the sources
of funding and in the types of research funded.
CBCRP’s Source of Funding: Unique Among the Nation’s Breast Cancer Research
Agencies
The primary source of funding for CBCRP is a 45 percent share of revenue from a 2¢ State tax on
cigarettes. This source of funding is unique among agencies that fund breast cancer research
across the nation. See Table 8 for a description of CBCRP income between July 1, 2010 and June
30, 2015.
Table 8: CBCRP Income, 2010–2015
Fiscal Year 2010–2011 2011–2012 2012–2013 2013–2014 2014–2015
5-Year
Summary
Breast Cancer
Research Account
(007)
ALLOCATION
$8,303,000 $9,959,000 $9,959,000 $11,058,000 $10,563,000 $49,842,000
California Breast
Cancer Research
Fund (0945)
ALLOCATION
$434,000 $484,000 $484,000 $618,000 $421,000 $2,441,000
EXTERNAL
FUNDING*
$1,002,862 $10,000 $216,000 $1,228,862
PRIVATE
DONATIONS
$139,457 $111,286 $112,768 $112,207 $115,915 $591,633
TOTAL FUNDS
$9,879,319 $10,554,286 $10,565,768 $11,788,207 $11,315,915 $54,103,495
* 2010–2011, National Institute of Environmental Health Sciences (NIEHS) grant 1RC4ES019826-01 and
Avon Foundation for Women grant; 2012–2013, NIEHS and National Cancer Institute Conference
Award 1 R13 ES022921-01; 2014–2015, NIH grant 1R25CA188482-01
In contrast, funding for breast cancer research at other programs in the U.S. comes from a variety
of different sources:
Federal Agencies (National Institutes of Health, Department of Defense) receive funding
through Congress from the national budget and from the public’s voluntary purchase of
more expensive postage stamps;
National Voluntary Health Organizations (such as the American Cancer Society,
Komen Foundation, Breast Cancer Research Foundation, Avon Foundation for Women)
receive funding through charitable contributions from individuals, corporations, and
foundations;
Regional Nonprofit Organizations (such as the Entertainment Industry Foundation, The
Wellness Foundation) also receive funding through charitable contributions; and
State Agencies (such as the New Jersey Breast Cancer Research Fund, Illinois Ticket for
the Cure State Lottery, and the Cancer Prevention and Research Institute of Texas, the
latter of which includes breast cancer) receive funding from state general funds, auto
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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license fees, lottery ticket sales and voluntary donations on individual state income tax
returns.
The California Breast Cancer Research Program’s primary source of funds, a State cigarette tax,
is declining due to reductions in smoking. Measures were proposed in the California State
Legislature that would have directly or indirectly decreased funding for CBCRP. Similar
measures may be proposed, and may pass, in the future. In order to maintain funding, CBCRP has
therefore turned to additional funding sources.
CBCRP also receives funding from the income tax checkoff program, which allows individuals to
make voluntary donations on state income tax returns. This was a result of legislation passed by
the California State Legislature that authorized donations for five years. In 2007, AB28, authored
by Assembly Member Jared Huffman, became law, providing individuals the opportunity to make
donations to CBCRP via voluntary tax contributions through 2012. In 2012, Senate Bill 1359,
sponsored by State Senator Joe Simitian, extended the voluntary contribution check-offs on state
tax forms for the California Breast Cancer Research Fund (CBCRF) and the California Cancer
Research Fund for five years. Without SB 1359, these popular check-offs would have expired on
January 1, 2013. The longevity of the CBCRF does have a drawback. The minimum total
contributions required for the fund to remain on the tax form increases every year and by 2013
the CBCRF had the largest minimum requirement of all of the funds on the form.
Assemblymember Nancy Skinner introduced A.B. 1286, which amended Section 18796 of the
Revenue and Taxation Code to hold the minimum contribution requirement at the 2013 level for
two years.
To increase these sources of revenue, CBCRP conducts a public outreach and fundraising effort,
the Community Partners Program. This effort, begun in 2002, has led to an increase in donations
to CBCRP from individuals, businesses, and foundations. CBCRP’s Community Partners
Program is discussed more fully in the Section VI: Activities to Increase Funding for Breast
Cancer Research and Awareness of Breast Cancer Research. See Figure 5 for an overview of
CBCRP’s sources of revenue since the program’s inception.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Figure 5: CBCRP Funding Sources, 1993–2015
CBCRP Funding Complements Federal Efforts
CBCRP has a deep commitment to using the funds provided by the State of California in the most
efficient and cost-effective manner, and to adhering to the Program’s mandate as defined by the
California Legislature. One of CBCRP’s mandates is to “fund innovative and creative research,
with a special emphasis on research that complements, rather than duplicates, the research funded
by the federal government.” CBCRP fulfills this mandate in four ways:
1. By funding breast cancer research areas that could have a major impact on breast
cancer—including leading to prevention and cure—that are not getting sufficient
attention from the federal government;
2. By having expert reviewers from across the U.S. review grant applications for their
innovation and impact;
Before funding a grant application, reviewing it for overlap with current and pending
funding from other agencies; and
3. By taking leadership in reducing duplication in state, federal, and international breast
cancer research funding
These four ways of assuring that CBCRP-funded research does not duplicate federally-funded
research are each discussed in more detail below.
$7,500,000
$9,500,000
$11,500,000
$13,500,000
$15,500,000
$17,500,000
$19,500,000
$21,500,000
1993‐1995
1995‐1996
1996‐1997
1997‐1998
1998‐1999
1999‐2000
2000‐2001
2001‐2002
2002‐2003
2003‐2004
2004‐2005
2005‐2006
2006‐2007
2007‐2008
2008‐2009
2009‐2010
2010‐2011
2011‐2012
2012‐2013
2013‐2014
2014‐2015
CIGARETTETAX TAXCHECKOFF EXTERNALFUNDING PRIVATEDONATIONS
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Funding Research Gaps
The federal government’s method for funding research has resulted in some promising areas of
breast cancer research being under-funded. The federal government funds most health-related
research through the National Institutes of Health (NIH). Most research proposals submitted to
the NIH address scientific questions in which the investigators have theoretical and empirical
interest, even though there may be no immediate connection to particular diseases. This is the
“plant many seeds” approach that has born many truly innovative and groundbreaking
discoveries.
CBCRP employs a different and complementary approach, which is to fund scientifically
meritorious research that is focused on speeding progress in preventing and curing breast cancer
specifically. CBCRP’s Research Council sets the Program’s funding priorities, taking into
account:
Opinions from national breast cancer experts;
Opinions from California advocates and activists, healthcare providers, public health
practitioners, community leaders, biotechnology scientists, and academic researchers; and
Current literature on breast cancer and current gaps in knowledge
The Research Council attempts to identify important research questions that could lead to
breakthroughs and that have not received sufficient attention. CBCRP is conducting program-
initiated research to fill a significant gap in breast cancer research. CBCRP is addressing three
overlapping research questions that California is uniquely positioned to address through program
initiated research. They are the environment's role in breast cancer, the reasons for the unequal
burden of breast cancer among various populations of women, and breast cancer prevention.
More information on these projects is found in Section II: CBCRP’s Strategy for Allocating
Research Funds.
Choosing Research for Innovation and Impact
To allow the Program’s expert reviewers to differentiate applications that are especially
innovative and that have the most potential impact on breast cancer, CBCRP created its own
scoring system. The scoring system has improved the Program’s ability to choose the most
innovative and creative research for funding.
In the past, the majority of research funding agencies, including the NIH, scored funding
proposals with a single score based solely on scientific merit. With this method, an application
with an excellent research plan to test an idea that was not particularly novel could receive the
same score as an application with a flawed research plan to test a novel idea. CBCRP’s scoring
method, based on the recommendations of an NIH Advisory Committee, can distinguish these
two applications. CBCRP scores applications separately for innovation, impact, approach and any
qualities that are specific to the award type. The separate scores are then used to inform funding
decisions. For example, under CBCRP’s “impact” criterion, researchers are required to describe
the steps necessary to turn their research into products, technologies, interventions, or policies
that will have an impact on breast cancer, and describe where their study fits into this critical
path. Since CBCRP developed its pioneering scoring system, the NIH has also abandoned the
single scientific merit score and developed a system that rates specific application qualities such
as innovation and significance.
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Reviewing Grant Proposals for Overlap with Federal Funding
As a final step to ensure that CBCRP-funded research doesn’t duplicate federally-funded
research, breast cancer science experts in other states and CBCRP program officers review all
grants recommended for funding for overlap with current and pending federal grants. If overlap
with federal funding is found, the overlapping grant (or portion of the grant) is not funded.
Taking Leadership to Reduce Duplication in Federal, State, and International Funding
CBCRP is part of an international effort to reduce duplication in cancer research. This effort, the
International Cancer Research Partnership (ICRP), includes more than $50 billion in cancer
research funding distributed by over 100 government and charitable research funding agencies in
the U.S., United Kingdom, Canada, the Netherlands, Australia and Japan. The organizations that
make up the ICRP are working to speed progress by increasing communication and avoiding
duplication among agencies that fund cancer research.
One way ICRP pursues these goals is through a research classification system to encourage
agencies to report their funding in an accessible and meaningful way. The ICRP web site
(https://www.icrpartnership.org/) includes research abstracts from more than 75,000 current and
past research projects totaling more than $50 billion in research. The online database is
searchable by cancer type, scientific area, funding organization, and other criteria. The web site
allows scientists to identify possible collaborators and plan their research based on current
research, as well as facilitate dialogue among cancer researchers. Access to information about
ongoing research also aids research-funding organizations in strategic planning. In addition, the
web site is a useful tool for other groups. Policy makers may use the database during the
formulation of new health care and service delivery policies. Healthcare professionals, patients,
survivors, and advocates may review the current status of funded research. CBCRP investigators
are required to use the database to describe how their proposed project is distinct from the
research being funded through all of these organizations.
ICRP has also taken international coordination to a higher level. In addition to an updated report
on the overall cancer research funding trends in the U.S, U.K., Canada, France and the
Netherlands, the partnership has published evaluations of international funding trends on topics
that include metastatic breast cancer, environment and breast cancer, as well as operational best
practices https://www.icrpartnership.org/publications.cfm. ICRP partners are actively exploring
additional opportunities to analyze research outcomes, identify prospects for collaboration and
refine best operational practices across funding agencies. CBCRP requires that Principal
Investigators consult ICRP’s database and describe how their proposals are distinct from work
that is already funded to ensure that their proposals are truly breaking new ground.
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IV. Funding and Research Highlights, 2010–2015
CBCRP is recognized as an innovative funder that addresses gaps in the field. CBCRP prioritizes
funding in areas that many other breast cancer research funders either ignore or under-fund. For
example, the report, Breast Cancer and the Environment: Prioritizing Prevention, released in
2013 by the Interagency Breast Cancer and Environmental Research Coordinating Committee
(IBCERCC) said:
“Environmental justice continues to be a broad public health issue and has not been
integrated adequately into research, public health actions, or regulatory policies related to
breast cancer. Examples of effective projects and programs that seek to alleviate environ-
mental injustices, however, do exist….One such program is the CBCRP, which has made
considerable efforts to fund projects in areas where there are research gaps with regard to
environmental exposures, health disparities, prevention, and translation and community-
based projects.”
This vanguard approach to funding has allowed CBCRP’s grantees to raise awareness and
address important questions about what might be contributing to the high prevalence of breast
cancer in the U.S. Below are highlights of some of the 124 CBCRP-funded research projects that
were funded between 2010 and 2015, and an additional 75 that were funded before July 1, 2010
and were active during this period. As these examples show, CBCRP-funded research has
influenced chemical testing and policy development at the national level, improved understanding
of risk factors that contribute to breast cancer, identified reasons for differences in mortality rates
from breast cancer, improved treatment of metastatic breast cancer, and fostered the development
of more informative prognostic markers and ways to detect breast cancer.
As mentioned above, CBCRP has four priority areas for research that are funded through a range
of award types. Table 9 provides an overview of funding investments made in each of our four
priority areas. Table 10 provides an overview of funding made through different award types.
This section provides highlights of progress made through the SRIs, followed by sections giving
greater detail on funding by priority area.
Table 9: Research Funded from July 1, 2010 to June 30, 2015 by Priority Area
Priority Area
No. of
Projects
Funded Funding Dollars
% of Total
Funding
Etiology and Prevention 34 $25,581,118 49%
Detection, Prognosis, and Treatment 48 $12,874,384 25%
Community Impact of Breast Cancer 22 $9,975,783 19%
Biology of the Breast Cell 20 $3,402,556 7%
Grand Total 124 $51,833,841 100%
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Table 10: Research Funded from July 1, 2010 to June 30, 2015 by Award Type
Award Type
No. of
Projects
Funded Funding Dollars
% of Total
Funding
Program-initiated Research 18 $25,331,780 48.9%
IDEA 58 $11,786,430 22.7%
Translational Research Award 7 $5,980,828 11.5%
CRC Full Research Award 6 $4,303,077 8.3%
CRC Pilot Award 13 $2,534,455 4.6%
IDEA Competitive Renewal** 3 $984,463 1.9%
Postdoctoral Fellowship*** 5 $390,240 0.8%
Dissertation Award* 5 $333,271 0.6%
Joining Forces Conference Award 9 $189,297 0.4%
CRC Conference Award 1 $150,418 0.3%
Grand Total 124 $51,833,841 100%
* 2010 was the last year Dissertation Awards were given.
** 2011 was the last year IDEA Competitive Renewal Awards were given.
*** 2010 was the last year Postdoctoral Fellowships were given.
The Grant-making Process
For all grants, the Research Council selects research to fund based on recommendations from
expert committees who review all research applications for scientific merit. To minimize conflicts
of interest, review committees are composed of experts from outside California. These experts
include scientists highly knowledgeable about the topics of the applications they consider. Each
review committee also has advocate reviewers. These are women and men active in breast cancer
advocacy organizations, many of them also living with the disease. The committees use a review
process based on established practices at the federal government's National Institutes of Health,
but tailored to focus on assessing the qualities of the applications that are important to CBCRP
(e.g., impact on breast cancer, translation potential). CBCRP’s review process is one of a handful
of non-federal peer review systems certified by the National Cancer Institute to meet the NIH
standards of peer review and funding. The members of CBCRP's review committees for 2010–
2015 are listed in Appendix 4 of this annual report.
A. Funding and Research Detail: The Special Research Initiatives
Funding of research needs identified in SRIs has had a significant impact in moving the field of
breast cancer research forward. To date, SRIs-funded projects have met goals and produced
products or tools that can be used to better understand the connections between, and create
solutions to, breast cancer and the environment and the unequal burden of the disease.
Most researchers funded through SRIs have produced papers in peer-reviewed literature and
made presentations at scientific meetings based on their findings. Some have disseminated
findings to a lay audience. A few projects have been able to leverage additional funding, although
most of the SRIs projects have just recently closed or are about to close. Therefore, another
assessment of whether the SRIs projects are successful in leveraging additional funding will be
useful to implement in the next three years.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
32
SRIs’ impact has reached the national level. By investing in research into environmental links to
breast cancer, CBCRP has informed national efforts to grapple with the challenge of
understanding the contributions of the environment to breast cancer through analyses such as the
Institute of Medicine’s report, Breast Cancer and the Environment: A Life Course Approach
(commissioned by Susan G. Komen for the Cure) and the federal Interagency Breast Cancer &
Environmental Research Coordinating Committee of the National Institute of Environmental
Health Sciences Breast Cancer and the Environment: Prioritizing Prevention. CBCRP has also
provided leadership to the International Cancer Research Partnership (ICRP) to focus on
environmental links to cancer as well as to inform the agenda set by the American Cancer
Society.
With nine distinct initiatives, SRIs have proved to be effective investments in moving the field of
breast cancer research forward. In total, 27 grants totaling approximately $22 million were
awarded to address the environmental causes of breast cancer and the unequal burden of the
disease. Below are highlights of a selection of research projects CBCRP has funded through the
SRIs, followed by Table 11 and 12, which provide funding details of research funded through the
SRIs and CBCPIs that was concluded and in progress, respectively, between 2010 and 2015.
SRI Initiative 1: Understanding Racial and Ethnic Differences in Stage-Specific Breast Cancer
Survival
This project, known as The California Breast Cancer Survivorship Consortium (CBCSC) was
funded for $2,728,665. It was established as a collaborative effort between Beckman Research
Institute at City of Hope, Kaiser Research Institute, Cancer Prevention Institute of
California and University of Southern California that leverages data collected by six
California-based studies of over 12,000 breast cancer patients. The inclusion of breast cancer
cases from four racial/ethnic groups (African Americans, Asian Americans, Latinas, and non-
Latina Whites) offered a unique opportunity to study the individual, clinical, and contextual
factors as potential determinants of the observed survival disparities across racial/ethnic groups.
These studies explored the interaction of factors (tumor, individual, social, environmental,
genetic) which account for racial and ethnic differences in stage-specific survival among women
diagnosed with breast cancer in California and sought to identify whether these factors lead to
higher risks in certain racial and ethnic groups than in other groups. Overall, researchers found
meaningful differences in breast cancer survival based on racial/ethnic differences in some areas
and not in others. Highlights include:
Neighborhood Environment and Breast Cancer Survival
Differences were found between the impact of a person’s neighborhood on breast cancer
survival based on race. For example, non-Latina white women living in lower
socioeconomic status neighborhoods had a higher breast cancer mortality rate, whereas
African American women in similar neighborhoods had a lower mortality rate. No
neighborhood associations were found for Asian Americans. For Latinas, crowded
neighborhoods and multifamily housing increased risk for breast cancer mortality.
Findings were published in Cancer, Epidemiology, Biomarkers and Prevention in August
2015.
History of Recreational Physical Activity and Survival After Breast Cancer
Women who were physically active before a breast cancer diagnosis had an overall lower
risk of mortality and a significantly reduced risk of mortality from cardiovascular disease.
No association was observed for breast cancer mortality. These findings were true for all
Report from the California Breast Cancer Research Program to the California Legislature December 2015
33
races/ethnicities. Overall, the findings suggest that physical activity is beneficial for all
breast cancer survivors but does not impact their breast cancer. Findings were published
in American Journal of Epidemiology in June 2015.
Diabetes and Other Comorbidities in Breast Cancer Survival
Risk of breast cancer-specific mortality increased among breast cancer cases with a
history of diabetes. Risk patterns were similar across race/ethnicity (non-Latina White,
Latina, African American and Asian American), body size, menopausal status, and stage
at diagnosis. Findings were published in Cancer, Epidemiology, Biomarkers and
Prevention in February 2015.
Obesity and Mortality after Breast Cancer
The relationship between weight and breast cancer mortality differs by race. For example,
for non-Latina white women, being underweight increased risk of mortality in breast
cancer survivors, though only morbid obesity in Latinas was associated with higher risk
of mortality. No BMI-mortality associations were apparent in African Americans and
Asian Americans. This study was highlighted by the National Cancer Institute
Epidemiology and Genomics Research division as having great potential scientific and/or
public health impact. Findings were published in American Journal of Epidemiology in
January 2014.
These findings give us greater insight into what does and does not contribute to the higher rates of
mortality seen in some racial/ethnic groups.
SRI Initiative 2: Demographic Questions for California Breast Cancer Research
While there is a general understanding that breast cancer affects different groups of people in
different ways, the lack of a standard approach to data collection has slowed progress in
understanding breast cancer disparities and what can be done about them. CBCRP invested
$430,588 to speed progress in disparities research. To address this, Scarlett Gomez of Cancer
Prevention Institute of California and Nancy Krieger of Harvard University developed a
standardized survey instrument to collect data such as an individual’s race, ethnicity, birthplace,
migration history, language, literacy, numeracy, community characteristics, disability status,
socioeconomic status, gender, and sexual orientation. The survey has been translated into
Spanish, Chinese, Tagalog and Vietnamese. With standardized ways to measure demographic
information, scientists can more effectively compare their results across studies, leading to new
knowledge about how the unequal burden of breast cancer in the population can be eliminated.
