New Frontiers in Breast Cancer Research

Boston Medical Center is committed to providing the best care and health outcomes for all patients from all walks of life. Because BMC cares for a widely diverse patient population, its mission is to provide excellent and cutting-edge care that is reflective of all racial, ethnic and socioeconomic backgrounds. Part of this includes conducting research that includes people of all backgrounds—something that has not been done historically. Doing so builds an evidence-based and generalizable understanding of how best to inform the development of treatments and care practices to suit the needs of all patients.

One way BMC is leading the charge is through research on breast cancer in diverse populations. Part of this work includes conducting research with a goal of ensuring all racial and ethnic backgrounds are represented. For example, co-director of BMC’s Breast Cancer Program, Naomi Ko, MD, MPH, AM, is carrying out both clinical and translational research to understand how biology and social determinants of health—which can include lack of housing, transportation and insurance—impact breast cancer patients, just like the ones she cares for in her clinical practice. Ko recalls a veteran nurse saying, “cancer is not their biggest problem,” remarking how BMC patients often face insurmountable barriers to care, like violence in their communities, lack of time, transportation, money and fear of missing work at a job that pays by the hour. These factors are not just mere inconveniences—they correlate with later stage diagnoses and worsened outcomes. That is why Ko is looking at what and how insurance can impact patients’ abilities to obtain the care and support that suits their needs in a timely and efficient manner. Her recently published article in JAMA Oncology illustrates these challenges. Ongoing research from both clinical and socioeconomic research will help to paint a complete picture of BMC’s patient population and be critical in creating solutions that deliver the best care possible to achieve the best outcomes possible.

These research projects stem from an array of work Ko and her colleagues are actively involved in such as addressing inclusion in clinical trial enrollment, identifying how pharmacy services can ensure adherence to medications, how best to address a patient’s specific needs and working with community partners to understand the contributing factors that affect a patient’s diagnoses’ and care. Ko is reaching out to the community as part of this research and was recently awarded a grant to study black women with breast cancer and their level of understanding about their disease. To do so, Ko is looking to her patients for answers. “The question is going to be, ‘Going back and knowing what you know now, what do you wish you knew then?’” Ko explains. “It’s not just [providers] teaching [patients]. It’s really [patients] teaching us what matters and then we take that and make sure we deliver.” Ko and her colleagues are also working “from bench to bedside,” where laboratory researchers collaborate to identify biological targets and new markers that can be used to improve treatment. The translational program is working hard to enroll patients onto specimen trials that will help us to see new opportunities for treatment. Overall, results from both clinical and translational research will be used to further evidence-based discoveries for all patients with breast cancer. “Ultimately, the research at BMC is finding out what we can do [to improve care and resources for a diverse patient population] and then letting people across the country learn from what we are learning from our patients,” she says.

As the breast cancer care landscape continues to be transformed by insightful research being carried out here at BMC, one thing remains constant: an unwavering commitment to all patients. “We are really committed to making BMC breast cancer, treatment, research and education exceptional, without exceptions,” Ko concludes.