Epidemiology postdoctoral researcher and recent School of Public Health and Health Sciences alumna Serena Houghton has received a three-year, $187,639 Ruth L. Kirschstein National Research Service Award Individual Postdoctoral Fellowship from the National Cancer Institute to examine a specific type of obesity and its relation to breast cancer risk and survival.
Houghton earned her Ph.D. in 2016 and now works with breast cancer expert Susan Hankinson, professor of epidemiology.
The fellowship is intended to enhance the research training of promising postdoctoral candidates who have the potential to become productive, independent investigators in scientific health-related research fields relevant to the missions of participating National Institutes of Health institutes and centers.
Houghton says, “I was surprised to receive the award since it was the first submission, but very excited since the fellowship is a great opportunity and the experience will benefit my scientific career moving forward.”
Hankinson says, “Serena developed strong skills in epidemiology and biostatistics as a doctoral student here at UMass, and she has only recently transitioned to concentrate on cancer epidemiology. She has shown herself to be smart, thoughtful and committed to applying her knowledge to better understand causes and ways to prevent cancer. That she obtained this prestigious NIH fellowship on her first submission speaks volumes to her work and her potential.”
Houghton’s study aims to evaluate whether central obesity, that is, waist circumference, is a better predictor of breast cancer risk and survival than general obesity measures such as body mass index (BMI). She will also assess specific tumor markers to try to confirm whether central obesity contributes to breast cancer and, if so, how. Results may suggest new ways to identify women who are at high risk of breast cancer, and who may benefit from increased screening or prevention strategies.
Houghton says BMI has been well established as a risk factor that is inversely related to premenopausal breast cancer and positively associated with postmenopausal breast cancer. In contrast, central obesity as measured by waist circumference or waist-to-hip ratio, is characterized by high levels of metabolically active visceral fat that leads to changes in several hormones such as insulin, inflammatory cytokines and adipokines, all of which have been implicated in breast cancer development.
She hypothesizes that measures of central obesity will offer better indications about breast cancer risk and survival than BMI alone. She notes that to date, few studies have evaluated the link with premenopausal breast cancers and even fewer have evaluated associations according to important tumor characteristics and molecular subtypes.
Analyzing questionnaire and biospecimen data from nearly 200,000 women enrolled in the Harvard Nurses’ Health Study, Houghton will examine the independent association of central obesity with breast cancer risk by menopausal status; the relationship by tumor molecular subtypes and by several key tumor characteristics such as estrogen receptor, androgen receptor, insulin receptor expression, PTEN loss, PIK3CA mutation status, and the association between central obesity and breast cancer survival.
“By evaluating subtypes and tumor characteristics, I should gain substantial new insight into biological mechanisms and help to confirm causality,” she says. “This will allow us to identify women at higher risk for breast cancer development and lower risk of breast cancer survival. The results gained from this work may improve risk prediction models to help identify women at high risk of developing breast cancer. These women may be potential candidates for chemoprevention or other risk-reducing options, such as increased physical activity.”