SRI Initiative 3: Piloting an Integrated Approach to Understanding Behavioral, Social and
Physical Environment Factors and Breast Cancer among Immigrants
This initiative devoted $722,098 to explore links between immigrant status and breast cancer risk.
The award was given to Scarlett Gomez at Cancer Prevention Institute of California and
focused specifically on the increasing incidence rates of breast cancer among Asian Americans in
California by exploring risk factors like diet and weight gain, and new risk factors, including
infectious exposures, family and community contexts, and social stressors related to the
immigration process, being an immigrant, and discrimination. The study found that breast cancer
rates are high among young U.S.-born women, rapidly increasing among some U.S.-born and
foreign-born groups, and in some cases, are even higher among non-Hispanic white women in
California. Investigators are continuing this project and have set up a website for the Asian
Community Health Initiative (http://www.asianchi.org) to recruit for a three-year study that will
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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enroll 350 Asian American cases (those with breast cancer) from a previous breast cancer study
as well as 700 women without breast cancer.
SRI Initiative 4: Toward the Development of a California Chemicals Policy that Considers Breast
Cancer
A major challenge to investigating the relationship between chemical exposure and breast cancer
is a lack of toxicity information for tens of thousands of commonly used chemicals. To address
this gap, CBCRP funded Megan Schwarman at the UC Berkeley Center for Occupational and
Environmental Health and Sarah Janssen at Natural Resources Defense Council for
$$234,739 to lead the Breast Cancer and Chemicals Policy Project. Investigators convened a
panel of 20 scientists and policy experts to review the biological mechanisms associated with
breast cancer and propose a strategy for screening and identifying chemicals that could increase
the risk of the disease. The panel followed a unique “disease end point” model, which works
backward from a disease to identify the changes caused by chemicals that could serve as early
indicators of toxicity. This was the first time this approach had been used for any disease. In the
absence of full understanding of the health impacts of all the chemicals people may be exposed
to, it also suggested screening for categories of chemicals, such as endocrine disruptors, which
are chemicals that can interfere with the hormonal balance in the body and can lead to
developmental effects and cancer progression.
The process led to the publication of Pathways to Breast Cancer: A Case Study for Innovation in
Chemical Safety Evaluation, a report documenting the outcomes. Findings were published in
Environmental Health Perspectives in June 2015 and Reproductive Toxicology in July 2015.
SRI Initiative 5: Making Chemicals Testing Relevant to Breast Cancer
Lack of data on toxicity makes the task of evaluating the impacts of exposure to many chemicals
on breast cancer risk unachievable. There is a critical need for a toxicity testing strategy for breast
cancer that would identify biological mechanisms in breast cancer and development of new tests
to screen for activity in these mechanisms. This initiative funded five studies for a total of
$4,909,249 to develop new methods and models for identifying and testing chemicals for their
potential to contribute to breast cancer. These projects specifically focused on developing a
battery of assays for screening chemicals that incorporates the spectrum of mechanisms (tumor
promotion, tumor initiation, tumor enabling and developmental disruption) by which chemicals
are known or suspected to contribute to breast cancer. Research outcomes include:
Through this initiative City of Hope developed a screening test that can analyze 16 times
as many chemicals as conventional means. The test—called AroER tri-screen™—can
quickly analyze up to 1,536 compounds' effect on estrogen and aromatase, an enzyme
that converts androgen to estrogen. The research team, led by Shiuan Chen, discovered
that the antidepressant paroxetine (Paxil) acts as an estrogen promoter. This is especially
important because women are commonly prescribed anti-depressants when they have
been diagnosed with breast cancer. Based on the excellent technical and biological
performance characteristics of the AroER tri-screen assay, it has been selected for
screening in the Tox21 10K compound library for identification of aromatase inhibitors-
like EDCs. Findings were published in Toxicological Sciences in May 2014.
Researchers at the California Pacific Medical Center Research Institute (CMPC), led
by Shanaz Dairkee, found that low doses of curcumin, the main ingredient in the spice
turmeric, reverses many of the major changes caused by exposure to bisphenol-A, (BPA).
BPA exposure has long been thought to be a risk factor for developing breast cancer and
Report from the California Breast Cancer Research Program to the California Legislature December 2015
35
other developmental changes, including fetal abnormalities and possibly male cancers
such as prostate cancer. Researchers found that BPA exposure induces aberrant
expression of multiple checkpoints that regulate cell survival, proliferation and apoptosis,
and that such changes can be effectively ameliorated.
Other researchers at CPMC, led by William Goodson, also took noncancerous breast
cells from high-risk patients, grew them in a laboratory and found that once the cells were
exposed to BPA and methylparaben, they started behaving like cancer cells. The team
also found that when tamoxifen, which is used to treat breast cancer, was introduced in
the lab, the cells exposed to the two chemicals kept growing and did not die. Findings
were published in Carcinogenesis in March 2013.
Humans are exposed to a wide variety of structurally diverse chemicals, including
environmental and food contaminants. Many chemicals are endocrine disruptors,
producing adverse hormonal effects including increased development and progression of
breast cancer. Most breast cancers are initially hormone-dependent and require estrogens
for growth. Aromatase, the final enzyme in the synthesis of estrogen, is regulated in a
complex manner in breast cancer by at least four different gene promoters. Little is
known about the chemicals to which women are exposed that can affect the expression of
aromatase and consequently estrogen production in breast tissue. Michael Denison of
UC Davis developed cell-based screening bioassays to identify and characterize
chemicals that increase the risk of development or progression of breast cancer via their
effect on aromatase promoter-specific gene expression. His study may provide new
insights into mechanisms by which contaminants and commercial chemicals can affect
estrogen synthesis and estrogen related responses.
Zena Werb of UCSF used mouse mammary tissue to develop improved models to
evaluate the impact of environmental stressors on breast tissues and identify related
biomarkers. She specifically investigated the role of environmental chemical stressors on
the perturbation of normal mammary development in mammary cells and tissues in
culture and in vivo. Her analysis showed that environmental chemicals altered the
carbohydrate structures in the breast cells in culture. Findings were published in Journal
of Cell Science in June 2012. She was funded to further develop her studies under
CBCPI.
Chris Vulpe of UC Berkeley worked to develop a chemical screening test that will
improve the ability to screen large numbers of chemicals as well as chemical mixtures,
such as those in consumer products, house dust, drinking water, and air. The team worked
closely with scientists at the US Environmental Protection Agency to coordinate the tools
developed through the CBCRP-funded project with the federal programs for testing
chemicals. The new screening tools could inform the design of safer chemicals (green
chemistry), enable manufacturers to select better materials, help regulatory agencies
identify chemicals of concern, and contribute to the understanding of environmental
factors that contribute to breast cancer risk.
Developing new ways of testing chemicals that are relevant to breast cancer risk continues to be a
priority. Additional funds were committed for future research in this area through CBCPI.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
36
SRI Initiative 6: Statistical Methods to Study Interacting Factors that Impact Breast Cancer
Three studies were funded to explore what statistical methods can best take into account the
complexity of breast cancer risk, including the likelihood that the effects of risk factors vary in
combination with each other and over the life course for a total of $1,037,347. Highlights of
projects include:
Model-building with Complex Environmental Exposures
David Nelson of Cancer Prevention Institute of California sought to build a model
that would allow increasingly large and complex sets of data to be analyzed for the link
between environmental exposures and breast cancer risk. He investigated links between
hazardous air pollutants and increased breast cancer risk in California teachers.
Researchers were able to conduct the first study to quantitatively examine the relationship
between ambient residential exposures to select hazardous air pollutants and risk of breast
cancer incidence among women using individual-level data. Additionally, important
challenges were identified in working with complex data sets. Findings were published in
Environmental Health on January 2015.
New Methods for Genomic Studies in African American Women
Daniel Stram of University of Southern California used genome-wide association
scans to explore the possibility that African American women may have unique genetic
variants that contribute to susceptibility to breast cancer than do women of European
descent. A specific trio of gene variants was found to be more predictive for African
American women. In addition, novel risk variant genes were discovered in three places
in the genome. Findings were published in PLOS Genetics in March 2013, Human
Genetics in January 2013 and PLOS One in February 2013.
California Breast Cancer Mapping Project (CBCMP)
Traditional breast cancer surveillance relies on aggregate county-level data. However,
important information can be lost when using these artificial boundaries. CBCMP, led by
Eric Roberts of the Public Health Institute developed and implemented a protocol to
map breast cancer rates within and across county boundaries by looking at data obtained
from the California Cancer Registry by census tract. This new approach to mapping
helped pinpoint four previously unidentified areas of California that have invasive breast
cancer rates substantially higher than the state average: sections of Ventura, Los Angeles,
Riverside and Orange counties, as well as parts of the north and south Bay Area. This
level of specificity will allow for more targeted research and more effective interventions.
Findings were published in Journal of Public Health Management and Practice in May–
June 2013.
SRI Initiative 7: Toward an Ecological Model of Breast Cancer Causation and Prevention
In the quest to identify the cause of breast cancer, scientists often investigate one factor at a
time—but it's becoming increasing clear that many factors interact with one another to contribute
to the disease. It can be hard for decision makers, scientists and the public to sort through the
research to fully understand the causal context of breast cancer. CBCRP invested $258,963 to
develop a new model for understanding breast cancer causation. Through the New Paradigm of
Breast Cancer Causation and Prevention research initiative, Robert Hiatt at UCSF led a team in
the creation of a breast cancer causation model that reflects the complexity of these interactions.
The model was developed through a collaboration of scientists who synthesized evidence from
scientific literature to offer their expert understanding of the relationships important to new cases
Report from the California Breast Cancer Research Program to the California Legislature December 2015
37
of post-menopausal breast cancer causation. This model is interactive
(http://www.cbcrp.org/research-topics/causal-model.html), allowing decision makers, researchers
and members of the public to explore connections and develop a conceptual framework for
research. The project has proved successful and compelling enough that a second phase of
research was funded through CBCPI. Findings were published in Cancer Epidemiology,
Biomarkers and Prevention in October 2014.
SRI Initiative 8: Environmental Causes of Breast Cancer Across Generations
The Three Generations Study leverages a large study of families whose mothers enrolled in the
Child Health and Development Studies when they were pregnant between 1959 and 1967. The
study looks at causes of breast cancer and other diseases affecting women that may pass from one
generation to the next or be caused by things in the environment. CBCRP invested $4,975,867 to
fund Barbara Cohn and her team at the Public Health Institute to test the idea that prenatal
exposure to environmental chemicals increases the risk of breast cancer. Cohn assessed data from
9,300 women whose mothers had been tracked in the initial study and identified 118 women (now
adults) diagnosed with breast cancer. For the first time researchers were able to show that women
who had been exposed to significant levels of DDT in their mother’s womb were four times as
likely to develop breast cancer as their counterparts who had been exposed to only a small
quantity of the pesticide. Findings were published in the Journal of Clinical Endocrinology and
Metabolism in August 2015.
Due to the significance of this study’s findings, results have been widely publicized, with articles
in Time, U.S. News and World Report, The San Francisco Chronicle, NBC Nightly News, WNYC
New York Public Radio, a two-part article in Environmental Health News, ASCO (American
Society of Clinical Oncology) Post, and Chicago Tribune.
SRI Initiative 9: Environmental Exposures & Breast Cancer in a Large, Diverse Cohort
The California Teachers Study (CTS), started in 1995, is a large ongoing study of breast cancer
among 133,479 female California professional school employees. The CTS cohort was
established by investigators interested in links between environmental exposures, genetics,
nutrition and breast cancer. This SRI initiative saw the potential of using a large, existing
California-based cohort such as CTS to investigate key environmental exposures that could
increase risk for breast cancer. CBCRP funded Peggy Reynolds of the Cancer Prevention
Institute of California for $4,863,028 to use data that had already been collected through the
CTS to investigate the risk of breast cancer associated with both older and newer persistent
organic pollutants of human health concern, including DDT, polychlorinated biphenyls,
polybrominated diphenyl ethers and other brominated flame retardants. She is also looking for
disparities in, and predictors of, body burden levels of these compounds and is exploring
potentially important windows of susceptibility—times in a woman’s life when exposure may
have different impacts. Results from this project were published in Environmental Health
Perspectives June 2015.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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Table 11: Program-initiated Awards with Funding that Concluded in 2010–2015
Initiative Year
Funded
Title Investigator(s) Institution(s) Dollars
SRI Initiative 1:
Understanding
Racial and Ethnic
Differences in
Stage-Specific
Breast Cancer
Survival – pilot
study
2009 Race & Ethnicity in
Stage-specific Breast
Cancer Survival
Wu, Anna University of
Southern California
$166,003
SRI Initiative 1:
Understanding
Racial and Ethnic
Differences in
Stage-Specific
Breast Cancer
Survival
2010 California Breast Cancer
Survivorship Consortium
– CPIC
Gomez, Scarlett
Cancer Prevention
Institute of
California
$677,000
California Breast Cancer
Survivorship Consortium
– COH
Bernstein, Leslie Beckman Research
Institute of the City
of Hope
$435,775
California Breast Cancer
Survivorship Consortium
– KaiserDOR
Kwan, Marilyn Kaiser Foundation
Research Institute
$392,441
California Breast Cancer
Survivorship Consortium
– USC MEC
Monroe, Kristine University of
Southern California
$216,332
SRI Initiative 2:
Demographic
Questions for
California Breast
Cancer Research
2009 Demographic Questions
for California BC
Research
Gomez, Scarlett Cancer Prevention
Institute of
California
$430,588
SRI Initiative 4:
Toward the
Development of a
California
Chemicals Policy
that Considers
Breast Cancer
2009 Breast Cancer &
Chemicals Policy
Schwarzman,
Megan
Balmes, John
UC Berkeley $234,739
SRI Initiative 5:
Making
Chemicals
Testing Relevant
to Breast Cancer
2011 Biologically Relevant
Screening of Endocrine
Disruptors
Chen, Shiuan Beckman Research
Institute of the City
of Hope
$1,512,000
Cell Bioassays for
Detection of Aromatase
Gene Activators
Denison, Michael UC Davis $421,680
Biomarkers for
Environmental Exposures
in Breast Cancer
Werb, Zena UCSF $900,000
Building on National
Initiatives for New
Chemicals Screening
Vulpe, Chris UC Berkeley $1,175,569
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Initiative Year
Funded
Title Investigator(s) Institution(s) Dollars
SRI Initiative 6:
Statistical
Methods to Study
Interacting
Factors that
Impact Breast
Cancer
2009 Model-building with
Complex Environmental
Exposures
Nelson, David
Cancer Prevention
Institute of
California
$280,753
New Methods for
Genomic Studies in
African American Women
Stram, Daniel University of
Southern California
$411,297
Cancer Mapping: Making
Spatial Models Work for
Communities
Roberts, Eric Public Health
Institute
$345,297
SRI Initiative 7:
Toward An
Ecological Model
of Breast Cancer
Causation and
Prevention
2009 New Paradigm of Breast
Cancer Causation and
Prevention
Hiatt, Robert UCSF $258,963
SRI Initiative 9:
Environmental
Exposures &
Breast Cancer in
a Large, Diverse
Cohort –Pilot
2009 Exploring Disparities,
Environmental Risk
Factors in Teachers
Hurley, Susan
Reynolds, Peggy
Cancer Prevention
Institute of
California
$130,837
Table 12: Program-initiated Awards with Funding in Progress 2010–2015
Initiative Fund
Year
Title Investigator(s) Institution(s) Dollars
SRI Initiative 1:
Understanding
Racial and
Ethnic
Differences in
Stage-Specific
Breast Cancer
Survival
2010 California Breast
Cancer Survivorship
Consortium - USC
AABCS
Wu, Anna University of
Southern California
$1,007,117
SRI Initiative 3:
Piloting an
Integrated
Approach to
Understanding
Behavioral,
Social and
Physical
Environment
Factors and
Breast Cancer
among
Immigrants
2011 Immigrant Experience
& Breast Cancer Risk in
Asians
Gomez, Scarlett Cancer Prevention
Institute of California
$722,098
SRI Initiative 5:
Making
Chemicals
Testing Relevant
to Breast Cancer
2011 Xenoestrogen-specific
perturbations in the
human breast
Dairkee, Shanaz California Pacific
Medical Center
Research Institute
$900,000
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Initiative Fund
Year
Title Investigator(s) Institution(s) Dollars
SRI Initiative 8:
Environmental
Causes of Breast
Cancer Across
Generations
2009 Environmental Causes
of Breast Cancer across
Generations
Cohn, Barbara Public Health
Institute
$4,975,867
SRI Initiative 9:
Environmental
Exposures &
Breast Cancer in
a Large, Diverse
Cohort
2010 Persistent Organic
Pollutants & Breast
Cancer Risk
Reynolds, Peggy Cancer Prevention
Institute of California
$4,850,028
CBCPI RFQ
2010 Partnership to Advance
Breast Cancer Research
Woodruff, Tracey UCSF $1,406,639
CBCPI 3:
Women
Firefighters
Biomonitoring
Collaborative
Study
2013 Women Firefighters
Biomonitoring
Collaborative
Morello-Frosch,
Rachel
Buren, Heather
UC Berkeley
United Fire Service
Women
$833,945
Stefani, Tony SF Fire Department
CBCPI 6:
Paradigm Model
for Breast
Cancer: Follow
On
2014 New Paradigm Model
for Breast Cancer:
Phase II
Hiatt, Robert UCSF $859,431
CBCPI 5:
Chemical Safety
Testing to
Reduce Breast
Cancer Risk
2015 Chemical Testing to
Prevent Cancer:
Research Translation
Schwarzman,
Megan
UC Berkeley $217,691
Chemical Safety During
Breast Cancer
Susceptible Windows
Cohn, Barbara
Public Health
Institute
$1,212,557
Human Mammary
Organotypic Cultures
for Chemical Screening
Yaswen, Paul Lawrence Berkeley
National Laboratory
$1,657,913
Identifying Human
Breast Carcinogens
using Exposomics
Smith, Martyn UC Berkeley $1,038,676
Testing Chemicals for
Likely Contribution to
Breast Cancer
Werb, Zena UCSF $1,125,000
B. Funding and Research Details: The Community Impact of Breast Cancer
California’s great strength comes from the diversity of the people who live here. Yet there are
clear discrepancies in who has access to resources. When it comes to breast cancer, there is not a
universal cause and effect. Differences in ethnicity, culture, language, sexual orientation,
Report from the California Breast Cancer Research Program to the California Legislature December 2015
41
immigration history, and socioeconomic status all contribute to disparities in prevention,
detection, treatment and care of people with the disease.
CBCRP encourages research that addresses disparities and the burden of breast cancer among
California's diverse communities. CBCRP seeks to address these disparities by investing in
research that answers critical questions, such as:
How do poverty, race/ethnicity, and social factors impact incidence and mortality for
breast cancer?
What are the sociocultural, behavioral, and psychological issues faced by women at risk
for or diagnosed with breast cancer?
What services are needed to improve access to care in order to improve quality of life and
reduce suffering?
What policies can help reduce disparities related to prevention, detection and treatment of
breast cancer?
This section highlights the research that focuses specifically on the community impact of breast
cancer. Over the past five years, we have made significant investments that have led to
innovations in health literacy, especially for underserved communities; the specific needs of
Latinas in accessing screening, education, care and support related to breast cancer; the specific
needs of young women diagnosed with breast cancer; and ways to make more effective policy
decisions around breast cancer.
