Breast Predict
The BREAST-PREDICT observational studies are part of the wider BREAST-PREDICT Collaborative Cancer Research Centre funded by the Irish Cancer Society in 2013. The overall project involves the unique amalgamation of available national data resources to enable an extensive novel population-based study of the effect of certain medication (statins/aspirin) and associated molecular biomarkers on breast cancer outcomes to support personalised approaches to breast cancer treatment.
Past studies suggest that women who took aspirin before their diagnosis of breast cancer were less likely to have cancer that had spread to their lymph nodes and were more likely to survive longer without a recurrence of their cancer. Similarly, previous studies suggest that women who take statins are less likely to have a breast cancer recurrence. However, it is unclear how these drugs affect breast cancer and which women are likely to benefit. We will identify those women who have and have not used the medications of interest and who have or do not have specific tumour characteristics (eg. biomarkers). We will compare how the disease progresses in these women and how they respond to treatment. This will make it possible to target these medications towards the women who are most likely to benefit.
The observational studies include two cohorts: a prospective and retrospective cohort study.
BREAST-PREDICT Prospective cohort study
BREAST-PREDICT has facilitated the recruitment and initial data collection of a cohort of breast cancer patients, while participating hospitals nationwide (including St James’s Hospital (SJH)) have gathered tissue samples and the National Cancer Registry of Ireland (NCRI) will supply linked cancer and potentially pharmacy claims data (from the HSE-PCRS for the subsample with eligibility for the GMS scheme). Although there is evidence to support an association between aspirin and statin use and breast cancer outcomes, we do not know the molecular mechanisms involved and the purpose of this project is to understand the mechanisms in response to commonly used medicines in breast cancer to personalize medicine.
Participants have provided explicit consent for data linkage with NCRI and HSE-PCRS data. The type of processing involves extracting the relevant biomarkers from tumour samples and linking the information to clinical data (from the NCRI and patient completed questionnaires, as well as pharmacy claims data). This study has already received full ethical approval from SJH (25/8/14 and updated 29/10/2024 for an extension).
BREAST-PREDICT Retrospective cohort
Similar to the prospective study, the study seeks to understand how commonly used medications – such as aspirin and statins taken for heart conditions, might influence breast cancer outcomes.
For this study we retrospectively obtained written consent from women diagnosed with breast cancer in St James’s Hospital, including consent for data linkage to the NCRI and HSE-PCRS pharmacy claims data. We aim to link the information on patient characteristics, tumour characteristics, treatments received and cancer outcomes from the National Cancer Registry Ireland (NCRI) and other data held by the NCRI including: information on prescription medications dispensed under the General Medical Services (GMS) Scheme from the HSE Primary Care Reimbursement Service (PCRS) pharmacy claims database (If made available to NCRI), and information on date and cause of death based on death certificates from the General Registry Office (GRO) Deaths Database.
Once established, this unique linked data resource including long-term patient follow up will be used to predict which patients are most likely to benefit from specific treatment or prevention measures.