Lina's Dream Fellowship
The
Lina's Dream Fellowship was established to foster independent breast cancer research in BC, specifically in the area of breast cancer in younger women.
We are very pleased to announce that in February 2013 Dr. Esta Bovill was awarded the one-year
Lina's Dream Fellowship . Women who have a family history of breast cancer and test positive for the mutated BRCA gene as a result, are at a high risk of developing breast cancer. Those who are in this position can opt for a mastectomy to significantly reduce their risk but the average wait time for this surgery in BC for this reason is one to three years. Dr. Bovill's research will focus on investigating whether long wait times to have a mastectomy for young women at risk for hereditary breast cancer increase the likelihood they will develop breast cancer during the wait time.
Dr. Esta Bovill, University of British Columbia, Vancouver
Dr. Bovill is a Plastic Surgeon with training in London, Oxford, and South West UK. She specializes in breast cancer reconstruction and has spent time with world-‐renowned surgeons in Toronto, Banff and Winnipeg to further her experience in this field. Dr. Bovill has extensive research experience, having been awarded a PhD in Molecular Medicine from the University of London in 2009, and has 20 published articles in peer-‐reviewed journals to her credit.
Project Description
It has been discovered that 60-‐80% of women diagnosed with mutated BRCA genes are at high risk of developing hereditary breast cancer. As a result, many women choose risk-‐reducing mastectomy, with or without breast reconstruction as a way to reduce the risk of developing breast cancer, particularly in younger women. Post surgery, the risk of breast cancer is estimated to decrease by 90%.
In the UK, laws require that when the mutated BCRA gene is discovered and the patient chooses a mastectomy, this procedure
must be done within 16-‐18 weeks of diagnosis. In BC the wait time is 1-3 years, during which time the patients are at risk for developing breast cancer and are subject to psychological stress.
Dr. Bovill's objective is to review BC patients to determine their average wait-‐time from diagnosis of the mutation to when they have a mastectomy and compare their incidence rates with those in the UK to determine if there is increased development of breast cancer associated with longer wait times.
This study will highlight the importance of quicker treatment for those women diagnosed with mutated BRCA genes and guide decision-‐making amongst clinicians and policy makers. The aim is to improve both psychological and clinical outcomes for young women at high risk for hereditary breast cancer.
Project Outcomes
Using the data from the BC Cancer Hereditary Cancer Program, the outcomes of 300 women with mutations in BRCA were studied; the data showed the average wait time to undergo a mastectomy was 17 months and 30 months for those that chose to have a mastectomy with immediate breast reconstruction. The findings also showed that 6% of the women who opted for a mastectomy with immediate breast reconstruction developed breast cancer while they were waiting for surgery. The results of Dr. Bovill’s research were used by the Regional Breast Reconstruction Surgery Working Group to successfully lobby the Regional Surgical Executive Council in BC for greater resources including new surgeons, more operating room time and the creating of a centralized access system. The research was also used to support a successful bid by the UBC Breast Reconstruction Program to the UBC Division of Plastic Surgery to recruit a new full-time plastic surgeon specializing in breast reconstruction who began working in July 2018. This research also prompted the creation and implementation of a new clinical guideline in May 2018 that aims to reduce surgical wait times in British Columbia from 30 months to 12 months for women with BRCA mutations. This work has been instrumental in the adoption of new measures that will reduce wait times and improve outcomes for young women in British Columbia.
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Fellowship 2013
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The Ruby Project
About 5% of breast cancer cases in Canada occur in women under the age of 40. For reasons that are currently unknown, these young women often experience a worse outcome than older women who are diagnosed with the disease. The rarity of these so-called very-early onset breast cancer cases has made it difficult to study the unique challenges faced by young patients and how to improve their chances of survival. The RUBY (Reducing the Burden of Breast cancer in Young women) study seeks to fill that knowledge gap through four subprojects led by researchers across Canada. Dr Christine Friedenreich is leading one of these, studying the impact of modifiable lifestyle factors on breast cancer survival in young women. The specific factors that she is examining include obesity, physical activity, sedentary behaviour, dietary supplements, vitamin D status and anti-inflammatory medication use. As of February 29, 2018, 611 patients have been recruited across Canada for the study and the goal is to recruit 1,200 women in total. Dr. Friedenreich and her team are collecting data from study participants at diagnosis and will be continuing to assess them at yearly intervals post-diagnosis. Dr Friedenreich and her team aim to identify the unique challenges facing young women with breast cancer and guide the development of new policies and treatments to improve the outcomes and quality of life for these patients. Dr Friedenreich is in the third year of this 5-year study and so further support from Lina’s Dream could help the team ensure that work continues unabated and the research can get completed on-time.
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1 Appreciation Report for Lina’s Dream, Your Impact in 2017, May 4, 2018, developed by Canadian Cancer Society