CBCRP invested over $15.3 million dollars in 34 investigator-initiated community impact
research projects that were conducted between 2010 and 2015. Below are highlights of a selection
of research projects CBCRP has funded, followed by Table 13 and 14, which highlight research
that was concluded between 2010 and 2015 and in progress (respectively) for all research related
to community impact of breast cancer.
Highlights of Funding that Concluded between 2010–2015
Cost-effectiveness Analysis to Inform BC Screening Policy
Every Woman Counts (EWC), a California breast cancer screening program, faced challenging
budget cutbacks and policy choices. Making effective policy choices can have significant impacts
on how many women are served and how well they are served. Carefully constructed computer
modeling can be useful in projecting potential outcomes of policy and budgetary choices. Joy
Melnikow of UC Davis developed a computer interface to enable breast cancer policy makers,
advocates, and researchers to choose program parameters and receive immediate feedback on the
costs and outcomes of policy alternatives they are considering. This project is aimed at creating a
user-friendly tool that will help to integrate research evidence into health policy making. Using
this model, researchers were able to find that for the EWC program, biennial screening
mammography starting at age 50 years was the most cost-effective strategy.
Building Mixtec Community Capacity to Address Breast Health
In recent decades, Mixtec people have emigrated from Oaxaca, one of the poorest areas of
Mexico, to California, becoming one of the largest indigenous groups of farm workers in the
state. Many are unable to read and write even at a basic level in any language and speak neither
Spanish nor English, but only their native non-written Mixteco language. They face exploitation
and discrimination in labor, housing and everyday life and most live in extreme poverty. Serving
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the health needs of this community is complex due to a lack of health care providers who speak
Mixteco, as well as cultural barriers and challenges in reaching out to the community. To address
these gaps, Sandra Young of the Mixteco/Indigena Community Organizing Project
(MICOP) and Annette Maxwell of the UCLA Center for Cancer Prevention and Control
Research partnered to conduct one of the largest systematic efforts to survey the needs of any
indigenous community undertaken by peers speaking the indigenous language. They trained 10
Mixtec-Spanish bilingual promotoras. During that training, MICOP staff and promotoras (lay
people trained to assist Latinas/Hispanic with health education and guidance through the health
care system) identified breast health as a community priority. These promotoras then conducted
focus groups with Mixtec community members. Health concerns discussed in the focus groups
include outdoor exercise among women being viewed as flirtatious; reluctance to ask for
governmental assistance due to fear that children will have to pay it back later; soda consumption
perceived as a symbol of socio-economic status; and unwillingness to obtain mammograms or
pap smears because private body parts are to be touched by husbands only. This research suggests
that training promotoras to conduct focus groups can increase organizational capacity to identify
pressing health needs in under-represented and hard-to-reach population groups. Findings from
this research have been published in Journal of Immigrant and Minority Health in April 2014.
Nuevo Amanecer: Promoting the Psychosocial Health of Latinas
Women with breast cancer often experience emotional distress including depression, anxiety, and
relationship problems. Latina breast cancer patients may be more likely than White women to
experience this distress. Psychosocial support services can greatly improve the quality of life for
some women, yet Latina breast cancer patients infrequently use them. Carmen Ortiz of Circulo
de Vida Cancer Support and Resource Center and Anna Napoles of UCSF have been
working together for more than ten years to answer the questions of how to improve access and
use of social support services for Latinas with breast cancer. Their first CBCRP CRC award in
2005 supported them in conducting telephone surveys with Spanish-speaking Latina cancer
patients to understand why these services were not being used. They went on to conduct a
randomized clinical trial of the Nuevo Amanecer program, a culturally tailored, peer-delivered
cognitive-behavioral stress management intervention for low-income Spanish-speaking Latinas
with breast cancer. They found that engaging community members in design and implementation
of community-based programs and trials enhances cultural appropriateness and congruence with
the community context. Findings were published in Clinical Trials in April 2014.
In 2015 the research team was funded for a Translational grant to make the program more
accessible (e.g., different literacy levels) and available across California. They expanded their
work together with a grant from CBCRP in 2013, called Meeting the Self-care Needs of Latinas
after Breast Cancer where they focus on the lack of culturally and linguistically appropriate
information on recommended health care and self-care following active cancer treatment (e.g.,
management of increased risks of subsequent cancer and treatment side effects) for Spanish-
speaking Latina breast cancer survivors.
Intervening on Reproductive Health in Young BC Survivors
Ten percent of the 2.8 million breast cancer survivors in the U.S. were diagnosed when they were
younger than 45 years old. Most young patients undergo chemotherapy and/or endocrine therapy,
treatments that impair ovarian function and result in significant adverse reproductive health
effects. These late effects include symptoms of estrogen deprivation such as hot flashes, fertility
concerns, limited contraception options and sexual problems. Together they can have a major,
negative impact on quality of life. Despite substantial research, treatment guidelines and clinical
Report from the California Breast Cancer Research Program to the California Legislature December 2015
43
expertise on these issues, most young breast cancer survivors and their healthcare providers have
limited guidance on how best to manage these reproductive health late effects. To address this,
Irene Su of UC San Diego is generating and testing the efficacy of the Reproductive Health
Survivorship Care Plan (SCP-R), a novel survivorship care tool to meet the reproductive health
needs of young breast cancer survivors (YBCS). The project will be the first to address a gap in
research on translating knowledge on reproductive health into health services delivery to improve
everyday outcomes in YBCS.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
44
Table 13: The Community Impact of Breast Cancer Funding that Concluded in 2010–2015*
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
CRC Full
Research
Award
2006 Telephone-Based
Decision Support for
Rural Patients
Belkora, Jeffrey UCSF
$310,914
O'Donnell, Sara Mendocino Cancer
Resource Center
$361,358
CRC Full
Research
Award
2007 Expanding Rural
Access: Distance
Delivery of Support
Groups
Koopman, Cheryl Stanford University $290,337
Ferrier, Susan
Kreshka, Mary
Anne
The Sierra Fund $197,283
CRC Full
Research
Award
2007 Underserved Women
with Breast Cancer at
End of Life
Adler, Shelley UCSF
$437,845
Stone, Kendra
Burns, Beverly
Wells, Denise
Charlotte Maxwell
Complementary
Clinic
$169,653
CRC Full
Research
Award
2008 Breast Cancer Clinical
Trials Education
Program
Malcarne, Vanessa San Diego State
University
$206,027
Riley, Natasha Vista Community
Clinic
$360,112
Sadler, Georgia UC San Diego $158,140
CRC Full
Research
Award
2008 Increasing
Mammography
Screening in Latinas
with Diabetes
Roussos, Stergios San Diego State
University Research
Foundation
$251,867
Noguera, Christine Golden Valley
Health Centers
$493,666
CRC Full
Research
Award
2009 Nuevo Amanecer:
Promoting the
Psychosocial Health
of Latinas
Ortiz, Carmen Circulo de Vida
Cancer Support and
Resource Center
$313,067
Napoles, Anna UCSF $349,547
CRC Full
Research
Award
2010 Recording Medical
Visits for People with
Breast Cancer
Belkora, Jeffrey UCSF
$637,500
O'Donnell, Sara Mendocino Cancer
Resource Center
CRC Pilot
Award
2011 At-Home Group
Video Calling to
Support Rural Women
Hild, Joanne
Kreshka, Mary
Anne
Sierra Streams
Institute
$112,500
Koopman, Cheryl Stanford University $93,960.51
CRC Pilot
Award
2011 Clinical Trials
Education and Access
for Underserved
Women
Caprio, Maria SHANTI $93,906
Joseph, Galen UCSF $74,875
Report from the California Breast Cancer Research Program to the California Legislature December 2015
45
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
CRC Pilot
Award
2012 Building Mixtec
Community Capacity
to Address Breast
Health
Maxwell, Annette UCLA $168,750
Young, Sandra Mixteco/Indigena
Community
Organizing Project
CRC Pilot
Award
2012 E-messaging for
Abnormal
Mammogram Follow-
up in Latinas
Londono, Carlos
Del Rio, Claudia
Tiburcio Vasquez
Health Center, Inc.
$203,730
Oakley-Girvan,
Ingrid
Cancer Prevention
Institute of
California
CRC Pilot
Award
2012 Latina Breast Cancer
Health Literacy Pilot
Project
Brongiel, Ilana Centro de Salud de
la Comunidad de
San Ysidro, Inc.
$210,071
Castaneda, Sheila San Diego State
University Research
Foundation
CRC
Conference
Award
2014 QuickStart: Training
in CBPR in BC,
Enviro, and
Disparities
Sarantis, Heather Commonweal $150,418
Dissertation
Award
2009 Health Anxiety as a
Risk for Insomnia in
Breast Cancer
Rissling, Michelle UC San Diego $72,976
IDEA
2008 Quality of
Mammography
Facilities Serving
Vulnerable Women
Goldman, L.
Elizabeth
UCSF $150,000
IDEA
2009 Health Literacy in
Older Patient's Breast
Cancer Treatment
Naeim, Arash UCLA $180,890
IDEA
2009 Patient and Clinician
Knowledge of Breast
Cancer Lymphedema
Kwan, Marilyn Kaiser Foundation
Research Institute
$227,784
IDEA
2011 Cost-effectiveness
Analysis to Inform BC
Screening Policy
Melnikow, Joy UC Davis $149,996
IDEA
Competitive
Renewal
2008 Neighborhoods and
Obesity in Pre-
adolescent Girls: Part
II
Yen, Irene UCSF $214,406
IDEA
Competitive
Renewal
2010 Quality of
Mammography
Facilities Serving
Vulnerable Women
Goldman, L.
Elizabeth
UCSF $238,230
Joining Forces
Conference
Award
2012 3rd Biannual National
Latino Cancer Summit
Gonzalez,
Christina
Latinas Contra
Cancer
$25,000
Joining Forces
Conference
Award
2012 Increasing California's
Capacity to Partner in
Global Breast
Ashing-Giwa,
Kimlin
Beckman Research
Institute of the City
of Hope
$25,000
Report from the California Breast Cancer Research Program to the California Legislature December 2015
46
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
Joining Forces
Conference
Award
2013 Sustainable Education
to Eliminate
Disparities (SEED)
Rhoads, Kim Stanford University $24,975
Postdoctoral
Fellowship
2009 Macrophages in
Breast Cancer Patients
of African Descent
Mukhtar, Rita UCSF $89,518
Postdoctoral
Fellowship
2009 Risk Factors and
Breast Cancer
Survival in
Black/White Women
Lu, Yani Beckman Research
Institute of the City
of Hope
$89,996
* Grant titles in this table may appear to repeat due either phased research (a pilot grant followed by a full
research grant) or due to continuation grants being given.
Table 14: The Community Impact of Breast Cancer Funding in Progress as of 2015
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
CRC Full
Research Award
2011 Sister Survivor:
Improving Access to
Survivorship Care
Plan
Britton, Florence
Pickens Isis
Tapp, Carolyn
Women of Color $93,750
Ashing-Giwa, Kimlin Beckman Research
Institute of the City of
Hope
$858,880
CRC Full
Research Award
2013 Reporting Personal
Levels of
Environmental
Chemicals: Impact
Cohn, Barbara
Havas, Laurie
Public Health Institute $756,093
CRC Full
Research Award
2014 Engaging
Underserved Women
in Health Research
Joseph, Galen UCSF
$375,000
Nickell, Alyssa SHANTI
CRC Pilot
Award
2013 Latinas' Experiences
of Breast Cancer
Treatment
Gomez, Carla
Halley, Meghan
Palo Alto Medical
Foundation Research
Institute
$212,648
CRC Pilot
Award
2013 Meeting the Self-care
Needs of Latinas
after Breast Cancer
Napoles, Anna UCSF
$191,431
Ortiz, Carmen Circulo de Vida
Cancer Support and
Resource Center
CRC Pilot
Award
2014 API-friendly
Resources for BC
Clinical Trials
Sadler, Georgia UC San Diego
$43,750
Malcarne, Vanessa San Diego State
University Research
Foundation
$52,325
Seligman, Fe Operation Samahan
Inc.
$100,000
CRC Pilot
Award
2014 Exploring Rural
Disparities in Breast
Cancer Mortality
Elvine-Kreis, Brenda
Uyeki, Terry
Humboldt Community
Breast Health Project
$217,102
IDEA
2013 Breast Cancer and
Neurocognitive
Outcomes
Patel, Sunita Beckman Research
Institute of the City of
Hope
$267,423
Report from the California Breast Cancer Research Program to the California Legislature December 2015
47
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
Translational
Research Award
2014 Intervening on
Reproductive Health
in Young BC
Survivors
Su, Irene UC San Diego $968,782
C. Funding and Research Details: Etiology and Prevention
Although our foundation of knowledge for the basic science aspects of breast cancer (tumor
biology) has expanded greatly over the past decades, there still remains a gap in our strategies for
large-scale prevention due to uncertainties over the underlying causes of the disease and their
relative importance. There is an extensive list of factors associated with increased or decreased
risk for breast cancer. However, critical questions remain: What environmental and biological
factors interact to increase the risk of developing breast cancer? What role does someone’s
neighborhood, occupation or immigrant status play in breast cancer risk? What approaches can
be used to reduce or eliminate breast cancer risk?
CBCRP especially encourages new California-based studies that seek an understanding of the
environmental and lifestyle causes of breast cancer, and how these factors increase risk and
impact different California communities. Specific topics for research in this area might include:
Etiology: What is the role of the environment and lifestyle in breast cancer risk?
Prevention and Risk Reduction: How can we end the danger of breast cancer?
The past five years have offered several significant advances in these research areas. CBCRP has
funded research into the effect of exposure to light at night, occupational risks such as working in
nail salons or in agriculture, the role of Vitamin D in breast cancer survival, and other areas.
CBCRP invested over $8.3 million dollars in 25 investigator initiated etiology and prevention
research projects that were conducted between 2010 and 2015. Below are highlights of a selection
of research projects CBCRP has funded. Tables 15 and 16 highlight research that was concluded
between 2010 and 2015 and in progress (respectively) for all research related to etiology and
prevention.
Highlights of Funding Concluded in 2010-2015
Light at Night and Breast Cancer Risk Among California Teachers
There has been convincing evidence that exposure to light at night promotes mammary (breast)
cancer in rodents for some time, however the role that light at night (LAN) plays in increasing
human breast cancer risk has been less understood. Peggy Reynolds at Cancer Prevention
Institute of California analyzed data from the California Teachers Study participants to
determine that women living in areas with very high levels of outdoor LAN had about a 10
percent increased risk of breast cancer compared to women who lived in areas with the lowest
levels of indoor LAN. Findings like these can have significant implications for people who work
night shifts or who live in urban areas. Findings were published in Epidemiology in September
2014.
Migration and Breast Cancer Risk in Hispanics
Elad Ziv of UCSF identified a gene variant that derived from indigenous American ancestry that
may protect women of Latin American descent from breast cancer. This may explain the lower
Report from the California Breast Cancer Research Program to the California Legislature December 2015
48
incidence of breast cancer observed in Latinas compared to other racial or ethnic groups. The
gene variant, which is called a single-nucleotide polymorphism (SNP), gives Latinas protection
from more aggressive estrogen receptor-negative types of breast cancer—the kinds that are linked
to poor long-term survival. Inheriting this variant may reduce the risk of breast cancer in Latinas
by 40–80 percent. Findings were published in Nature Communications in October 2014.
Breast Cancer Risks in California Nail Salon Workers
CBCRP is committed to supporting research to understand how occupational exposures may
increase risk for breast cancer and other health problems. Beginning in 2005, CBCRP began
funding research focused on health risks for nail salon workers. In the San Francisco Bay Area
many of the nail salon workers are Vietnamese. Researchers at the Cancer Prevention Institute
of California partnered with Linda Okahara of Asian Health Services to understand what
chemicals these nail salon workers are exposed to and how this may affect them. While an
increased risk for breast cancer was not identified for the population studied compared to the
general Vietnamese female population, other risks were identified. Workers wore air monitoring
devices that detected high levels of toluene, methyl methacrylate and total volatile organic
compounds at levels higher than recommended guidelines to prevent health symptoms like
headaches, irritations, and breathing problems. Findings were published in American Journal of
Public Health in December 2011. Through these efforts, a strong and lasting community/scientist
partnership has been built. These partnerships have helped salon owners address these exposures
and informed public policy in California and nationally. The research partners have also secured
multiple NIH grants based on this work and continue to work together to promote worker health
and safety.
Table 15: Etiology and Prevention Funding that Concluded in 2010–2015
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
CRC Full
Research
Award
2007 Breast Cancer Risks
in California Nail
Salon Workers
Reynolds, Peggy Cancer Prevention
Institute of California
$348,319
Okahara, Linda Asian Health Services $315,778
Dissertation
Award
2008 Prognostic
Implications of DNA
Glycation in Breast
Cancer
Tamae, Daniel Beckman Research
Institute of the City of
Hope
$67,060
IDEA
2008 Pesticide and Gene
Interactions in Latina
Farm Workers
Mills, Paul UCSF $160,718
IDEA
2008 Antidepressants and
Breast Cancer
Treatment
Interactions
Haque, Reina Kaiser Foundation
Research Institute
$156,068
IDEA
2010 Vitamin D and Breast
Cancer Survival
John, Esther
Wei, Wang
Cancer Prevention
Institute of California
$220,132
IDEA
2010 Light at Night and
Breast Cancer Risk in
California Teachers
Reynolds, Peggy Cancer Prevention
Institute of California
$197,333
IDEA
2011 Epigenetic Changes
as Modifiers of
BRCA1/ BRCA2
Cancer Risk
Neuhausen, Susan Beckman Research
Institute of the City of
Hope
$251,128
IDEA
2011 Cadmium, Age at
Menarche, and Early
Puberty in Girls
Horn-Ross, Pamela
Rull, Rudolph
Cancer Prevention
Institute of California
$204,553
Report from the California Breast Cancer Research Program to the California Legislature December 2015
49
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
IDEA
2011 Soy, DNA
Methylation and
Breast Cancer
Wu, Anna University of Southern
California
$244,524
IDEA
18IB-
0008
Maternal Folic Acid
Intake, Mammary
Development, and
Cancer
Miller, Joshua,
Hovey, Russell
UC Davis $149,944
Joining
Forces
Conference
Award
2011 5th International
Workshop on Breast
Cancer Risk
Assessment
Shepherd, John UCSF $20,000
Joining
Forces
Conference
Award
2013 6th International
Workshop on Breast
Cancer Risk
Assessment
Shepherd, John UCSF $25,000
Joining
Forces
Conference
Award
2015 GIS for Community
Impact: From
Technology to
Translation
Barlow, Janice
Zero Breast Cancer $24,299
Postdoctoral
Fellowship
2008 Genes in Hormone
Metabolism Pathway
and Breast Cancer
Lee, Eunjung University of Southern
California
$134,996
Translational
Research
Award
2009 Breast Cancer Risk
Reduction: A Patient-
Doctor Intervention
Kaplan, Celia
UCSF $740,685
Translational
Research
Award
2009 Soy Treatment for
High-risk Women
and DCIS Patients
Wu, Anna University of Southern
California
$1,203,784
Table 16: Etiology and Prevention Funding in Progress as of 2015
Award
Type
Year
Funded
Title Investigator(s) Institution(s) Dollars
CRC
Full
Research
Award
2012 HERMOSA: Hlth &
Enviro Res on Make-
up of Salinas
Adolescents
Harley, Kim UC Berkeley $687,585
Parra, Kimberly Clinica de
Salud del Valle
de Salinas
CRC
Pilot
Award
2013 Is Cost of Beauty
Putting Black Women
at Risk? IEAAWC
Study
Montgomery, Susanne Loma Linda
University
$136,924
Mitchell, Eudora Quinn
Community
Outreach
Corporation
$62,500
Clark, Phyllis Healthy
Heritage
Wellness
$19,076
Report from the California Breast Cancer Research Program to the California Legislature December 2015
50
Award
Type
Year
Funded
Title Investigator(s) Institution(s) Dollars
CRC
Pilot
Award
2013 Using CBPR to
Promote
Environmental Justice
in Wilmington, CA
Maxwell, Annette UCLA $93,750
Marquez, Jesse Coalition for a
Safe
Environment
$93,750
CRC
Pilot
Award
2013 Cadmium and Arsenic
Exposure in a Mining
Impacted Community
Hild, Joanne
Sellen, Jane
Sierra Streams
Institute
$202,989
Reynolds, Peggy Cancer
Prevention
Institute of
California
IDEA
2012 Predicting BRCA1
Mutation Status from
Tumor Pathology
Hamilton, Ann University of
Southern
California
$246,000
IDEA
2013 Getting a Jump on
Cancer with a Genomic
Risk Classifier
West, Robert Stanford
University
$260,110
IDEA
2013 Internal Chemical
Exposure Study among
Mexican Immigrants
Fejerman, Laura UCSF $124,996
IDEA
2014 Breast Cancer and the
Human Oral
Microbiome
Campbell, Michael UCSF $187,264
IDEA
2014 Persistent Organic
Pollutants and
Mammographic
Density
Lee, Eunjung University of
Southern
California
$248,244
D. Funding and Research Details: Detection, Prognosis and Treatment
Until we learn how to prevent all breast cancers, research on detection, prognosis and treatment is
critical. Topics funded by CBCRP in these areas continue to change as novel technologies and
approaches come under investigation—breast cancer detection technology is moving past
traditional mammography; diagnosis is depending on understanding the genetic profile of tumors
rather than the anatomy; and treatment is moving toward more tailored and personalized
approaches.
