October 9, 2019

Studying life after breast cancer

Breast cancer is an active area of study for Kaiser Permanente researchers who explore important questions about prevention, treatment, and risk.

Breast cancer survivor Sandra Domingue does a balance exercise at her local YMCA.

When Sandra Domingue attends her regular fitness class at the Bayview Hunters Point YMCA in San Francisco, she’s not thinking about how her time at the gym, which includes both socializing and exercise, could help her live longer.

“It’s just wonderful to come here and see my friends,” she said one morning after finishing her class. “I’m a hugger, so everyone knows I’ll want a hug.”

Domingue is a 73-year-old Kaiser Permanente member and a breast cancer survivor. She’s also a participant in the Kaiser Permanente Division of Research Pathways Study. The study follows more than 4,000 Northern California members who’ve received a diagnosis of invasive breast cancer.

One of the study’s well-publicized findings is that breast cancer survivors benefit from social networks and support, much like what Domingue enjoys at her local YMCA.

“Repeatedly, we see that women who have larger, supportive networks have better survival after a diagnosis of cancer,” said Candyce Kroenke, ScD, MPH, co-investigator for the Pathways Study. “My work really focuses on the why and the how of that, so we can figure out how to improve outcomes in women.”

Millions of breast cancer survivors

After skin cancer, breast cancer is the most commonly diagnosed cancer among women in the United States. An estimated 1 in 8 women will develop invasive breast cancer sometime in their life. The good news is that advances in treatment have led to higher survival rates. There are now more than 3.8 million women with a history of breast cancer living in the United States.

That number underscores the importance of research around survivorship. Pathways’ principal investigator Lawrence Kushi, ScD, said the study, which started enrolling women in 2006, was born of the natural questions breast cancer patients ask after diagnosis.

“They wonder if there are things they can do aside from surgery and conventional therapy that could help improve the quality of their lives, lower the likelihood of cancer recurrence, and maybe prolong their lives,” he said. “When it comes to breast cancer studies that are collecting and analyzing data on lifestyle choices such as diet, physical activity, dietary supplements, and alternative therapies, this is one of the largest studies in the world.”

The Pathways Study is also examining data on survivors’ medical care, tumor traits, genetic factors, quality of life, and neighborhoods. In 2016, the study published findings that women with higher levels of vitamin D in their blood following a breast cancer diagnosis had significantly better long-term outcomes.

“As we publish more, I hope our work helps provide women, their families, and their health care providers with strategies and tools to help them live longer, better lives,” Kushi said. “For example, some of our preliminary analysis suggests that women who are more physically active do better in terms of cancer recurrence and survival rates.”

‘It’s your health’

Now nearing the 7-year anniversary of her cancer diagnosis, Sandra Domingue is doing well. She says her faith sustained her through her cancer treatments, and she sees her work with the Pathways Study as a way to help other survivors.

Since a mammogram was essential in helping doctors at Kaiser Permanente San Francisco diagnose her cancer, Domingue urges her friends to stay on top of their cancer screenings.

“I tell them not to be afraid to get their regular mammograms and checkups. It’s your body, and it’s your health.”

Learn more about breast cancer research at Kaiser Permanente.