The long-term goal of the Hawaiʻi Pacific Islands Mammography Registry (HIPIMR) is to develop accurate and validated models of breast cancer risk and detection in real-time for women with the diverse breast cancer risk profiles as described above who have not been well represented in breast cancer cohorts and clinical trials so far.
Despite recent advances in early detection and treatment, breast cancer remains a major cause of morbidity and mortality. Native Hawaiian women have the highest breast cancer incidence in Hawaii despite their favorable reproductive patterns. Japanese American women now experience the same breast cancer risk as non-Hispanic White women. Further, advanced breast cancer rates are considerably higher in Asian American Women in Hawaii and the Pacific compared to the US mainland, 15% versus 9%. The absolute risk of invasive cancer and advanced cancer in these groups of the US population is not known.
Our long-term goal is to develop accurate and validated breast cancer risk biomarkers that can contribute to screening strategies for Asian groups with diverse breast cancer risk profiles who to date have not been well represented in breast cancer cohorts and clinical trials. The Hawaii Pacific Islands Mammography Registry (HIPIMR) will be a resource to identify and validate novel image biomarkers for the diverse ethnic groups of this region with varying risk factor profiles including Native Hawaiians, Japanese, Filipino, Chinese, and other ethnic groups.
Combining San Francisco Mammography Registry and HIPIMR cohorts will give us the statistical power to describe the risk of invasive and advanced cancer in Asian groups.
Our central hypothesis is that standard breast cancer risk factors and image factors and their prevalence are different in the diverse populations found in high concentrations in the Pacific (Hawaii, Guam, American Samoa) and Asian ethnic groups in the mainland US compared to non-Hispanic White, non-Hispanic Black and Hispanic women. We plan to test the hypothesis that using risk factor profiles and next generation breast composition and texture features across Asian groups, the fastest growing segment of the US population, and NHPI ethnic groups will improve cancer risk prediction. Our specific aims are as compared to non-Hispanic White women:
- Examine clinical risk factors and their association with invasive and advanced breast cancer in women undergoing breast cancer screening by Asian (Japanese, Filipino, Chinese) and Native Hawaiian Pacific Islander (AANHPI) ancestry
- Identify next generation breast imaging characteristics from 2D and 3D mammography, including volumetric breast density, calcifications, masses, texture features and their association with invasive and advanced breast cancer for AANHPI women, using advanced artificial intelligence and machine learning approaches
- Identify the combination of clinical risk factors and image factors associated with invasive and advanced breast cancer risk among AANHPI women.
This study addresses the need for accurate identification of defined clinical and radiomic risk factors among AANHPI populations and their relation to breast cancer risk to improve outcomes for these women.