The past five years of CBCRP-funded research has yielded promising results. Below are
highlights from studies that have uncovered that cancer stem cells may become resistant to
radiation treatment, that the “wellderly”—people over 80 who are healthy—may be able to teach
us something about antibodies that fight cancer, and that a simple saliva test for breast cancer
may be on the horizon. Findings such as these may provide doctors and patients tools to address
breast cancer that are less invasive and more effective. Importantly, they may also greatly reduce
the need for unnecessary interventions.
Two research topics are represented in this section:
Imaging, Biomarkers, and Molecular Pathology: Improving Detection and Diagnosis
Innovative Treatment Modalities: Search for a Cure
Report from the California Breast Cancer Research Program to the California Legislature December 2015
51
CBCRP invested over $18.7 million dollars in 66 investigator initiated detection, prognosis and
treatment research projects that were conducted between 2010 and 2015. Below are highlights of
selected research projects CBCRP has funded. Tables 17 and 18 list research that was concluded
between 2010 and 2015 and in progress (respectively) for all research related to detection,
prognosis and treatment.
Highlights of Funding Concluded in 2010–2015
Modulation of Breast Cancer Stem Cell Response to Radiation
The relationship between breast cancer and radiation is complex. It has long been understood that
radiation treatment carries health risks, but researchers are now finding that it may actually create
treatment-resistant breast cancer cells. Frank Pajonk of UCLA looked into the properties of
breast cancer stem cells (which contribute to breast cancer recurrence) to see how they respond to
ionizing radiation. He found that ionizing radiation treatment kills about half of all malignant
cells during each treatment; however, the remaining cancer cells can become treatment resistant.
Thus, developing treatment-resistant cells can offset otherwise highly effective radiation
treatment. The potential to understand how to modify this effect may lead to options that reduce
radiation exposure and improve treatment outcomes. Findings from this study have been
published in Breast Cancer Research in February 2010, Stem Cells in April 2010, Stem Cells in
May 2012 and PLOS One in March 2012.
Combating Breast Cancer with the Wellderly Immune Repertoire
What can healthy, older adults teach us about breast cancer? Brunhilde Felding of Scripps
Research Institute took a unique approach to explore this question by examining blood samples
of the ““wellderly”—healthy adults over 80—to understand the reasons for their long life. By
studying antibodies, she was able to identify footprints, or memories, of past victories against
cancer, specifically triple negative breast cancer, which currently lacks effective treatment
options. Understanding how the wellderly have naturally fought off the disease provides
important opportunities to develop effective treatment therapies for this aggressive form of breast
cancer. Findings have been published in Nature Reviews Cancer in February 2011, Journal of
Molecular Biology in March 2011, Journal of Neurooncology in September 2011, Chemistry and
Biology in March 2011, Bioconjugate Chemistry in August 2011, Cancer Cell in November 2011,
Proceedings of the National Academy of Sciences if the United States of America in October 2012
and Journal of Clinical Investigation in March 2013.
Stratifying DCIS Biopsies for Risk of Future Tumor Formation
Thea Tlsty and her team at UCSF have discovered a way to predict whether women with ductal
carcinoma in situ (DCIS) —the most common form of non-invasive breast cancer—are at risk for
developing more invasive tumors in later years. Historically, women diagnosed with DCIS have
often pursued aggressive treatments such as chemotherapy, radiation or mastectomy, though it is
becoming increasingly clear that this may not be necessary for everyone. Not all cases of DCIS
develop into life-threatening breast cancer. However, without a reliable screen for what risk each
person’s DCIS poses, doctors and patients have often opted for interventions. It is hoped that
these findings will give women with DCIS the opportunity to be more selective about their
treatment. Findings were published in the Journal of the National Cancer Institute in May 2010,
Cancer Prevention Research in May 2010, Cancer Prevention Research in February 2010 and
Breast Cancer Research in December 2009.
Report from the California Breast Cancer Research Program to the California Legislature December 2015
52
Measuring Real-World Breast Cancer Outcomes
Emerging interventions are improving breast cancer survival; however, we still know very little
about their impact on the "real world" of breast cancer care. Alison Kurian of Stanford University
Cancer Institute in partnership with Palo Alto Medical Foundation built a highly innovative data
resource using the electronic health records from both institutions. This project resulted in a
uniquely informative multidisciplinary research tool, Oncoshare, which contains de-identified
data from about 15,000 California breast cancer patients diagnosed since 2000. Investigators from
multiple institutions are using it to understand, and ultimately to improve, real-world breast
cancer care. Findings were published in Journal of the American Medical Informatics Association
in June 2012 and Cancer in January 2014.
Salivary Biomarkers for Early Detection of Breast Cancer
Diagnosing breast cancer can be invasive and costly, however, UCLA researcher Lei Zhang’s
investigation points to a potential breakthrough using a simple saliva test. He hypothesized that a
primary tumor stimulates changes in DNA and RNA throughout the body. With the CBCRP
funding, he validated markers that the team suspected indicated the presence of a tumor and
found seven more. Based on this, he is developing tests that detect changes in saliva cells that
indicate the presence of breast cancer. If successful, this research will lead to possibly the least
invasive way to diagnose breast cancer. In principle, this test could be developed not just for
breast cancer screening but also for monitoring an individual's response to different therapeutic
options, offering hope for truly personalized cancer diagnostics. Findings were published in
PLOS One in December 2010 and updated in the National Center for Biotechnology Information
gene expression omnibus in 2015.
Table 17: Detection, Prognosis and Treatment Funding that Concluded in 2010–2015*
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
CRC Full
Research
Award
2010 Increasing Mammography
Screening Among Native
Women
Navarro, Linda Turtle Health
Foundation
$519,269
von Friederichs-
Fitzwater, Marlene
UC Davis
Dissertation
Award
2009 Diffusion-weighted MRI in
Monitoring Breast Cancer
Treatment
Singer, Lisa UCSF $48,115
Dissertation
Award
2009 Sound Speed Tomography
for Early Breast Cancer
Detection
Nebeker, Jakob UC San Diego $74,325
Dissertation
Award
2009
A Predictive Factor for
Eribulin Treatment of
Breast Cancer
Smith, Jennifer UC Santa Barbara $74,988
Dissertation
Award
2010
Targeting Breast Tumor
Stem Cells with Cell Cycle
Inhibitors
Huskey Mullin,
Noelle
UCSF $75,981
Dissertation
Award
2010
MRI Registration for
Therapy Evaluation and
Annual Screening
Lin, Muqing UC Irvine $76,000
Dissertation
Award
2010 Electronics for High
Resolution Breast-
Dedicated PET
Lau, Frances Stanford
University
$75,924
Report from the California Breast Cancer Research Program to the California Legislature December 2015
53
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
Dissertation
Award
2010 A Novel Mediator of AI
Resistance in Breast Cancer
Petrossian, Karineh Beckman
Research Institute
of the City of
Hope
$76,000
IDEA
2009 Antibody-based Targeting
of Breast Cancer Stem Cells
Gottstein, Claudia UC Santa Barbara $150,000
IDEA
2009 Combating Breast Cancer
with the Wellderly Immune
Repertoire
Felding, Brunhilde Scripps Research
Institute
$284,718
IDEA
2009 Targeting DNA Repair
Function of Breast Cancer
Stem Cells
Wu, Xiaohua Scripps Research
Institute
$284,660
IDEA
2009 Membrane-associated
Estrogen Receptors in
Breast Cancer
Pietras, Richard UCLA $149,119
IDEA
2009 Metabolite Imaging to
Identify Drug Resistant
Breast Cancer
Northen, Trent Lawrence
Berkeley National
Laboratory
$171,892
IDEA
2009 Reducing Surgical
Morbidity of Breast Cancer
Staging
Chen, Steven UC Davis $149,983
IDEA
2009 Inhibitors of Condensin I as
Chemotherapy for Breast
Cancer
Yokomori, Kyoko UC Irvine $100,000
IDEA
2009 Survival in de novo and
Recurrent Metastatic Breast
Cancer
Pal, Sumanta Beckman
Research Institute
of the City of
Hope
$249,000
IDEA
2010 Salivary Biomarkers for
Early Detection of Breast
Cancer
Zhang, Lei UCLA $123,748
IDEA
2010 Targeting Drug Resistant
Breast Cancer by
microRNAs
Hu, Hailiang UCLA $100,000
IDEA
2010 Targeting Brain Metastasis
with a Cell-
b
ased Approach
Felding, Brunhilde,
Lorger, Mihaela
Scripps Research
Institute
$284,354
IDEA
2010 New Estrogen Receptor
Downregulators for Breast
Cancer
Pietras, Richard UCLA $150,000
IDEA
2010 Inhibiting Breast Cancer
Brain Metastasis with
Cilengitide
Felding, Brunhilde Scripps Research
Institute
$284,435
IDEA
2010
Multimarker miR Blood
Assay for Breast Cancer
Detection
Hoon, David John Wayne
Cancer Institute
$265,415
IDEA
2010
Breast Cancer Neoadjuvant
Chemotherapy Response
with miRNA
Wang, Shizhen
Emily
Beckman
Research Institute
of the City of
Hope
$249,000
IDEA
2010
Enhancing Trastuzumab
Therapy with an NK
Activating Antibody
Levy, Ronald Stanford
University
$224,749
IDEA
2010 HER2 Co-Amplified Genes
and Treatment Response
Press, Michael University of
Southern
California
$241,988
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Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
IDEA
2010 Receptor Re-expression in
ER and PR Negative Breast
Cancer
Holmes, Dennis
Garcia, Agustin
University of
Southern
California
$18,203
IDEA
2011
Targeting Histone
Acetyltransferase in Triple
Negative BC
Gjerset, Ruth Torrey Pines
Institute for
Molecular Studies
$272,995
IDEA
2011
Identifying Novel Drugable
Targets Against TNBC
Goga, Andrei UCSF $150,000
IDEA
2011 Targeting Prolactin as a
Novel Treatment for Breast
Cancer
Walker, Ameae UC Riverside $150,000
IDEA
2012 Sub-millimeter PET for
Improving Outcomes in
Breast Cancer
Chaudhari, Abhijit UC Davis $149,332
IDEA
2012 Host Hypoxia to Treat
Breast Cancer Brain
Metastasis
Felding, Brunhilde Scripps Research
Institute
$284,250
IDEA
2012 Genetic Predictors of
Chemotherapy Toxicity in
Breast Cancer
Kroetz, Deanna UCSF $99,998
IDEA
2012 Compositional
Mammography for Breast
Cancer Detection
Shepherd, John UCSF $149,895
IDEA
2012 Co-Targeting the Notch and
EphB4 Receptors in Breast
Cancer
Tripathy, Debasish University of
Southern
California
$243,362
IDEA
2013 Radiation-Induced
Migration of Breast Cancer
Cells
Graves, Edward Stanford
University
$234,189
IDEA
2013 A First-in-class Allosteric
RAF Inhibitor for Breast
Cancer
Cheresh, David UC San Diego $187,500
IDEA
2014 Drug to Block Double-
strand Break Repair in
Breast Cancer
Chu, Gilbert Stanford
University
$135,436
IDEA
Competitive
Renewal
2007 Early Breast Cancer
Detection Using 3D
Ultrasound Tomography
Nelson, Thomas UC San Diego $225,000
IDEA
Competitive
Renewal
2008 Topoisomerase-IIa as a
Predictor of Anthracycline
Response
Press, Michael University of
Southern
California
$405,393
IDEA
Competitive
Renewal
2009 Modulation of Breast
Cancer Stem Cell Response
to Radiation
Pajonk, Frank UCLA $250,000
IDEA
Competitive
Renewal
2011
Reducing Surgical
Morbidity of Breast Cancer
Staging
Chen, Steven Beckman
Research Institute
of the City of
Hope
$272,483
IDEA
Competitive
Renewal
2011
Combating Breast Cancer
with the Wellderly Immune
Repertoire
Felding, Brunhilde Scripps Research
Institute
$473,750
Joining
Forces
Conference
Award
2011
7th International
Symposium on the
Intraductal Approach
Love, Susan Dr. Susan Love
Research
Foundation
$25,000
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Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
Joining
Forces
Conference
Award
2014 UCSF Breast Oncology
Program Scientific Retreat
van't Veer, Laura UCSF $8,023
Joining
Forces
Conference
Award
2015 UCSF Breast Oncology
Program Scientific Retreat
van't Veer, Laura UCSF $12,000
Postdoctoral
Fellowship
2009 Compounds Blocking
Assembly of LRH-1 in
Breast Cancer
Benod, Cindy UCSF $90,000
Postdoctoral
Fellowship
2009 Chemerin as an
Immunotherapeutic Agent
in Breast Cancer
Pachynski, Russell Palo Alto Institute
for Research &
Education
$89,600
Postdoctoral
Fellowship
2010 The Role of ANCCA in
Tamoxifen Resistant Breast
Cancer
Andrews, Nicolas UC Davis $84,822
Postdoctoral
Fellowship
2010 MRI Guided Focused
Ultrasound in Breast Cancer
Treatment
Bitton, Rachel Stanford
University
$88,257
Translational
Research
Award
2007 Intraductal Therapy of
DCIS: A Presurgery Study
Love, Susan Dr. Susan Love
Research
Foundation
$851,559
Translational
Research
Award
2008 Stratifying DCIS Biopsies
for Risk of Future Tumor
Formation
Tlsty, Thea UCSF $750,000
Translational
Research
Award
2008 Genetics of Tamoxifen
Response
Ziv, Elad UCSF $803,111
Translational
Research
Award
2010 Measuring Real-world
Breast Cancer Outcomes
Kurian, Allison Stanford
University
$1,066,225
Translational
Research
Award
2010
Towards Highly Effective
Inactivation of HER2-HER3
Signaling
Moasser, Mark UCSF $744,957
Translational
Research
Award
2011 Vitamin D and Breast
Cancer in Obesity:
Therapeutic Trials
Feldman, David Stanford
University
$1,156,703
* Grant titles in this table may appear to repeat due either phased research (a pilot grant followed by a full
research grant) or due to continuation grants being given.
Table 18: Detection, Prognosis and Treatment Funding in Progress as of 2015
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
IDEA
2013 Vitamin D Signals Via a
Novel Pathway to Inhibit
Metastasis
Feldman, Brian Stanford University $236,434
IDEA
2013
Expression Profiling of
Circulating Tumor Cells
Lang, Julie University of
Southern California
$244,756
IDEA
2013 Imaging, Genomics, and
Glycoproteomics for
Cancer Detection
Pitteri, Sharon Stanford University $235,500
IDEA
2013 Intranasal Drug Delivery
for Brain Metastatic
Breast Cancer
Schonthal, Axel University of
Southern California
$242,530
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Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
IDEA
2014 Gut Microbiota in
Association with
Chemotherapy Treatment
Wu, Anna University of
Southern California
$246,937
IDEA
2014
A Novel TNBC
Therapeutic Opportunity:
Cystine Addiction
Timmerman, Luika UCSF $187,500
IDEA
2014 CT-guided DOT for
Breast Cancer Imaging
Li, Changqing UC Merced $193,750
IDEA
2014 Sulindac-derived
Compounds for Breast
Cancer Therapy
Zhang, Xiao-Kun The Burnham
Institute for Medical
Research
$292,498
Translational
Research
Award
2012 Using Epigenetic
Changes to Stratify DCIS
Biopsies
Tlsty, Thea UCSF $750,000
Translational
Research
Award
2012 Predicting Breast Cancer
Recurrence to Improve
Care
Esserman, Laura UCSF $793,127
Translational
Research
Award
2013 Cardiovascular Toxicity
Following Aromatase
Inhibitor Use
Haque, Reina Kaiser Foundation
Research Institute
$501,034
E. Funding and Research Details: Biology of the Breast Cell
To understand the origin of breast cancers, more research is needed on the pre-cancerous,
causative events in the normal breast. Research in recent years increasingly points to the
importance of looking at breast development at different stages of development, such as
embryonic and pubertal development of the gland. By studying the different stages of breast
development, researchers are better able to understand when girls and women are most vulnerable
and most susceptible to increased risk for breast cancer.
Studying the biology of the breast cell we can infer what is creating the conditions that may later
develop into breast cancer. In breast development, cell populations must coordinate migration,
proliferation, and apoptosis (cell death) over space and time. In cancer progression these
processes become deregulated, initially at the genetic level that leads to the physiological changes
associated with malignancy.
It is not just mutations in DNA that can lead to a cell becoming cancer, but changes to the way
the DNA is modified, folded, and packaged, called epigenetics, which can turn on or off the
ability of the DNA to code for proteins. An inability to recognize and properly repair damage to
DNA that occurs in normal cell physiology and can be enhanced by environmental factors is
recognized as a driving force of cancer progression. The interaction between different types of
cells in the breast increasingly is found to play a critical role in the regulation of normal growth
and differentiation. Studying the normal way that cells move and communicate with each other
provides insights into the processes that go awry as cancers become more aggressive and
metastasize.
Researchers funded by CBCRP have gained understanding in the short-term increased risk for
breast cancer after pregnancy, developed a model for understanding the interaction between
breast cancer cells and fat cells, and found markers that help detect breast cancer earlier and more
accurately.
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Two of CBCRP’s research areas are presented in this section:
Biology of the Normal Breast: The Starting Point
Pathogenesis: Understanding the Disease
CBCRP invested over $6.7 million dollars in 38 investigator initiated biology of the breast cell
research projects that were conducted between 2010 and 2015. Below are highlights of a selection
of research projects CBCRP has funded, followed by Tables 19 and 20 listing all research that
was concluded between 2010 and 2015 and in progress (respectively) for all research related to
biology of the breast cell.
Highlights of Funding Concluded in 2010–2015
Examining Metastatic Potential in Mammary Stem Cells
Jay Desgrosellier of UC San Diego found that a molecule, integrin alpha v beta 3, that is highly
expressed in metastatic breast cancer cells is also found in breast cancer stem cells necessary for
normal mammary stem cell behavior and mammary gland formation during pregnancy. There is
an increased short-term risk for a highly aggressive form of breast cancer following each
pregnancy, and this study’s findings may explain why this happens. Findings were published in
Developmental Cell in August 2014.
