Joanne Knight Breast Health Cohort at Siteman Cancer Center

Abstract

Purpose The Joanne Knight Breast Health Cohort was established to link breast cancer risk factors, mammographic breast density, benign breast biopsies and associated tissue markers, and blood markers in a diverse population of women undergoing routine mammographic screening to study risk factors and validate models for breast cancer risk prediction. Methods Women were recruited from November 2008 to April 2012 through the mammography service at the Joanne Knight Breast Health Center at Washington University in St. Louis, Missouri. Baseline questionnaire risk factors, blood, and screening mammograms were collected from 12,153 women. Of these, 1,672 were excluded for prior history of any cancer (except non-melanoma skin) or diagnosis of breast cancer within 6 months of blood draw/registration for the study, for a total of 10,481 women. Follow-up is through linking to electronic health records, tumor registry, and death register. Routine screening mammograms are collected every 1–2 years and incident benign breast biopsies and cancers are identified through record linkage to pathology and tumor registries. Formal fixed tissue samples are retrieved and stored for analysis. County-level measures of structural inequality were derived from publicly available resources. Results Cohort Composition: median age at entry was 54.8 years and 26.7% are African American. Through 2020, 74% of participants have had a medical center visit within the past year and 80% within the past 2 years representing an average of 9.7 person-years of follow-up from date of blood draw per participant. 9,997 women are continuing in follow-up. Data collected at baseline include breast cancer risk factors, plasma and white blood cells, and mammograms prior to baseline, at baseline, and during follow-up. Conclusion This cohort assembled and followed in a routine mammography screening and care setting that serves a diverse population of women in the St. Louis region now provides opportunities to integrate study of questionnaire measures, plasma and DNA markers, benign and malignant tissue markers, and repeated breast image features into prospective evaluation for breast cancer etiology and outcomes.

Longitudinal Analysis of Change in Mammographic Density in Each Breast and Its Association With Breast Cancer Risk

“…Follow-up mammograms from 2008 to 2020 reflect current clinical practice. The cohort was generated from a population undergoing routine screening and reflects the broader community . The mean (SD) time from most recent mammogram to breast cancer diagnosis was 2.0 (1.5) years, and we excluded mammograms within 6 months of diagnosis to avoid bias that can be induced if density is spuriously increased owing to undetected cancer .…”

“…Women were recruited and provided consent for follow-up from November 3, 2008, to April 30, 2012, through the mammography service at the Joanne Knight Breast Health Center at Washington University in St Louis, Missouri. As previously described, more than 50% of eligible women presenting for screening mammography accepted the invitation to enroll, completed a risk factor questionnaire, and consented to follow-up . Screening mammograms were obtained from 12 153 women.…”

“…Routine screening mammograms were obtained every 1 to 2 years. A total of 8908 of the 10 481 women in our cohort (85%) had either a mammogram or clinic visit within the last 3 years of follow-up (through October 31, 2020) . The median number of mammograms for each woman in the cohort was 4 (range, 1-10), with an SD of 2.4.…”

Causal Mediation Analysis Using High-Dimensional Image Mediator Bounded in Irregular Domain with an Application to Breast Cancer

“…Women who had no baseline mammogram available and those with breast implants have been excluded from this analysis. Women were matched on baseline age and year of entry; see Colditz et al (2022) for more details. None of the women in this study were diagnosed with breast cancer upon entry to the cohort; the average year from entry to the diagnosis of breast cancer was 5.19 years (SD = 2.42).…”

Supervised Two-Dimensional Functional Principal Component Analysis with Time-to-Event Outcomes and Mammogram Imaging Data

“…The data that motivated this study come from the Joanne Knight Breast Health Cohort at Siteman Cancer Center, Washington University School of Medicine in St. Louis (Colditz et al. , 2022). This cohort was established to link breast cancer risk factors, mammographic BD, and blood markers in a diverse population of women undergoing routine mammographic screening to estimate breast cancer incidence.…”