Breast/Chest Cancer

The incidence of early-onset breast cancer in adults under 50 years old has increased dramatically in the U.S. over recent decades. Knowing what is contributing to these trends is important to mitigate risk and inform screening guidelines. However, we continue to know little about what’s causing early onset breast cancer beyond family history or a recent pregnancy. We are aiming to discover novel risk factors for  breast/chest cancer using metabolomics as well as on the ground perspectives of young adults with breast cancer.

We measure the full steroid metabolome to better understand the etiology of breast cancer. Most epidemiological research largely focuses on the role of estrogens, as the classic female sex hormones, to determine breast cancer risk. But our studies examine the full steroid metabolome in relation to risk, leading us to be the first to demonstrate that glucocorticoids are positively associated with BC incidence. Routine measures of the steroid metabolome, may be a more informative pre-screening strategy for early onset breast cancer.

We also study what it’s like for young adults with breast cancer. There is no population-based screening for young adults; being breast aware—familiar with your own breast to monitor any changes—is the only current recommendation young adults have to detect their breast cancer. Yet our ongoing work with the Young Survivor Coalition shows that young adults are often dismissed when they bring breast concerns to their doctors and must persist to get the right diagnoses. We are currently investigating if hormone monitoring may be a viable screening option for young adults, specifically in Black women through a Velocity award from the Herbert Irving Comprehensive Cancer Center.

See “Mixed Methods” for more about how we approach this work.

Ulanday KT, Topaz M, Shekelle J, Gibbons M, Walker D, Castaño PM, Nixon A, Lewis S, Terry MB, Houghton LC. Cancers missed, women dismissed yet persist: natural language processing of online forums. Breast Cancer Res. 2025 May 13;27(1):78. doi: 10.1186/s13058-025-01985-z. PMID: 40361232; PMCID: PMC12076973.

Lauren C. Houghton, Renata E. Howland, Ying Wei, Xinran Ma, Rebecca D. Kehm, Wendy K. Chung, Jeanine M. Genkinger, Regina M. Santella, Michaela F. Hartmann, Stefan A. Wudy, Mary Beth Terry; The Steroid Metabolome and Breast Cancer Risk in Women with a Family History of Breast Cancer: The Novel Role of Adrenal Androgens and Glucocorticoids. Cancer Epidemiol Biomarkers Prev 1 January 2021; 30 (1): 89–96. https://doi.org/10.1158/1055-9965.EPI-20-0471