Local Adipocyte Function in Breast Cancer
Obesity is a risk factor for the development of postmenopausal breast cancer (but is protective
against premenopausal breast cancer). Adipocytes (fat cells) increase in number and size in
obesity and are abundant in the mammary microenvironment. These cells produce endocrine,
inflammatory, and angiogenic factors that have tremendous potential to affect adjacent breast
cancer cells. Barbara Mueller of Torrey Pines Institute for Molecular Studies developed a
model for investigating the interaction between breast cells and fat cells. She was able to
demonstrate that hormone-dependent human breast cancer cells, which are not tumorigenic when
injected into mice by themselves, grow tumors when they are inoculated together with fat cells.
Importantly fat cells are only able to support tumor growth when they are in direct contact with
the breast cancer cells and not when they are at a distant site in the same mouse. Given the extent
of obesity, this finding opens the door to greater understanding of potential causes of breast
cancer and possibly interventions. Findings were published in Adipocyte in July 2013.
Stroma Expression Patterns in Breast Cancer
The earliest recognizable stages of breast neoplasia (tumor development) are several types of cell
lesions; however, there has been inadequate information on how to detect and interpret these
lesions. To address this gap, Robert West of Palo Alto Institute for Research & Education
undertook the first global examination of gene expression within early neoplasias. He identified
several features that appear to characterize early neoplasias as a whole and represent insights into
this very early stage of cancer development. His findings will help researchers to accurately
profile invasive ductal carcinoma, ductal carcinoma in situ, early neoplasias and normal breast
tissue within the same patient. This type of information has the potential to significantly improve
efforts in breast cancer detection and prevention. Findings were published in Genome Biology in
May 2014 and the Journal of Pathology in October 2010.
Discovery of Fusion Genes in Breast Cancer
Understanding fusion genes, or genes that form from two previously separate genes, can provide
both diagnostic markers and therapeutic targets for cancer. Despite progress in understanding
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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fusion genes in other cancers, until Jonathan Pollack of Stanford University undertook his
CBCRP-supported research, there was very little understanding of the role of fusion genes in
breast cancer. His analysis showed that gene fusion may have both a causal role in breast cancer
as well as be required for cancer cell growth. This new knowledge shows great potential to
support improved diagnosis and therapy for breast cancer. Findings were published in PLOS
Genetics in April 2013.
Table 19: Biology of the Breast Cell Funding that Concluded in 2010–2015
Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
Dissertation
Award
2008 Role of Estrogen-
modulated Protein AGR2
in Breast Cancer
Geyfman, Mikhail UC Irvine $71,491
Dissertation
Award
2009 A Genetic System for
Identification of Mammary
Stem Cells
Engle, Dannielle Salk Institute for
Biological
Studies
$76,000
Dissertation
Award
2009
Substrate Profiling of
Breast Cancer Related
Proteases
Dix, Melissa Scripps Research
Institute
$76,000
Dissertation
Award
2009 The Role of Estrogen
Receptor in Endocrine
Resistance
Chan, Hei Beckman
Research Institute
of the City of
Hope
$76,000
Dissertation
Award
2010 Pharmacological
Modulation of PP2A
Activity in Breast Cancer
Bachovchin, Daniel Scripps Research
Institute
$29,366
IDEA
2008 Nanolipoproteins to Study
Breast Cancer Growth
Receptors
Henderson, Paul UC Davis $99,000
IDEA
2009 A Molecular Strategy to
Inhibit Breast Cancer
Metastasis
Brodsky, Frances UCSF $150,000
IDEA
2009 Novel Tumor Suppressors
in Breast Development and
Cancer
Fuller, Margaret Stanford
University
$230,373
IDEA
2009 Role of p68 in Breast
Cancer
Wang, Daojing Lawrence
Berkeley
National
Laboratory
$165,335
IDEA
2009
Podocalyxin as a Basal-
like Breast Cancer Stem
Cell Marker
Casey, Graham University of
Southern
California
$243,676
IDEA
2009 The Role of EGF Variant
mLEEK and Grp78 in
Breast Cancer
Wong, Albert Stanford
University
$241,380
IDEA
2009 Proline Metabolism in
Metastatic Breast Cancer
Richardson, Adam The Burnham
Institute for
Medical Research
$284,895
IDEA
2009
Discovery of Fusion Genes
in Breast Cancer
Pollack, Jonathan Stanford
University
$160,000
IDEA
2009
Finding BRCA1
Ubiquitinated Substrates in
Breast Cancer
Spruck, Charles,
del Rincon, Sonia
The Burnham
Institute for
Medical Research
$191,000
IDEA
2009 Breast Cancer Tumor-
Stroma Interactions in an
In Vivo Model
Borgstrom, Per Vaccine Research
Institute of San
Diego
$279,336
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Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
IDEA
2010 Local Adipocyte Function
in Breast Cancer
Mueller, Barbara Torrey Pines
Institute for
Molecular
Studies
$272,993
IDEA
2010 Inhibiting Mutation to
Prevent and Treat Breast
Cancer
Romesberg, Floyd Scripps Research
Institute
$63,021
IDEA
2010 Complement-mediated
Stem Cell Recruitment to
Breast Cancer
Schraufstatter, Ingrid Torrey Pines
Institute for
Molecular
Studies
$136,500
IDEA
2010 p97 as a Therapeutic
Target in Breast Cancer
Metastasis
Latterich, Martin Proteomics
Research Institute
for Systems
Medicine
$292,500
IDEA
2010
Reelin Signaling
Involvement in Breast
Cancer Cell Migration
Carpenter, Ellen UCLA $149,493
IDEA
2010 Myeloperoxidase Mediated
Protection in Breast
Cancer
Reynolds, Wanda The Burnham
Institute for
Medical Research
$286,500
IDEA
2011 Molecular Classification of
Early Breast Neoplasia
West, Robert Stanford
University
$156,561
IDEA
2011 Novel Cell-matrix Markers
and Drivers of Breast
Cancer
Muschler, John California Pacific
Medical Center
Research Institute
$262,500
IDEA
2011 Breast Cancer-secreted
MicroRNAs in the Pre-
metastatic Niche
Wang, Shizhen Emily Beckman
Research Institute
of the City of
Hope
$252,000
IDEA
2012 Establishing Cell
Lifespans in Cancer and
Normal Breast
Borowsky, Alexander UC Davis $155,728
IDEA
2012 Examining Metastatic
Potential in Mammary
Stem Cells
Desgrosellier, Jay UC San Diego $150,000
IDEA
2012 Understanding HER3 and
mTor Signaling in Breast
Cancer
Moasser, Mark UCSF $100,000
IDEA
2012 Rescuing HR DNA Repair
in BRCA1-Mutation
Carriers
Stark, Jeremy Beckman
Research Institute
of the City of
Hope
$166,406
IDEA
Competitive
Renewal
2009
Stroma Expression
Patterns in Breast Cancer
West, Robert Palo Alto
Institute for
Research &
Education
Stanford
University
$164,403
$188,097
Postdoctoral
Fellowship
2008 Global Analysis of Protein
Ubiquitination in Breast
Cancer
Grotegut, Stefan The Burnham
Institute for
Medical Research
$89,558
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Award Type Year
Funded
Title Investigator(s) Institution(s) Dollars
Postdoctoral
Fellowship
2008 Regulation of Breast Stem-
Progenitor Cell Chromatin
by Pygo2
Gu, Bingnan UC Irvine $135,000
Postdoctoral
Fellowship
2009
Targeting MYC in Human
Breast Cancer
Horiuchi, Dai UCSF $90,000
Postdoctoral
Fellowship
2009 P32: New Functional
Target in Breast Cancer
Brain Metastasis
Staflin, Karin Scripps Research
Institute
$71,577
Postdoctoral
Fellowship
2009
Control of BRCA2-
mediated Homologous
Recombination
Meyer, Damon UC Davis $90,000
Postdoctoral
Fellowship
2010 The Role of Twist1 in
Epithelial-mesenchymal
Transition
Tsai, Jeff UC San Diego $90,000
Postdoctoral
Fellowship
2010 The Role of Clim Proteins
in Breast Cancer
Verma, Suman UC Irvine $37,961
Postdoctoral
Fellowship
2010
The Role of microRNAs in
Triple-Negative Breast
Cancer
Kusdra, Leonard UCSF $89,200
Table 20: Biology of the Breast Cell Funding in Progress as of 2015
Award
Type
Year
Funded
Title Investigator(s) Institution(s) Dollars
IDEA
2014 Mechanical Stressors and
Age as Regulators of
Telomerase
LaBarge, Mark Lawrence Berkeley
National Laboratory
$219,077
IDEA
2014 Systemic Metabolic
Reprogramming by BC-
Secreted MicroRNAs
Wang, Shizhen
Emily
Beckman Research
Institute of the City of
Hope
$252,000
IDEA
2014 Targeting Breast Cancer
Metastasis to Bone
Contag, Christopher Stanford University $240,750
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V. Program Highlights, 2010–2015
CBCRP remains a leader in engaging communities in the research process, ensuring research is
not just conducted with scientific rigor but also is designed to address real needs, such as policy
changes, and distributing the information and lessons learned through its funded research. Below
are some examples of how CBCRP is expanding the role of research in addressing real world
problems.
Fostering Community Based Participatory Research
CBCRP has been a national leader in engaging community members in research. In 1997,
CBCRP pioneered the Community Research Collaboration awards (CRC). These grants allow
community groups and breast cancer advocacy organizations to team up with experienced
scientists to pursue research important to the community in a scientifically rigorous way. This
approach to research is called community-based participatory research (CBPR). CRC awards are
open to nonprofit organizations or ad hoc community groups in any California community
affected by breast cancer. They support scientists and community members to work in partnership
conducting CBPR focused on environmental links to breast cancer and health disparities and
breast cancer risk.
There are four overarching areas of benefit to conducting CBPR:
1. Research quality is improved
2. Communities are strengthened and empowered
3. Scientists are strengthened
4. Public health is improved, as the research is linked directly to communities efforts to
advocate on their own behalf
In 2010–2015, CBCRP provided $6,837,532 million in funding to 19 collaborative projects
conducted by 29 different California institutions and community groups.
Community-based Research Infrastructure to Better Science (CRIBS)
Despite the success of growing investment in CBPR, evaluations conducted by CBCRP showed
that community groups would greatly benefit from training in various aspects of conducting
scientific research. Additionally, scientists and community groups could greatly benefit from a
collaborative learning process to build their research partnership. To address this, CBCRP made
significant investments in CBPR capacity-building in recent years.
Beginning in 2010, the National Institute of Environmental Health Sciences (NIEHS) recognized
CBCRP's leadership in community-based participatory research by funding an in-depth training
program (Award Number 1RC4ES019826). In collaboration with the nonprofit organization
Commonweal and the training and coaching organization Plumbline Consulting, CBCRP's
Community-based Research Infrastructure to Better Science (CRIBS) training prepared research
teams to develop winning research proposals to address the link between environmental
exposures, health disparities and breast cancer risk.
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Twelve diverse teams of 33 community members and scientists from across the state took part in
the training from January 2011 to January 2012. It included ten days of in-person training, seven
online sessions, technical assistance calls and a “mock” review of trainees funding proposals.
Every one of the teams trained submitted research applications to CBCRP. Of the 12 applications
from CRIBS fellows, 33 percent were funded by CBCRP on the first attempt, an impressive
success rate. Further, 80 percent of CRC pilot grant applications funded in 2013 by CBCRP came
from the CRIBS cohort. In 2014 one additional CRIBS team resubmitted an application and was
funded. In total, five out of 12 teams (42 percent) were eventually funded through CBCRP as of
2015.
QuickStart Training
Building on the success of CRIBS, CBCRP, Commonweal and Plumbline offered a revised
version of CRIBS. This training, renamed “QuickStart,” was updated and shortened based on
evaluations of CRIBS. QuickStart was offered in the summer of 2014 through a grant from
CBCRP to Commonweal. The training program was shortened to six days of face-to-face
training, seven weekly online sessions, two technical assistance phone calls and various written
assignments (including developing a partnership plan and drafting a grant proposal) over the
course of 12 weeks. After the 12 weeks, a mock review of proposals was held in January 2015.
Six of the 10 teams from the QuickStart training submitted applications for the 2015 CRC award.
One team was awarded a planning grant (17 percent) and two teams were awarded pilot funding
(33 percent), for a total of 50 percent awarded funding of those who applied.
In 2014, CBCRP, Commonweal and Plumbline were awarded a four-year grant from the National
Cancer Institute of the National Institutes of Health (Award Number R25CA188482). This will
allow for four more rounds of QuickStart training, which will largely follow the model of training
used in 2014. The next round of QuickStart training is anticipated to start in Spring 2016.
Technical Assistance
In addition to the intensive training opportunities, CBCRP also offers free technical assistance
support to people interested in engaging in CBPR. One-on-one technical assistance calls provide
support as teams prepare their CRC application. Teams also can have a pre-application research
plan review, in which research plans are critiqued by active CBPR researchers before the formal
application is submitted. CBCRP staff are also available by phone for teams to debrief and plan
how to respond to the feedback. CBCRP also offers webinars to help prospective teams
understand the application process and requirements.
Policy Initiative: New Funding mechanism
As part of our program-initiated research, CBCRP launched the Policy Initiative in 2015. This
funding mechanism allocates $150,000 annually for a rapid-response, policy-related research
related to prevention, detection, and treatment of breast cancer, as well as research into the
formulation of policy alternatives that will reduce the incidence of and morbidity and mortality
from breast cancer in California. To implement the Policy Initiative, science, advocate, and policy
experts as well as interested individuals and organizations contribute to the development of policy
topics, research questions and recommendations made to the Research Council. The goal is to fill
a critical gap to allow policy changes to be grounded in science that is relevant and credible.
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In this context, policy is defined broadly as “a law, regulation, procedure, administrative action,
incentive, or voluntary practice adopted or proposed by a local, regional, tribal, state or federal
government, business, organization, or institution that will reduce the incidence of and/or the
morbidity and mortality from breast cancer in California.”
The Policy Initiative is guided by a Research Council policy committee, a Policy Research
Advocacy Group (PRAG), made up of California-based policy-makers (state legislators, state and
federal legislative staff, former state governmental staff), representatives of organizations
involved in breast cancer-related policy development and advocates, individual topic nominators
and peer reviewers from outside California (see Appendix 5). The PRAG is tasked with providing
ideas and guidance in the identification and development of policy topics relevant to California
and to recommend to the Research Council a prioritized policy topic(s) for the Policy Initiative.
In early 2015, a Request for Qualifications was released to select teams of on-call investigators to
conduct rapid response research for our new Policy Initiative. Awarded funds may be dedicated
to one team or spread out over multiple teams, depending on the complexity of the topics and the
potential for impact of the projects. Two teams were selected in June 2015 and will remain the
Policy Initiative On-Call Teams until June 2018. They are:
Health Policy Research for Cancer Prevention and Control team, led by Ninez Ponce
at UCLA’s Center for Health Policy Research (CHPR) and its Center for Cancer
Prevention and Control Research (CPCR).
Rapid Response for Environmental Research team (RaRE Research), led by Peggy
Reynolds at Cancer Prevention Institute of California and Bob Harrison at the California
Department of Public Health Occupation Health Branch
The first policy topic to be researched is: What are the significant barriers or challenges to
access to breast cancer oncology care if you are uninsured, underinsured, on public or private
insurance? Research is expected to start late 2015.
Symposium
In May 2013, CBCRP hosted a two-day statewide symposium “From Research to Action:
Celebrating Two Decades of Change,” commemorating twenty years of innovative research.
More than 300 advocates, scientists, health care providers, policy makers and public citizens
gathered to learn about the advances made in breast cancer research and the work that has yet to
be done.
The audience was comprised of 47 percent of people who described themselves as patients,
advocates or general public. Their participation was supported in part by a $10,000 conference
grant from the NIEHS and NCI (1R13 ES022921-01) to support travel scholarships for breast
cancer advocates to attend the event. The attendees’ diverse experiences with breast cancer
provided a unique opportunity to exchange ideas and build new networks.
Highlights of the symposium program included a keynote by Susan Love, a visionary in the
breast cancer research field, where she shared her journey in breast cancer research and CBCRP’s
role in “pushing the envelope.” Dennis Slamon, a leader whose work resulted in a breakthrough
treatment for breast cancer, also gave a keynote on how CBCRP’s advancements have driven
down breast cancer mortality.
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More than 15 plenary sessions were offered on topics including environmental links to breast
cancer, disparities in breast cancer, community involvement in breast cancer research and others.
Two sessions, “The Role of Research in Setting Breast Cancer Policy” and “Changing Federal
Priorities for Breast Cancer Research,” demonstrated how we are on the verge of a sea change in
how we approach research in the coming years.
Illustrated Posters depicting the results of 35 research projects funded by CBCRP were on display
throughout the symposium. Researchers were on hand for a poster viewing session where they
could answer questions and receive comments about their research directly from the public and
their scientific colleagues.
The full program booklet is available at http://www.cabreastcancer.org/files/symposia-
docs/2013symposium-booklet.pdf. Select videos from the symposium are available at
http://vimeopro.com/vcube/cbcrp-2013.
Conferences
CBCRP funded 11 conferences during this reporting period (2010–2015). Examples include the
Stanford Cancer Institute 2
nd
Annual Conference on Breast Cancer and African Americans in
2013, the National Latino Cancer Summit in 2010 and 2012, and GIS for Community Impact:
From Technology to Translation in 2015.
Sharing Progress with Scientists and the Public
CBCRP prides itself on transparency and proactive communication with the public. There are
numerous online and in-person ways this is done:
Website: In 2014, CBCRP undertook a comprehensive overhaul of their website.
Significant effort was made to make information available in clearer, more concise ways.
Additionally, navigation was greatly improved so information is considerably easier to
find. Some of the features on the website include:
Links between abstracts of research supported by CBCRP funding to the
publications that report results through the National Institutes of Health’s
PubMed, a public-access database of biomedical journals
Funding opportunity announcements and technical assistance for applying for
grants
Downloadable versions of all CBCRP publications
Opportunities to request specific information from CBCRP, and make online
donations to CBCRP
Reports on progress and outcomes of CBCRP’s research strategy development
E-newsletter: CBCRP’s email newsletter gives subscribers timely announcements of
funding opportunities, early notification of new research resources and breast cancer
conferences, and avenues to stay involved, informed, and active in the fight against
breast cancer. It is distributed to over 2,800 stakeholders each month.
Facebook and Twitter: CBCRP currently has nearly 2,000 likes of our Facebook page.
Our Facebook page presents up-to-date information about breast cancer research, along
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with an online space to exchange ideas, ask questions, and follow links to information
about CBCRP-funded research studies. Facebook users can also access invitations to
events such as the CBCRP symposium, announcements of new CBCRP publications,
and links to other breast-cancer-related organizations. The Program's Twitter feed also
keeps followers current about breast cancer research and opportunities to take part in
CBCRP activities.
Serving the Media: CBCRP does regular outreach to the media about the Program and
about CBCRP-funded research projects that are of interest to the general public. When
reporters from TV, newspapers, magazines, or other media need information on breast
cancer research, CBCRP links them with the appropriate experts. News about CBCRP
and research funded by CBCRP also appeared over the past year in local California
newspapers, and on a variety of general news, health news, international news, and blog
Web sites.
