The Pathways Study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California

Abstract

Objective-With 2.3 million breast cancer survivors in the U.S. today, identification of modifiable factors associated with breast cancer recurrence and survival is increasingly important. Only recently new studies have been designed to examine the impact of lifestyle factors on prognosis, including Pathways, a prospective study of women with breast cancer in Kaiser Permanente Northern California (KPNC).Methods-Pathways aims to examine the effect on recurrence and survival of 1) lifestyle factors such as diet, physical activity, quality of life, and use of alternative therapies and 2) molecular factors such as genetic polymorphisms involved in metabolism of chemotherapeutic agents. Eligibility includes any woman diagnosed with invasive breast cancer within KPNC, no previous diagnosis of other invasive cancer, age 21 years or older, and ability to speak English, Spanish, Cantonese, or Mandarin. Newly-diagnosed patients are identified daily from electronic pathology records and are enrolled within two months of diagnosis. An extensive baseline interview is conducted, blood and saliva samples are collected, and body measurements are taken. Women are followed for lifestyle updates, treatment, and outcomes by self-report and query of KPNC databases.Results-Recruitment began in January 9, 2006, and as of January 16, 2008, 1,539 women have been enrolled along with collection of 1,323 blood samples (86%) and 1,398 saliva samples (91%). Conclusions-ThePathways Study will become a rich resource to examine behavioral and molecular factors and breast cancer prognosis.

Use of antioxidant supplements during breast cancer treatment: a comprehensive review

“…One study (SWOG S0221A-ICSC, PI: Ambrosone) is examining the effects of supplemental antioxidants on treatment outcomes among patients (n = 3,250) in a therapeutic trial of adjuvant doxorubicin, cyclophosphamide and paclitaxel for breast cancer. Another, the Pathways Study (R01CA105274, PI: Kushi), is using rapid case ascertainment to identify women within Kaiser Permanente Northern California who are diagnosed with invasive breast cancer (n = 3,000) [52]. The study will follow women over time to investigate effects of lifestyle and molecular factors, including diet, supplement use, and genetic polymorphisms, in addition to treatment, on long-term outcomes.…”

Intrinsic Subtypes from PAM50 Gene Expression Assay in a Population-Based Breast Cancer Cohort: Differences by Age, Race, and Tumor Characteristics

“…The Pathways Study enrolled women diagnosed with invasive breast cancer from 2005–2013 in KPNC with no previous diagnosis of other invasive cancer, and at least 21 years of age; most women were approached for enrollment within two months of diagnosis (mean time from diagnosis to enrollment = 1.8 months, maximum 7.2 months). Details of the Pathways study methods have been described (31). For the PAM50 intrinsic subtyping study, we included Pathways women diagnosed in 2006 through 2008.…”

The Impact of DNA Input Amount and DNA Source on the Performance of Whole-Exome Sequencing in Cancer Epidemiology

“…Genomic DNA samples were obtained from the Pathways Study, a prospective cohort study that recruited recently-diagnosed breast cancer patients from the Kaiser Permanente Northern California (KPNC) health plan membership (18). At the baseline in-person interview after patient consent, blood samples were collected from 90% of participants via phlebotomy, and saliva samples were also collected from 96% of participants by the Oragene™ DNA Self-Collection kit (DNA Genotek Inc., Kanata, Ontario, Canada) as an alternative source of genomic DNA.…”