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Principal Investigator: Zahna Bigham
Organization: TUFTS UNIVERSITY BOSTON
Fiscal Year: 2024
Award: $48,972
Funding agency: National Cancer Institute
PROJECT SUMMARY/ABSTRACT
Despite improvements in breast cancer incidence and mortality rates in the general population, breast cancer
incidence rates in Black women have continued to rise and they exhibit the highest breast cancer mortality rate
out of any other racial population. Increased mammographic density has been well established as one of the
strongest, independent breast cancer risk factors. However, to date, there have been very few studies that
have included Black women in our understanding of mammographic breast density, which is a significant
limitation given that Black women are more likely to have denser breasts. Breast cancer disparities are likely
multifactorial and driven by related combinations of social determinants of health, the paucity of data in Black
women has resulted in a limited understanding of the contribution of breast density to cancer disparities. While
race, a social construct, is an unlikely direct predictor of mammographic density, it can serve as a marker of
differential lived experiences due to various cultural practice, environmental exposures, and experiences of
structural racism. Childhood, puberty, and pregnancy represent times of increased breast development and
susceptibility to such exposures and host factors. In fact, Black women display differing anthropometric and
reproductive patterns – which are known contributors to mammographic density in white women – across their
life course. We hypothesize that unique distributions of body and sexual maturation characteristics during
childhood and puberty, and varying reproductive outcomes during adulthood may, in part, explain the
increased incidence of high mammographic density in Black women. Using the Black Women’s Health Study,
the largest cohort of Black women in the United States (59,000 women), we have developed a large
mammogram repository consisting of over 10,000 participants. Leveraging this analytic tool, in Aim 1, we will
determine the associations of anthropometric, body habitus, and sexual development characteristics across
the life course with percent and absolute mammographic density. Aim 2 will explore the association between
specific pregnancy-related characteristics and percent and absolute mammographic density. This will be the
first study to assess factors from birth to adulthood as predictors of mammographic density in Black women.
Successful completion of these aims will offer insight into the etiology of increased mammographic density in
Black women and contribute to a better understanding of breast cancer incidence and survival disparities in
this vulnerable population. This proposal also integrates advanced epidemiologic techniques and fundamental
biostatistical skills with clinical training to prepare the PI for a career as an independent physician scientist with
expertise in cancer health disparities research.
Terms: <21+ years old><65 and older><65 or older><65 years of age and older><65 years of age or more><65 years of age or older><65+ years><65+ years old><> 65 years><Address><Adult><Adult Human><Age><Age at Menarche><Aged 65 and Over><Asian Females><Asian Women><BMI><BMI percentile><BMI z-score><Big Baby><Biological><Biology><Biometrics><Biometry><Biostatistics><Birth><Birthweight High><Body Build><Body Types><Body mass index><Breast><Breast Cancer><Breast Cancer Prevention><Breast Cancer Risk Factor><Breast Cancer Treatment><Breast Feeding><Breast fed><Breastfed><Breastfeeding><Cancer Treatment><Caucasian Females><Caucasian Women><Causality><Characteristics><Childhood><Cognitive Discrimination><Coupling><Data><Death Rate><Development><Developmental Course><Diagnosis><Discrimination><Disparities><Disparity><Doctor of Philosophy><Environment><Environmental Exposure><Epidemiologic Methods><Epidemiological Methods><Epidemiological Techniques><Epidemiology><Etiology><European ancestry><Exhibits><Exposure to><Female Health><First Births><Funding><Future><General Population><General Public><Gestation><Goals><Growth and Development><Growth and Development function><Health Care Systems><Health Disparities Research><Health disparities related research><Healthcare Systems><Heavy baby><Height><High birth weight baby><High birth weight infant><High birthweight baby><History><Host Factor><Host Factor Protein><Incidence><Integration Host Factors><Intervention><Intervention Strategies><Investigation><Investigators><Large baby><Large baby for gestational age><Large birth weight><Lead><Learning><Life Cycle><Life Cycle Stages><Literature><Lived experience><Lived experiences><Malignant Breast Neoplasm><Malignant Neoplasm Therapy><Malignant Neoplasm Treatment><Mammogram><Mammographic Density><Mammography><Mediator><Menarche><Methods Epidemiology><Parents><Participant><Parturition><Pattern><Pb element><Ph.D.><PhD><Physicians><Population><Predisposition><Pregnancy><Preventative health care><Preventative healthcare><Prevention><Preventive health care><Preventive healthcare><Puberty><Quetelet index><Race><Races><Racial Group><Recording of previous events><Reproductive Factors><Reproductive History><Reproductive History Epidemiology><Reproductive Issues><Research><Research Personnel><Researchers><Risk Factors><Risk Reduction><Sample Size><Scientist><Sex Maturation><Sexual Development><Sexual Maturation><Social Behavior><Somatotype><Structural Racism><Surrogate End Points><Surrogate Endpoint><Susceptibility><Techniques><Testing><Time><Training><United States><Vulnerable Populations><Waist-Hip Ratio><Weight><White Females><White Women><Woman><Women's Health><Work><above age 65><adulthood><after age 65><age 65 and greater><age 65 and older><age 65 or older><age > 65><age of 65 years onward><aged 65 and greater><aged 65+><aged ≥65><ages><analytical tool><anti-cancer therapy><biobehavior><biobehavioral><biologic><black female><black women><breast cancer risk><breast density><cancer disparity><cancer health disparity><cancer risk><cancer therapy><cancer-directed therapy><cancer-related health disparity><career><causation><child adiposity><child obesity><childhood adiposity><childhood obesity><clinical training><cohort><density><depository><developmental><digital><disease causation><disparity in cancer><early adulthood><emerging adult><epidemiologic><epidemiological><experience><health disparities science><heavy metal Pb><heavy metal lead><histories><human old age (65+)><improved><insight><interventional strategy><life course><malignant breast tumor><mammary cancer prevention><mammary tumor prevention><mammographic Imaging><mammographic breast density><mammographic examinations><mammographic exams><mortality rate><mortality ratio><novel><obese children><obesity during childhood><obesity in children><old age><over 65 years><parent><parity><pediatric><pediatric obesity><prevent breast cancer><public health intervention><racial><racial background><racial origin><racial population><racial subgroup><reduce risk><reduce risks><reduce that risk><reduce the risk><reduce these risks><reduces risk><reduces the risk><reducing risk><reducing the risk><repository><reproductive><reproductive outcome><risk-reducing><sex development><skills><social><social disadvantage><social disparities><social health determinants><social inequality><sociobehavior><sociobehavioral><survival disparity><vulnerable group><vulnerable individual><vulnerable people><waist-to-hip ratio><weights><≥65 years>