For example, Mhel Kavanaugh-Lynch was featured in the documentary “Pink Ribbons,
Inc.,” which explores the complexity and controversy of the use of pink ribbons as
marketing tools for breast cancer fundraising. Dr. Kavanaugh-Lynch was also a co-
author of an opinion piece in Science Magazine in response to Science dedicating a full
issue to breast cancer but leaving out the body of scientific evidence linking toxic
chemicals and radiation to breast cancer.
Speakers and Educational Bureau: When community organizations want speakers on
breast cancer research for meetings and public events, CBCRP provides referrals from
the Program’s network of researchers and advocates. The Program also refers research
experts to teach continuing education classes for healthcare professionals.
Scientific Presentations at Conferences: CBCRP staff and CBCRP-funded researchers
present research results at scientific conferences. Examples include:
Institute of Medicine Committee on Breast Cancer and the Environment, “The
Scientific Evidence, Research Methodology, and Future Directions,” San
Francisco, CA July 6–8, 2010. Mhel Kavanaugh-Lynch, presenter.
California Black Women’s Health Project Policy Summit, Sacramento, CA May
9, 2011. Catherine Thomsen, presenter.
7th International Symposium on the Intraductal Approach to Breast Cancer: The
Normal Human Breast: Building our Understanding from Mice to Women,
“Translational and Community-Based Funding Opportunities at the California
Breast Cancer Research Program.” Santa Monica, CA February 23-26, 2011.
Mhel Kavanaugh-Lynch, presenter.
Interagency Breast Cancer and Environmental Research Coordinating
Committee” California Breast Cancer Research Program: Special Research
Initiatives” San Francisco, CA February 23, 2011. Mhel Kavanaugh-Lynch,
presenter.
28
th
Annual Women in Medicine Conference, “Environmental Chemicals &
Cancer” July 26, 2011. Stowe, VT Mhel Kavanaugh-Lynch, presenter.
Washington Hospital, “Chemicals & Breast Cancer” Fremont, CA October 13,
2011. Mhel Kavanaugh-Lynch, presenter.
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66
American Association for Cancer Research Frontiers in Breast Cancer Research,
Anaheim, CA October 15–20, 2012. Catherine Thomsen, presenter.
American Association for Cancer Research, “The Science of Cancer Health
Disparities in Racial/Ethnic Minorities and the Medically Underserved” San
Diego, CA October 27–30, 2012. Senaida Fernandez, presenter.
American Public Health Association’s 140th Annual Meeting and Expo,
“What’s Causing Cancer Disparities? The Roles of the Social and Physical
Environments across the Lifespan” San Francisco, CA October 31, 2012.
Catherine Thomsen, presenter.
Breast Cancer Fund’s Pioneering Prevention, “Ushering in a new era in the
breast cancer movement” May 30, 2013 San Francisco, CA. Mhel Kavanaugh-
Lynch, presenter.
American Public Health Association’s annual conference, November 6, 2013.
Poster titled “Evaluation of community-academic partnerships after participation
in an intensive CBPR training program” Boston, MA Senaida Fernandez,
Catherine Thomsen, Mhel Kavanaugh-Lynch, presenters and can be viewed at:
https://apha.confex.com/apha/141am/webprogram/Paper292452.html.
Breast Cancer and the Environment Research Program of the National Institutes
of Environmental Health Sciences and National Cancer Institute, Extended
Environmental Exposures Annual Meeting, Future Directions in Breast Cancer
and the Environment, “A Midstream View of the California Breast Cancer
Prevention Initiative.” November 8, 2013, Madison, WI. Mhel Kavanaugh-
Lynch, presenter.
National Summit on Cancer in the LGBT Community, NYC, “Breast and
Gynecological Cancer in the LGBT Community,” New York, NY January 18,
2014. Mhel Kavanaugh-Lynch, presenter.
American Cancer Society Cancer and the Environment Team, “California Breast
Cancer Research Program–Program Initiatives,” November 3, 2014. Mhel
Kavanaugh-Lynch, presenter.
Exhibits at community meetings: CBCRP presented displays of the program’s work at
a number of community events and scientific meetings during 2010–2013 (CBCRP
stopped exhibiting in 2013 due to reduced staffing). Examples include:
7th International Symposium on the Intraductal Approach to Breast Cancer,
Santa Monica, February 23–25, 2011
The North Face Benefit Fair, San Leandro, October 5–6, 2011
Breast Cancer and African American Women: Messages that Count, San
Francisco, October 7, 2011
AACR Advances in Breast Cancer, October 12–15, 2011
11th Annual Allison Taylor Holbrooks/Barbara Jo Johnson Breast Cancer
Conference, San Francisco, March 3, 2012
Young Women’s Breast Health Summit, San Francisco, March 31, 2012
Linking Tobacco Control Research and Practice for a Healthier California,
Sacramento, April 10–12, 2012
American Society for Investigative Pathology 2012 Annual Meeting, San Diego,
April 21–25, 2012
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67
The Global Chinese Breast Cancer Organizations Alliance (GCBCOA) 4th
Global Chinese Breast Cancer Organizations Alliance Conference, Pasadena,
April 25–28, 2012
12th Annual Conference Breast Cancer & African Americans, Oakland, May 5,
2012
African American Community Health Advisory Committee’s Soul Stroll 2012,
San Mateo, May 19, 2012
Susan G. Komen’s Many Faces One Voice Conference, San Francisco, June 18,
2012
Latinas Contra Cancer, Mission Bay SF, July 24–25, 2012
American Association for Cancer Research Frontiers in Breast Cancer Research,
Anaheim, October 15–20, 2012
American Public Health Association’s 140
th
Annual Meeting and Expo, San
Francisco, October 27–31, 2012
American Association for Cancer Research The Science of Cancer Health
Disparities in Racial/Ethnic Minorities and the Medically Underserved, San
Diego, October 27–30, 2012
2nd Annual Breast Cancer & African Americans Conference, Oakland, May 4,
2013
ActNOW: Oakland, June 8, 2013
Publications
In 2007, CBCRP released Identifying Gaps in Breast Cancer Research. This research paper
reviewed previous research in two areas covered under the CBCRP’s Special Research Initiatives:
environmental links to breast cancer and the reasons why some groups of women bear a greater
burden of the disease. Through the CBCPI process, the report was updated by the UCSF Program
on Reproductive Health and Environment and CBCRP. In 2013 the updated report, called
California Breast Cancer Research Program Prevention Initiatives (CBCPI) Gaps Supplement:
Targeted Scans of the 2007 “Gaps” Document “Identifying Gaps in Breast Cancer Research:
Addressing Disparities and the Roles of the Physical and Social Environment, was released.
Additionally, CBCRP staff were published in several academic publications. Examples include:
J. Green Brody, R.A. Rudel, M. Kavanaugh-Lynch. Testing Chemicals for Effects
on Breast Development, Lactation, and Cancer. Environ Health Perspect 119:a326-
a327 (2011).
P. Sutton, M.H.E. Kavanaugh-Lynch, M. Plumb, I.H. Yen, H. Sarantis, C.L.
Thomsen, S. Campleman, E. Galpern, C. Dickenson, T.J. Woodruff
.
California
Breast Cancer Prevention Initiatives: Setting a research
agenda for prevention.
Reprod Toxicol. 2015 Jul; 54:11-8.
Senaida Fernandez, Marj Plumb, Catherine Thomsen, Susan Braun, Heather
Sarantis, Juliana van Olphen, Emily Galpern, Marion Kavanaugh-Lynch. Technical
assistance as part of capacity building for collaborative research in breast cancer,
the environment, and/or disparities. [abstract]. In: Proceedings of the Fifth AACR
Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities
and the Medically Underserved; 2012 Oct 27–30; San Diego, CA. Philadelphia
(PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr
B05.
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68
Juliana Elizabeth Van Olphen, Senaida Fernandez, Marj Plumb, Heather Sarantis,
Catherine Thomsen and Emily Galpern. Evaluation of community-academic
partnerships after participation in an intensive CBPR training program.
Conference: 141st APHA Annual Meeting and Exposition 2013.
Awards and Recognition
CBCRP received one award in this reporting period. In November 2011, CBCRP was recognized
at the National Coalition for Cancer Survivorship’s 25th Annual Rays of Hope® Gala winning its
most prestigious award, the Catherine Logan Award for Service to Survivorship.
In October 2014, CBCRP was recognized by Money Magazine for leadership in research quality,
accountability, and integrity. The magazine identified CBCRP as one of five charitable
organizations that are making the biggest impact against breast cancer. The article noted: "These
organizations have high levels of accountability, have successfully sustained their programs over
time, and spend a high percentage of their revenue on programs and services rather than
administrative or fundraising costs." CBCRP was chosen in particular for research quality, focus
on prevention, and because 95 percent of the revenue goes directly to funding breast cancer
research and education.
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69
VI. Activities to Increase Funding for Breast Cancer Research and Awareness of Breast
Cancer Research
Funding for CBCRP from the State tobacco tax decreases every year. Moreover, current funds are
not sufficient to do all that needs to be done. During 2010–2015, CBCRP turned down
investigator-initiated grant applications requesting a total of $26,447,895 that were rated by
expert reviewers as having sufficient scientific merit for funding. Commitment and action are
needed to ensure our present funding sources and increase funds from new sources. CBCRP does
this by increasing awareness of breast cancer research through public education and offering a
high-publicity award, the Faith Fancher Research Award. CBCRP also actively fundraises
through a California state income tax checkoff program, private foundations and donations from
the public. Progress in these areas is highlighted in this section.
Increasing Voluntary Donations to the California State Income Tax Checkoff Program
To address the pressing need to increase funds, CBCRP established the Community Partners
Program, which pursues two goals:
Increasing donations to CBCRP through the California income tax voluntary contribution
program and new sources
Increasing public awareness of breast cancer, breast cancer research, and the California
Breast Cancer Research Program
CBCRP conducts outreach campaigns focused on raising awareness of breast cancer research
results and the Program’s work to encourage donations through state tax return contributions. A
special CBCRP website, “405–Check the Box Fund the Fight” (http://www.endbreastcancer.org),
informs stakeholders about fundraising progress. It also summarizes progress researchers
achieved with the grants funded via contributions made on state income tax returns. CBCRP has
used Google, Facebook and YouTube ads to alert California taxpayers to these resources.
To further increase state tax return contributions, President Janet Napolitano and Provost and
Executive Vice President Aimée Dorr sent letters to over 180,000 University of California
employees notifying them of the opportunity to contribute to the fund. CBCRP also conducted a
combined outreach effort, named Checkoff California, with other California nonprofit
organizations who receive these contributions. Together, CBCRP and these nonprofit
organizations created a social media marketing campaign to alert the public to the income tax
checkoff program that included a presence on Facebook, Twitter, and a website highlighting all
nonprofit organizations included in the income tax checkoff program.
Governors Arnold Schwarzenegger and Jerry Brown further boosted California's awareness of the
opportunity to make donations through the tax checkoff by issuing official proclamations
declaring March as Checkoff California Month.
The Community Partners Program has led to growth and diversification in donations to CBCRP.
An average of 29,000 individuals annually donated over $2.1 million to CBCRP during 2010–
2015 through the state income tax checkoff program. This made CBCRP one of the checkoff
program’s top beneficiary organizations. The grants that were funded in part through voluntary
tax contributions can be found in Table 21.
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Table 21: Grants funded in part through voluntary tax contributions
Grant Title Investigator(s) Institution(s)
Targeting Brain Metastasis with a
Cell-based Approach
Mihaela Lorger The Scripps Research Institute
Light at Night and Breast Cancer Risk
in California Teachers
Peggy Reynolds Cancer Prevention Institute of
California
Salivary Biomarkers for Early
Detection of Breast Cancer
Lei Zhang UCLA
Measuring Real-World Breast Cancer
Outcomes
Allison Kurian Stanford University School of
Medicine
Combating Breast Cancer with the
Wellderly Immune Repertoire
Brunhilde Felding Scripps Research Institute
Vitamin D and Breast Cancer in
Obesity: Therapeutic Trials
David Feldman Stanford University
Communicating Research Results
Effectively to Policy Makers
Joy Melnikow UC Davis
Decreasing Endocrine Disruptor
Exposure in Latina Teens
Kim Harley and
Kimberly Parra
UC Berkeley and Clinica de Salud del
Valle de Salinas
Co-Targeting the Notch and EphB4
Receptors in Breast Cancer
Debasish Tripathy University of Southern California
Genetic Predictors of Chemotherapy
Toxicity in Breast Cancer
Deanna Kroetz UCSF
Meeting the self-care needs of Latinas
after breast cancer
Anna Napoles and
Carmen Ortiz
UCSF and Circulo de Vida Cancer
Support and Resource
Vitamin D Signals Via a Novel
Pathway to Inhibit Metastasis
Brian Feldman Stanford University
Intranasal Drug Delivery for Brain
Metastatic Breast Cancer
Axel Schonthal University of Southern California
Targeting Breast Cancer Metastasis to
Bone
Christopher Contag Stanford University
Intervening on Reproductive Health in
Young Survivors
Irene Su UC San Diego
CT-guided DOT for Breast Cancer
Imaging
Changqing Li UC Merced
Gut Microbiota in Association with
Chemotherapy Treatment
Anna Wu University of Southern California
Persistent Organic Pollutants and
Mammographic Density
Eunjung Lee University of Southern California
Foundation and Government Funding
The Avon Foundation for Women contributed $500,000 to support CBCRP’s Special Research
Initiatives. The funds help support a study examining long-term environmental exposures and
breast cancer in a large, diverse population group and a study investigating why women from
some minority groups, once they are diagnosed with breast cancer, are less likely than others to
be successfully treated.
CBCRP also has been successful in securing grant funds from the National Institute for
Environmental Health Sciences and the National Cancer Institute for CRIBS (Award number
1RC4ES019826), QuickStart (Award number R25CA188482), and the Symposium (Award
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number 1R13 ES022921-01) These projects are described in Section V: Program Highlights
2010–2015.
Community Foundation for Monterey County granted CBCRP $107,800 through The Anita Tarr
Turk Fund for Breast Cancer Research to co-fund an IDEA grant to Mark LaBarge at the
Lawrence Berkeley National Laboratory to investigate Mechanical Stressors and Age as
Regulators of Telomerase.
Donations from the Public
Californians continue to demonstrate enthusiasm for CBCRP's research. Thanks to many
generous individuals, CBCRP received nearly $600,000 in donations during 2010–2015.
Donations can be accepted through the following website:
http://www.cabreastcancer.org/support-us/.
The following organizations and businesses also raised funds for CBCRP through events and
campaigns: United Way of the Bay Area; Wells Fargo Community Support Campaign; AT&T
Employee Giving Campaign; Kaiser Permanente Community Giving Campaign; Spectrum Clubs,
Inc.; Lighthouse Quilters Guild; Chevron Humankind Matching Gift Campaign; Amgen
Matching Gift Campaign; and Microsoft Matching Gift Campaign, Truist, Truist PWC, and the
Silicon Valley Community Foundation.
We also received a generous bequest of $380,000 from the Katie Ann Buzbee Trust. Details of
grants that were funded through this bequest are provided in Table 22.
Table 22: Grants funded all or in part by Katie Ann Buzbee Trust.
Title Investigator Institution
Epigenetic changes as modifiers of BRCA1/
BRCA2 cancer risk
Susan Neuhausen Beckman Research Institute at the
City of Hope
Predicting BRCA1 mutation carrier status
from tumor pathology
Ann Hamilton University of Southern California
Rescuing HR DNA repair in BRCA1-
mutation carriers
Jeremy Stark Beckman Research Institute at the
City of Hope
Getting a jump on cancer with a genomic risk
classifier
Robert West Stanford University
Drug to block double-strand break repair in
breast Cancer
Gilbert Chu Stanford University
Honoring a Pioneer in CBCRP Visibility and Fundraising: The Faith Fancher Research
Award
Faith Fancher was a long-time television news anchor and personality with KTVU (Oakland)
who waged a very public battle against breast cancer. She also was the founding member of the
CBCRP Executive Team, which formed in 2001 to help raise the visibility and fundraising profile
of the Program. Faith passed away in October 2003 after a six-year struggle with breast cancer. In
Faith's honor, CBCRP created the annual Faith Fancher Research Award. The award is presented
each year to a researcher or research team embarking on a CBCRP-funded breast cancer study
that reflects the values that Faith held most closely and extends the work that Faith did for all
Report from the California Breast Cancer Research Program to the California Legislature December 2015
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women facing breast cancer. The recipients of the Faith Fancher Research Award in 2010–2015
are highlighted in Table 23.
Table 23: Recipients of the Faith Fancher Research Award, 2010–2015
Title Investigator(s) Institution(s)
Recording Medical Visits for
People with Breast Cancer
Jeffrey Belkora and Sara
O’Donnell
UCSF and Mendocino Cancer
Resource Center
Sister Survivor: Improving
Access to Survivorship Care
Plan
Kimlin Ashing-Giwa, Kimlin and
Carolyn Tapp, Florence Britton
and Isis Pickens
City of Hope National Medical
Center and Women of Color
Breast Cancer Survivors Support
Project
Building Mixtec Community
Capacity to Address Breast
Health
Annette Maxwell and Sandra
Young
UCLA and Mixteco/Indigena
Community Organizing Project
Is Cost of Beauty Putting Black
Women at Risk? IEAAWC
Study
Susanne Montgomery and Eudora
Mitchell
Loma Linda University and
Quinn Community Outreach
Corporation
Engaging Underserved Women
in Health Research
Galen Joseph and Allyssa Nickell UCSF and Shanti Project, Inc.
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VII. Impact Beyond CBCRP
CBCRP is not the largest breast cancer research funder, but its impact rivals foundations with
much larger budgets. Our commitment to researching areas that are largely underfunded,
combined with a commitment to support applicable research puts us in the position of influencing
international research agendas as well as state and national policy. Below are some highlights of
the impacts we have made since 2010.
Impacting Statewide and National Policy
CBCRP's research strategy is designed not only to increase knowledge about breast cancer, but
also to influence the research agenda in a way that leads to solutions to decrease the suffering
caused by the disease. For example, the process for defining and funding SRIs has served as
templates for groups who are plotting the course of national breast cancer research policies. The
evidence that the program’s efforts are being embraced at the national level is demonstrated by
requests to provide testimony and advice to national bodies.
CBCRP helped inform the efforts of the National Academies of Sciences Institute of Medicine in
their preparation of the report Breast Cancer and the Environment: A Life Course Approach
(http://www.nap.edu/catalog/13263/breast-cancer-and-the-environment-a-life-course-approach)
(commissioned by Susan G. Komen for the Cure) and the Department of Health and Human
Services Interagency Breast Cancer & Environmental Research Coordinating Committee
(IBCERCC) of the National Institute of Environmental Health Sciences to release Breast Cancer
and the Environment: Prioritizing Prevention (https://www.niehs.nih.gov/about/boards/ibcercc/).
In each of these cases, CBCRP was asked to describe innovative initiatives to inform
recommendations for federal and national funders.
The following excerpts from the Congressionally-mandated IBCERCC report illustrate the
esteem with which CBCRP and its programs are regarded on the federal level:
“The CBCRP is another excellent model of research translation. The program requires that
funding applicants place research projects on a “critical path” that leads from “basic
concept to a measurable impact.” Research translation was a key priority of this program,
which drew from applied research literature to create three critical paths that apply to the
disciplines of (1) clinical research; (2) behavior change and supportive services; and (3)
other disciplines, including environmental research. The three context-specific versions of
the critical path specify that translation efforts be adapted for a variety of audiences and
desired outcomes.” Page 8–12
“The CBCRP evaluated research awards focused on community research collaboration and
found that involving multiple stakeholders facilitates better dissemination of research
findings and more effective communication” Page 8–13
“The SRI has funded multiple research projects that have expanded the body of science in
the areas of environmental health and prevention.” Page 8–14
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Spurring Nationwide Research Progress
One goal underlying CBCRP’s funding strategy is to leverage funds to spur nationwide progress
in breast cancer research. CBCRP is part of a much larger research system. The federal
government funds breast cancer research through agencies like the National Cancer Institute and
the U.S. Department of Defense and Congressionally Directed Medical Research Programs.
Nonprofit organizations and for-profit corporations also fund breast cancer research.
Although CBCRP is the largest state funding source specific for breast cancer research, these
funds make up only a small part of the funds granted through the larger system. CBCRP tries to
influence this larger research system to move in directions that will lead to research
breakthroughs. Researchers have applied the findings from their CBCRP-funded investigations to
win funding from other organizations to continue their work. In a survey conducted in 2013, 92
investigators who had active grants between 2010 and 2013 reported that they were able to
leverage their CBCRP funding into grants from foundations and federal funders. Principal
investigators were awarded 28 new grants totaling $25,354,151, and applied for an additional 18
pending grants to external funders in the amount of $23,108,305.
Additionally, CBCRP’s emphasis on funding innovative ideas that have a high potential for
scientific payoff and projects that are designed to translate into practical use in the real world has
yielded meaningful results, such as:
Based on the research conducted by Jeff Belkora of UCSF and Sara O’Donnell of the
Mendocino Cancer Resource Center, the nationwide Cancer Support Community
launched a toll-free hotline called Open to Options that provides telephone-based
decision support.
Life is Precious—Hmong Breast Health Study, the intervention to increase breast cancer
screening among Hmong adults (developed through a CRC award by Mary Ann Foo of
the Orange County Asian and Pacific Islander Community Alliance, Sora Tanjasiri
of CSU Fullerton and Marjorie Kagawa-Singer of UCLA) was accepted to the NCI’s
Research-tested Intervention Programs database, a searchable peer-reviewed database of
cancer control interventions and program materials and is designed to provide program
planners and public health practitioners easy and immediate access to research-tested
materials.
Reina Haque of the Kaiser Foundation Research Institute Kaiser Research leveraged
pilot funding of a study to examine adverse effects of combined tamoxifen and
antidepressants on breast cancer recurrence into the highly competitive, hallmark NIH
R01 grant that studied the interactions in a cohort of 16,887 women. She found that there
was some increased risk in the first year of combined use that dissipated with extended
use of tamoxifen.
Gertrude Buehring of UC Berkeley has discovered evidence that the Bovine Leukemia
Virus, which causes mammary tumors in animals, can be transmitted from cows to
humans and that it is present in human blood and tumors. This may reveal one modifiable
cause of some breast cancers.
Noriyuki Kasahara while at the University of Southern California developed a gene
therapy procedure that has been combined with a cellular therapy approach to target
metastatic tumors in the brain. The trials of 5-FC delivery are ongoing at UCLA.
Sean McAllister of the California Pacific Medical Center Research Institute has
identified a component from marijuana that may be effective in treating breast cancer.
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Stefanie Jeffrey of Stanford University developed and patented a method for capturing
circulating tumor cells, which is a first step in developing blood-based tumor monitoring
and detection.
Margaret Wrensch of UCSF and Georgianna Farren at Zero Breast Cancer
conducted follow up research to a CBCRP-funded grant that explored why Marin County
has elevated breast cancer levels. They found a genetic variant of the Vitamin D receptor
that was present in the predominantly white population. This receptor was present in 64
percent of the women at high risk for breast cancer, a significant 1.9 fold difference from
the overall population. While further investigation is needed, the study gives hope for the
use of Vitamin D supplements to reduce breast cancer risk in some populations.
Shiuan Chen of City of Hope developed AroER tri-screen, a chemical screening test
that can analyze 16 times as many chemicals as conventional means. Based on the
excellent technical and biological performance characteristics of the AroER tri-screen
assay, it has been selected for screening in the Tox21 10K compound library for
identification of aromatase inhibitors-like EDCs.
The progress listed here is just a sampling of some of the real world impact CBCRP has been able
to spark in California and beyond.
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VIII. Looking Forward
As CBCRP celebrates more than 20 years of funding innovation in breast cancer research, there is
considerable work to be done. Through its ongoing evaluation and strategic planning process,
CBCRP has been able to set a path that will continue to advance scientific understanding of the
causes, prevention and treatments for the disease. CBCRP’s work directly benefits thousands of
women and their families across California.
Program-initiated research will provide important new opportunities to address occupational
exposures to chemicals, new chemical testing technologies that will better protect women’s
health, and research that addresses racial disparities. It will create data that can be used to
improve policies, resulting in direct improvements in people’s lives.
Investigator-initiated research continues to be a way for researchers to develop creative
approaches to understanding how breast cancer develops, how to detect it and how to treat the
disease. It provides opportunities for communities to engage in the research that they can use to
lessen the impact of breast cancer locally.
CBCRP plays a unique role in the field of breast cancer research. In the coming years, CBCRP
will continue to support important research that will reduce physical and emotional suffering, as
well as the economic burden of the disease.
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Appendix 1: California Breast Cancer Research Program Council (2010–2015)
Chairs
Jon Greif (2014–2015)
Naz Sykes (2012–2014)
Teresa Burgess (2011–2012)
Jeanne Rizzo (2010–2011)
Jim Ford (2009–2010)
Vice-Chairs
Sharima Rasanayagam (2014–2015)
Jon Greif (2013–2014)
Teresa Burgess (2012–2013)
Naz Sykes (2011–2012)
Teresa Burgess (2010–2011)
Barbara Brenner (2009–2010)
Advocates
Susan Braun, Commonweal (2009–2012)
Barbara Brenner, J.D., Breast Cancer Action (2008–2010)
Maria Caprio, Shanti Project, Inc. (2013–2015)
Ysabel Duron, Latinas Contra Cancer (2010–2013)
Karren Ganstwig, Los Angeles Breast Cancer Alliance (2007–2010)
Karuna Jaggar, Breast Cancer Action (2012–2015)
Cacilia Kim, J.D., Ph.D., California Women’s Law Center (2010–2013)
Janice Mathurin, West Fresno Health Care Coalition (2013–2016)
Marta Nichols, Breast Cancer Connections (2012–2015)
Sharima Rasanayagam, Ph.D., Breast Cancer Fund (2012–2017)
Jeanne Rizzo, RN, Breast Cancer Fund (2008–2012)
Donna Sanderson, Komen for the Cure (2009–2012)
Scientists/Clinicians
Lisa Barcellos, Ph.D., UC Berkeley (2009–2012)
Moon Chen, Ph.D., UC Davis (2008–2011)
Laura Fenster, Ph.D., California Department of Public Health (2007–2010)
James Ford, M.D., Stanford University School of Medicine (2008–2011)
Cynthia Gomez, Ph.D., San Francisco State University (2011–2014)
Shelley Hwang, M.D. UCSF Comprehensive Cancer Center (2007–2010)
Marjorie Kagawa-Singer, Ph.D., UCLA (2014–2017)
Melanie Marty, Ph.D., Office of Environmental Health Hazard Assessment (2012–2015)
Arash Naeim, M.D., Ph.D., UCLA (2012–2015)
Sora Park Tanjasiri, Dr.PH, M.P.H., California State University, Fullerton (2010–2013)
Kristiina Vuori, M.D., Ph.D., Sanford-Burnham Medical Research Institute (2013–2016)
David Wellisch, Ph.D., UCLA (2013–2016)
Mary Alice Yund, Ph.D. UC Berkeley (2007–2010)
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Industry Representatives
Chris Bowden, Ph.D., Genentech (2007–2010)
Teresa Burgess, Ph.D., Amgen, Inc. (2008–2013)
Marjorie Green, M.D., Genentech (2013–2016)
Kathy Kamath Ph.D., Cytom X Therapeutics, LLC (2010–2013)
K. Alice Lueng, Sapientiae (2013–2016)
Medical Specialists
Jon Greif, DO, FACS, Bay Area Breast Surgeons, Inc. (2012–2016)
Michael Moffett, M.D., Cancer Care Associates (2010–2011)
Klaus Porzig, M.D. Stanford Cancer Center (2006–2010)
Nonprofit Health Organization Representatives
Roxanna Bautista, M.P,H., C.H.E.S., Asian & Pacific Islander American Health Forum (2007–
2010)
Carlina Hansen, Women’s Community Clinic (2009–2012)
Ted Schettler, M.D., M.P.H., Science and Environmental Health Network (2012–2015)
Naz Sykes, Dr. Susan Love Research Foundation (2010–2015)
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Appendix 2: California Breast Cancer Research Program Staff (2010–2015)
Current Program staff
Marion H. E. Kavanaugh-Lynch, M.D., M.P.H. Director
Lyn Dunagan, Project Coordinator
Carmela Lomonaco, Ph.D., Environmental Health & Health Policy Sciences Program Officer
Katherine McKenzie, Ph.D., Clinical and Prevention Sciences Program Officer
Lisa Minniefield, Program Specialist
Senaida Poole, Ph.D., Community Initiatives & Public Health Sciences Program Officer
Former staff between 7/1/2010–6/30/2015
Sharan Campleman, Ph.D., Environmental Health & Health Policy Sciences Program Officer
Mary Daughtry, Administrative Assistant
Brenda Dixon-Coby, Outreach Analyst
Laurence Fitzgerald, Ph.D., Core Funding Program Officer
Eric Noguchi, Senior Media Designer
Catherine Thomsen, M.P.H., Environmental Health & Health Policy Sciences Program Officer
Report from the California Breast Cancer Research Program to the California Legislature December 2015
80
Appendix 3: CBCPI Steering Committee and Strategy Advisors lists
CBCPI Steering Committee
Co-Chairs:
Tracey Woodruff, M.P.H., Ph.D., UCSF
Marion (Mhel) Kavanaugh-Lynch, M.D., M.P.H., California Breast Cancer Research Program
Julia G. Brody, Ph.D., Silent Spring Institute
Richard Clapp, D.Sc., MPH, Boston University School of Public Health
Jeanne Rizzo, R.N., Breast Cancer Fund
Saraswati Sukumar, Ph.D., Johns Hopkins Medical Institute
Beti Thompson, Ph.D., Fred Hutchinson Cancer Research Center
David Williams, Ph.D., Harvard University
Co-investigator:
Marj Plumb, Dr.P.H., Co-Investigator, Plumbline Consulting and Coaching, Inc.
Ex-Officio Members:
Marc Hurlbert, Ph.D., Avon Foundation for Women
Kimberly Sabelko, Susan G. Komen for the Cure
CBCPI Strategy Advisors
Electra D. Paskett, Ph.D., Ohio State University
Jessica Schifano, J.D., M.P.H., U.S. Department of Labor, Occupational Safety & Health
Administration
Sarah Gehlert, Ph.D., University of Chicago
George Sawaya, M.D., UCSF
Judy E. Garber, M.D., MPH, Johns Hopkins Medical Institute
Kala Visvanathan, M.B.B.S., FRACP, M.H.S.,
Lisa A. Bero, Ph.D., UCSF
Nsedu Obot Witherspoon, M.P.H., Children’s Environmental Health Network
Toshihiro Shioda, M.D., Ph.D., Harvard Medical School
William H. Dow, Ph.D., UC Berkeley
Marjorie Kagawa-Singer, Ph.D., UCLA
Rachel Morello-Frosch, Ph.D., M.P.H., UC Berkeley
Sue Fenton, Ph.D., National Institute of Environmental Health Sciences
Report from the California Breast Cancer Research Program to the California Legislature December 2015
81
Appendix 4: CBCRP 2010–2015 Research Review Committees
Reviewer
Role
Reviewer Title Affiliation Location
SRI Environmental Exposure Cohort Review, 2010
Chair Suzanne Fenton, Ph.D. Reproductive
Endocrinologist
National Institute of
Environmental Health
Sciences
Research Triangle
Park, NC
Scientific
Julia Brody, Ph.D. Executive Director Silent Spring Institute Newton, MA
Francine Laden, Sc.D. Associate Professor of
Environmental
Epidemiology
Harvard University School of
Public Health
Boston, MA
Stephanie Robert, Ph.D. Professor and Director of
Doctoral Studies
University of Wisconsin-
Madison
Madison, WI
John Vena, Ph.D. UGA Foundation Professor
& Department Head
University of Georgia Athens, GA
Advocate Ann Hernick President Breast Cancer Alliance of
Greater Cincinnati
Cincinnati, OH
SRI Partnership Review 2010
Chair Julia Brody, Ph.D. Executive Director Silent Spring Institute Newton, MA
Scientific Sarah Gehlert, Ph.D. E. Desmond Lee Professor
of Racial and Ethnic
Diversity
Washington University St. Louis, MO
Sandra Steingraber, Ph.D. Distinguished Visiting
Scholar
Ithaca College Ithaca, NY
Community Impact 2011
Chair Shiraz Mishra,
M.B.B.S., Ph.D
Professor University of New Mexico Albuquerque, NM
Scientific Sherrie Flynt Wallington,
Ph.D.
Asst. Prof. of Oncology;
Prog. Dir., Health
Disparities
Georgetown University Washington, DC
Elmer Freeman, M.S.W. Executive Director Center for Community Health
Education Research and
Services
Boston, MA
Carolyn Gotay, Ph.D. Prof. & Can. Cancer Soc.
Chair in Cancer Primary
Prev.
University of British
Columbia
Vancouver, BC
Kathryn Kash, Ph.D. Owner KM Behavioral Consulting
LLC
Spring Hill, FL
Reginald Tucker-Seeley,
ScD
Assistant Professor of Social
and Behavioral Sciences
Harvard University School of
Public Health
Boston, MA
Mayumi Willgerodt,
Ph.D.
Associate Professor University of Washington Seattle, WA
Advocate Beverly Canin Advocate Breast Cancer Option, Inc Rhinebeck, NY
Susan Pelletier Advocate Vermont Breast Cancer
Coalition
Stockbridge, VT
Ad Hoc Ellyn Matthews, PhD,
RN, AOCN
Assistant Professor University of Colorado,
Denver
Aurora, CO
Susan Schneider, PhD,
RN, AOCN®, FAAN
Associate Professor, Lead
Faculty Onc Nursing
Specialty
Duke University Medical
Center
Durham, NC
Advocate
Observers
Nancy Bellen
Connie Engel, MA
Advocate
Program Coordinator
No affiliation
Breast Cancer Fund
Santa Rosa, CA
San Francisco, CA
Report from the California Breast Cancer Research Program to the California Legislature December 2015
82
Etiology & Prevention 2011
Chair Kirsten Moysich, Ph.D. Prof. of Oncology, Prog
Chair, Cancer Pathology &
Prev.
Roswell Park Cancer Institute Buffalo, NY
Scientific Stefan Ambs, Ph.D. Principal Investigator National Cancer Institute Bethesda, MD
Leena Hilakivi-Clarke,
Ph.D.
Associate Professor,
Oncology
Georgetown University Washington, DC
Chi-Chen Hong, Ph.D. Assistant Professor Roswell Park Cancer Institute Buffalo, NY
Advocate Ann Fonfa, BPS Founder and President The Annie Appleseed Project Delray Beach, FL
Sara William Advocate The Carolina Breast Cancer
Study (UNC)
Mebane, NC
Ad Hoc David Euhus, M.D. Professor, Marilyn R
Corrigan Distinguished
Chair
University of Texas,
Southwestern Medical Center
Dallas, TX
Francine Laden, Sc.D. Associate Professor of
Environmental
Epidemiology
Harvard University School of
Public Health
Boston, MA
Advocate
Observer
Mary Aalto Advocate USC Norris Cancer
Survivorship Advisory
Council
Studio City, CA
Treatment, Detection & Prognosis 2011
Chair Mark Pegram, M.D. Professor of Medicine University of Florida Miami, FL
Scientific Benjamin Anderson, M.D. Professor University of Washington Seattle, WA
Ralph Bernacki, Ph.D. Professor; Cancer Research
Scientist
Roswell Park Cancer Institute Buffalo, NY
Ulrich Bierbach, Ph.D. Associate Professor Wake Forest University Winston-Salem, NC
Sandra Demaria, M.D. Assistant Professor NYU Langone Medical
Center
New York, NY
Kristine Glunde, Ph.D. Associate Professor of
Radiology and Oncology
Johns Hopkins University Baltimore, MD
Eldon Jupe, Ph.D. Vice President, Clinical
Laboratory Director
InterGenetics, Incorporated Oklahoma City, OK
Paul Kinahan, Ph.D. Professor of Radiology University of Washington Seattle, WA
William Redmond, Ph.D. Assistant Professor Earle A. Chiles Research
Institute
Portland, OR
Fredika Robertson, Ph.D. Executive Director, Clinical
Research Sciences
Virginia Commonwealth
University
Richmond, VA
Ratna Vadlamudi, Ph.D. Professor University of Texas at San
Antonio
San Antonio, TX
Martin Woodle, Ph.D. Scientist & CSO Aparna Biosciences Corp. Bethesda, MD
Advocate Roberta Gelb Advocate SHARE New York, NY
Nancy Key Advocate Susan G. Komen Foundation Camano Island, WA
Kimberly Newman-
McCown
Advocate VWR International, LLC Radnor, PA
Beverly Parker, Ph.D. Advocate Breast Cancer Network of
Strength
Naperville, IL
Ad Hoc David Mankoff, M.D.,
Ph.D.
Associate Professor of
Radiology
University of Washington
Medical Center
Seattle, WA
Silvia Formenti, M.D. Professor of Medicine New York University
Medical Center
New York, NY
Matthew Rowling, Ph.D. Assistant Professor Iowa State University Ames, IA
John Ward, M.D. Professor and Chief University of Utah Salt Lake City, UT
Advocate
Observer
Karuna Jaggar Executive Director Breast Cancer Action San Francisco, CA
Report from the California Breast Cancer Research Program to the California Legislature December 2015
83
Tumor Biology 2011
Chair Harikrishna Nakshatri,
BVSc (DVM), Ph.D.
Marian J. Morrison
Professor of Breast Cancer
Research
Indiana University-Purdue
University, Indianapolis
Indianapolis, IN
Scientific Hava Avraham, Ph.D. Associate Professor of
Medicine
Beth Israel Deaconess
Medical Center
Boston, MA
Qihong Huang, M.D.,
Ph.D.
Associate Professor The Wistar Institute Philadelphia, PA
Julie Lang, M.D. Principal Investigator Arizona Health Sciences
Center
Tucson, AZ
Joan Lewis-Wambi, Ph.D. Assistant Professor Fox Chase Cancer Center Philadelphia, PA
Cindy Miranti, Ph.D. Scientific Investigator Van Andel Research Institute Grand Rapids, MI
Patricia Schoenlein, Ph.D. Associate Professor Medical College of Georgia Augusta, GA
Joyce Schroeder, Ph.D. Associate Professor University of Arizona Tucson, AZ
Advocate Valerie Fraser Advocate Inflammatory Breast Cancer
Research Foundation
Huntington Woods,
MI
Theresa Martyka Advocate Breast Cancer Network of
Strength
Chicago Ridge, IL
Nancy Singleton Patient Navigator SHARE Hoboken, NJ
Ad Hoc James Kaput, Ph.D. Postgraduate Researcher UC Davis Davis, CA
Thomas Ludwig, Ph.D. Associate Professor Columbia University New York, NY
Advocate
Observer
Chira Chen-Tanyolac UCSF Breast Cancer
SPORE Advocate
UCSF San Francisco, CA
SRI Chemicals Testing 2011
Chair Vincent Cogliano, Ph.D. Acting Director, Integrated
Risk Information System
United States Environmental
Protection Agency
Washington, DC
Scientific Stephen Barnes, Ph.D. Professor University of Alabama Birmingham, AL
Billy Day, Ph.D. Professor and Director,
Proteomics Core Lab
University of Pittsburgh Pittsburgh, PA
Karam El-Bayoumy,
Ph.D.
Distinguished Professor &
Assoc. Dir. of Basic
Research
Pennsylvania State
University
Hershey, PA
Jean Latimer, Ph.D. Associate Professor of
Pharmaceutical Sciences
University of Pittsburgh Pittsburgh, PA
Mary Beth Martin, Ph.D. Professor Georgetown University Washington, DC
Advocate Anna Cluxton, MBA Advocate Young Survival Coalition Columbus, OH
SRI Immigration Review 2011
Chair Sarah Gehlert, Ph.D. E. Desmond Lee Professor
of Racial and Ethnic
Diversity
Washington University St. Louis, MO
Scientific Francesca Gany, MD,
MS
Director, Center for
Immigrant Health
New York University School
of Medicine
New York, NY
Shiraz Mishra,
M.B.B.S., Ph.D
Professor University of New Mexico Albuquerque, NM
Dorothy Pathak, Ph.D.,
MS
Professor Michigan State University East Lansing, MI
Advocate JoAnn Tsark, MPH Research Director Papa Ola Lokahi Honolulu, HI
Ad Hoc Patricia Thompson
Carino, Ph.D.
Professor, Dept. of
Pathology Assoc Dir. for
Basic Res.
State University of New York
at Stony Brook
Stony Brook, NY
Report from the California Breast Cancer Research Program to the California Legislature December 2015
84
Community Impact 2012
Chair Carolyn Gotay, Ph.D. Prof. & Can. Cancer Soc.
Chair in Cancer Primary
Prev.
University of British
Columbia
Vancouver, BC
Scientific Sherrie Flynt Wallington,
Ph.D.
Asst. Prof. of Oncology;
Program Director, Health
Disparities
Georgetown University Washington, DC
Anna Hoover, Deputy Director University of Kentucky Lexington, KY
Kathryn Kash, Ph.D. Owner KM Behavioral Consulting
LLC
Spring Hill, FL
Advocate Susan Pelletier Advocate Vermont Breast Cancer
Coalition
Stockbridge, VT
Ad Hoc Rachel Ceballos, PhD Assistant Professor Fred Hutchinson Cancer
Research Center
Seattle, WA
Advocate
Observer
JoAnn Loulan, M.A.,
M.F.T.
Advocate Breast Cancer Action Portola Valley, CA
Etiology, Prevention & Biology 2012
Chairs Kirsten Moysich, Ph.D. Professor of Oncology,
Program Chair, Cancer
Pathology & Prevention
Roswell Park Cancer Institute Buffalo, NY
Harikrishna Nakshatri,
BVSc (DVM), Ph.D.
Marian J. Morrison
Professor of Breast Cancer
Research
Indiana University-Purdue
University, Indianapolis
Indianapolis, IN
Scientific Alexander Bishop,
D.Phil.
Associate Professor Cellular
and Structural Biology
University of Texas at San
Antonio
San Antonio, TX
Charles Clevenger,
M.D., Ph.D.
Professor of Pathology Northwestern University Chicago, IL
Suzanne Fenton, Ph.D Reproductive
Endocrinologist
National Institute of
Environmental Health
Sciences
Research Triangle
Park, NC
Chi-Chen Hong, Ph.D. Assistant Professor Roswell Park Cancer Institute Buffalo, NY
Qihong Huang, M.D.,
Ph.D.
Associate Professor The Wistar Institute Philadelphia, PA
Roxana Moslehi, Ph.D. Assistant Professor State University of New York
at Albany
Rensselaer, NY
Joyce Schroeder, Ph.D. Associate Professor University of Arizona Tucson, AZ
Wade Welshons, Ph.D. Associate Professor University of Missouri Columbia, MO
Advocate Theresa Martyka, Advocate Y-ME National Breast
Cancer Organization
Chicago Ridge, IL
Carrie Wells Advocate Survivors' Retreat Baltimore, MD
Madeleine Tress, Ph.D. Advocate SHARE New York, NY
Advocate
Observer
Hannah Klein Connolly UCSF SPORE breast cancer
advocate
UCSF Spore Core Burlingame, CA
Treatment & Detection 2012
Chair Fredika Robertson, Ph.D. Executive Director, Clinical
Research Sciences
Virginia Commonwealth
University
Richmond, VA
Scientific Joanna Burdette, Ph.D. Associate Professor University of Illinois at
Chicago
Chicago, IL
Eldon Jupe, Ph.D. Vice President, Clinical
Laboratory Director
InterGenetics, Incorporated Oklahoma City,
OK
Julie Lang, M.D. Principal Investigator Arizona Health Science
Center
Tucson, AZ
William Redmond, Ph.D. Assistant Professor Earle A. Chiles Research
Insitute
Portland, OR
Report from the California Breast Cancer Research Program to the California Legislature December 2015
85
Treatment & Detection 2012 (continued)
Scientific Edward Sauter, M.D.,
Ph.D.
Director, Cancer Treatment
and Prevention Center
University of Texas at Tyler Tyler, TX
Natalie Serkova, Ph.D. Director, Colorado Cancer
Imaging Core
University of Colorado Aurora, CO
Eva Marie Sevick, Ph.D. Professor and Director University of Texas Houston, TX
Ratna Vadlamudi, Ph.D. Professor University of Texas at San
Antonio
San Antonio, TX
Martin Woodle, Ph.D. Scientist & CSO Aparna Biosciences Corp. Bethesda, MD
Advocate David Bake Advocate National Breast Cancer
Coalition
Bellaire, TX
Valerie Fraser Advocate Michigan Breast Cancer
Coalition
Huntington Woods,
MI
Nancy Key Advocate Susan G. Komen Foundation Camano Island,
WA
Debra Madden Advocate National Breast Cancer
Coalition
Newtown, CT
Advocate
Observer
Sharima Rasanayagam,
Ph.D.
Director of Science Breast Cancer Fund San Francisco, CA
Clinical, Prevention & Biological Sciences 2013
Chairs Harikrishna Nakshatri,
BVSc (DVM), Ph.D.
Marian J. Morrison
Professor of Breast Cancer
Research
Indiana University-Purdue
University, Indianapolis
Indianapolis, IN
Fredika Robertson, Ph.D. Executive Director, Clinical
Research Sciences
Virginia Commonwealth
University
Richmond, VA
Scientific Alexander Bishop,
D.Phil.
Associate Professor Cellular
and Structural Biology
University of Texas at San
Antonio
San Antonio, TX
Joanna Burdette, Ph.D. Associate Professor University of Illinois at
Chicago
Chicago, IL
Chi-Chen Hong, Ph.D. Assistant Professor Roswell Park Cancer Institute Buffalo, NY
Shelley Hwang, M.D.,
MPH
Professor of Surgery Duke University Durham, NC
Cheryl Jorcyk, Ph.D. Professor Boise State University Boise, ID
Eldon Jupe, Ph.D. Vice President, Clinical
Laboratory Director
InterGenetics, Incorporated Oklahoma City,
OK
Roxana Moslehi, Ph.D. Assistant Professor State University of New York
at Albany
Rensselaer, NY
William Redmond, Ph.D. Assistant Professor Earle A. Chiles Research
Insitute
Portland, OR
Carol Sartorius, Ph.D. Associate Professor of
Pathology
University of Colorado Aurora, CO
Edward Sauter, M.D.,
Ph.D.
Director, Cancer Treatment
and Prevention Center
University of Texas at Tyler Tyler, TX
Natalie Serkova, Ph.D. Director, Colorado Cancer
Imaging Core
University of Colorado Aurora, CO
Steven Swanson, Ph.D. Professor of Pharmacognosy University of Illinois at
Chicago
Chicago, IL
Ratna Vadlamudi, Ph.D. Professor University of Texas at San
Antonio
San Antonio, TX
Martin Woodle, Ph.D. Scientist & CSO Aparna Biosciences Corp. Bethesda, MD
Advocate Brenda Bryan Advocate The Virginia Breast Cancer
Foundation
Arlington, VA
Lisa DeFerrari, M.B.A. Advocate The Virginia Breast Cancer
Foundation
Henrico, VA
Report from the California Breast Cancer Research Program to the California Legislature December 2015
86
Clinical, Prevention & Biological Sciences 2013 (continued)
Advocate Barbara Holtz, MBA Advocate Dana-Farber Cancer Institute Wayland, MA
Eunice Hostetter Advocate Susan G. Komen Foundation Kirkland, WA
Beverly Parker, Ph.D. Advocate Breast Cancer Network of
Strength
Naperville, IL
Ad Hoc John Ward, M.D. Professor and Chief University of Utah Salt Lake City, UT
Advocate
Observer
Karen Weixel Patient Navigator UCSF Carol Franc Buck
Breast Care Center
Walnut Creek, CA
Community Impact 2013
Chair Carolyn Gotay, Ph.D. Prof. & Can. Cancer Soc.
Chair in Cancer Primary
Prev.
University of British
Columbia
Vancouver, BC
Scientific Sandra Halverson,
MPH, PhD
Adjunct Assistant Professor
of Medicine
Vanderbilt University Durham, NC
Kathryn Kash, Ph.D. Owner KM Behavioral Consulting
LLC
Spring Hill, FL
Patricia O'Brien, Assistant Professor University of Vermont Burlington, VT
Victoria Seewaldt, M.D. Associate Professor of
Medicine
Duke University Durham, NC
Beti Thompson, Ph.D. Professor Fred Hutchinson Cancer
Research Center
Seattle, WA
Tom Webster, DSc Professor Boston University Boston, MA
Armin Weinberg, Ph.D. COE Life Beyond Cancer
Foundation
Houston, TX
Sacoby Wilson, Ph.D.,
M.S.
Assistant Professor University of Maryland College Park, MD
Advocate Christine Carpenter, President Iowa Breast Cancer Edu-
Action
Cedar Falls, IA
Venus Gines, M.A. CEO/Founder Dia de la Mujer Latina Pearland, TX
Marion Morra, D.Sc. President Morra Communications Milford, CT
Advocate
Observer
Jamie Ledezma, Esq. Central California Regional
Director
Cancer Legal Resource
Center
San Diego, CA
CBCPI Paradigm 2014
Chair Sarah Gehlert, Ph.D. E. Desmond Lee Professor
of Racial and Ethnic
Diversity
Washington University St. Louis, MO
Scientific Anthony Gatrell, Ph.D. Dean of the School of
Health and Medicine
Lancaster University Lancaster,
Julie Goodman, Ph.D.,
DABT, FACE
Principal Gradient Cambridge, MA
Advocate Vernal Branch Patient Research Advocate Cancer Action Coalition of
Virginia
Richmond, VA
Chemicals Testing and Occupational Exposures 2014
Chair Vincent Cogliano, Ph.D. Acting Director, Integrated
Risk Information System
United States Environmental
Protection Agency
Washington, DC
Scientific Dana Boyd Barr, Ph.D. Research Professor Emory University Atlanta, GA
Julie Goodman, Ph.D.,
DABT, FACE
Principal Gradient Cambridge, MA
Stephen Grant, Ph.D. Associate Professor NOVA Southeastern
University
Pittsburgh, PA
Mary Beth Martin,
Ph.D.
Professor Georgetown University Washington, DC
Report from the California Breast Cancer Research Program to the California Legislature December 2015
87
Chemicals Testing and Occupational Exposures 2014 (continued)
Scientific Kristine Thayer, Ph.D. Director, Office of Health
Assessment and Translation
National Institute of
Environmental Health
Sciences
Research Triangle
Park, NC
Guangdi Wang, Ph.D. Professor of Chemistry Xavier University New Orleans, LA
Advocate Lisa DeFerrari, M.B.A. Advocate The Virginia Breast Cancer
Foundation
Henrico, VA
Ann Fonfa, BPS Founder and President The Annie Appleseed Project Delray Beach, FL
Clinical, Prevention, & Biological Sciences 2014
Chairs Leena Hilakivi-Clarke,
Ph.D.
Associate Professor,
Oncology
Georgetown University Washington, DC
Fredika Robertson, Ph.D. Executive Director, Clinical
Research Sciences
Virginia Commonwealth
University
Richmond, VA
Scientific Stefan Ambs, Ph.D. Principal Investigator National Cancer Institute Bethesda, MD
Alexander Bishop,
D.Phil.
Associate Professor Cellular
and Structural Biology
University of Texas at San
Antonio
San Antonio, TX
Abenaa Brewster, M.D.,
M.H.S.
Associate Professor of
Medicine
M.D. Anderson Cancer
Center
Houston, TX
Joanna Burdette, Ph.D. Associate Professor University of Illinois at
Chicago
Chicago, IL
Suzanne Fenton, Ph.D Reproductive
Endocrinologist
National Institute of
Environmental Health
Sciences
Research Triangle
Park, NC
Qihong Huang, M.D.,
Ph.D.
Associate Professor The Wistar Institute Philadelphia, PA
Shelley Hwang, M.D.,
MPH
Professor of Surgery Duke University Durham, NC
Cheryl Jorcyk, Ph.D. Professor Boise State University Boise, ID
Peter Kabos, MD Assistant Professor University of Colorado,
Denver
Aurora, CO
Edward Sauter, M.D.,
Ph.D.
Director, Cancer Treatment
and Prevention Center
University of Texas at Tyler Tyler, TX
Natalie Serkova, Ph.D. Director, Colorado Cancer
Imaging Core
University of Colorado Aurora, CO
Eva Marie Sevick, Ph.D. Professor and Director University of Texas Houston, TX
Steven Swanson, Ph.D. Professor of Pharmacognosy University of Illinois at
Chicago
Chicago, IL
Advocate Lisa DeFerrari, M.B.A. Advocate The Virginia Breast Cancer
Foundation
Henrico, VA
Eunice Hostetter Advocate Susan G. Komen Foundation Kirkland, WA
Kimberly Newman-
McCown
Advocate VWR International, LLC Radnor, PA
Madeleine Tress, Ph.D. Advocate SHARE New York, NY
Mary Whitehead Advocate National Breast Cancer
Coalition
Sharon, CT
Advocate
Observer
Shirley Brown Advocate Women of Color Breast
Cancer Survivor’s Support
Los Angeles, CA
Community Impact 2014
Chair Carolyn Gotay, Ph.D. Prof. & Can. Cancer Soc.
Chair in Cancer Primary
Prev.
University of British
Columbia
Vancouver, BC
Scientific Sherrie Flynt Wallington,
Ph.D.
Asst. Prof. of Oncology;
Prog. Dir., Health
Disparities
Georgetown University Washington, DC
Report from the California Breast Cancer Research Program to the California Legislature December 2015
88
Community Impact 2014 (continued)
Scientific Sandra Halverson,
MPH, PhD
Adjunct Assistant Professor
of Medicine
Vanderbilt University Durham, NC
Shiraz Mishra,
M.B.B.S., Ph.D
Professor University of New Mexico Albuquerque, NM
Beti Thompson, Ph.D. Professor Fred Hutchinson Cancer
Research Center
Seattle, WA
Reginald Tucker-Seeley,
ScD
Assistant Professor of Social
and Behavioral Sciences
Harvard University School of
Public Health
Boston, MA
Advocate Beverly Canin Advocate Breast Cancer Option, Inc Rhinebeck, NY
Patricia O'Brien Assistant Professor University of Vermont Burlington, VT
Advocate
Observer
Maija Witte, MPH Advocate Breast Cancer Fund San Francisco, CA
Clinical, Prevention and Biological Sciences 2015
Chairs Leena Hilakivi-Clarke,
Ph.D.
Associate Professor,
Oncology
Georgetown University Washington, DC
Fredika Robertson, Ph.D. Executive Director, Clinical
Research Sciences
Virginia Commonwealth
University
Richmond, VA
Scientific Qihong Huang, M.D.,
Ph.D.
Associate Professor The Wistar Institute Philadelphia, PA
Shelley Hwang, M.D.,
MPH
Professor of Surgery Duke University Durham, NC
Cheryl Jorcyk, Ph.D. Professor Boise State University Boise, ID
Peter Kabos, MD Assistant Professor University of Colorado,
Denver
Aurora, CO
Lina Mu, M.D., Ph.D. Associate Professor State University of New York
at Buffalo
New York, NY
Jose Russo, M.D. Professor Fox Chase Cancer Center Philadelphia, PA
Edward Sauter, M.D.,
Ph.D.
Director, Cancer Treatment
and Prevention Center
University of Texas at Tyler Tyler, TX
Natalie Serkova, Ph.D. Director, Colorado Cancer
Imaging Core
University of Colorado Aurora, CO
Eva Marie Sevick, Ph.D. Professor and Director University of Texas Houston, TX
Patricia Thompson
Carino, Ph.D.
Professor, Dept. of
Pathology Assoc Dir. for
Basic Res.
State University of New York
at Stony Brook
Stony Brook, NY
Douglas Yee, M.D. Professor of Medicine and
Pharmacology
University of Minnesota Minneapolis, MN
Siyuan Zhang, M.D.,
Ph.D.
Nancy Dee Assistant
Professor
University of Notre Dame Notre Dame, IN
Advocate Lisa DeFerrari, M.B.A. Advocate The Virginia Breast Cancer
Foundation
Henrico, VA
Valerie Fraser Advocate Michigan Breast Cancer
Coalition
Huntington Woods,
MI
Eunice Hostetter Advocate Susan G. Komen Foundation Kirkland, WA
Kimberly Newman-
McCown
Advocate VWR International, LLC Radnor, PA
Carrie Wells Advocate Survivors' Retreat Baltimore, MD
Ad Hoc Gloria Bachmann, M.D.,
M.M.S.
Professor, Int. Chair, Assoc.
Dean for Women's Health
Robert Wood Johnson
Foundation
New Brunswick,
NJ
Ralf Landgraf, Ph.D. Associate Professor University of Miami Miami, FL
Advocate
Observer
Eveline Chang, M.S.W. Manager of Program
Development
Women's Cancer Resource
Center
Oakland, CA
Report from the California Breast Cancer Research Program to the California Legislature December 2015
89
Occupational Chemical Exposures in California and Breast Cancer Risk Invitation-only Review
Scientific Francine Laden, Sc.D. Associate Professor of
Environmental
Epidemiology
Harvard University School of
Public Health
Boston, MA
Susan Pinney, Ph.D. Professor of Epidemiology University of Cincinnati
College of Medicine
Cincinnati, OH
Jessica Schifano, J.D.,
M.P.H.
Health Scientist U.S. Department of Labor,
Occupational Safety &
Health Administration
Washington, DC
Advocate Beverly Canin Advocate Breast Cancer Option, Inc Rhinebeck, NY
Policy Initiative 'Policy Teams' Request for Qualifications
Chair Diana Petitti,
M.D.,M.P.H.
Adjunct Professor Arizona State University Phoenix, AZ
Scientific Sally McCarty, M.A. Senior Research Fellow Georgetown University
Health Policy Institute
Indianapolis, IN
Joel Tickner, Sc.D. Associate Professor University of Massachusetts
Lowell
Lowell, MA
Advocate Christine Carpenter President Iowa Breast Cancer Edu-
Action
Cedar Falls, IA
Report from the California Breast Cancer Research Program to the California Legislature December 2015
90
Appendix 5: Policy Research Advocacy Group
Garen Corbett, M.S., University of California Office of the President
Angela Gilliard, J.D., University of California Office of the President
Citseko Staples Miller, American Cancer Society Cancer Action Network
Diane Griffiths, Office of Senator Rober M. Hertzberg
Usha Ranji, M.S., Kaiser Family Foundation
Nancy Buermeyer, The Breast Cancer Fund
Karren Ganstwig, Los Angeles Breast Cancer Alliance
Michael Lipsett, CA Department of Public Health, retired
