Title
The Women’s Environmental Cancer and Radiation Epidemiology (WECARE) Study
Principal Investigator
What is the WECARE Study?
Dr. Jonine Bernstein leads an international consortium group of investigators that are continuing analyses using an established epidemiologic and biospecimen resource, known as the WECARE Study. The WECARE Study is an umbrella study funded through several NCI U01 and R01 grants, which were first issued in 1999.
The WECARE Study is an international multicenter population-based case-control study of cases with asynchronous contralateral breast cancer (CBC) and individually matched controls with unilateral breast cancer (UBC). Study participants in each phase were identified through eight population-based cancer registries, including six in the United States that contribute to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program in California, Seattle, and Iowa and by using the Ontario Cancer Registry (Canada) and the Danish Breast Cancer Cooperative Group Registry, supplemented by data from the Danish Cancer Registry.
Recruitment and data collection were conducted in two phases by the data collection sites. The WECARE I Study, conducted during the years 2001–2004, recruited 708 cases with asynchronous contralateral breast cancer (CBC) and 1399 matched controls with unilateral breast cancer (UBC). The WECARE II Study, conducted during the years 2009–2012, recruited 813 cases with CBC and 813 matched controls with UBC. The study design of WECARE I, including eligibility and matching criteria, are described in detail in the following publication [Bernstein JL, et al 2004, PMID: 15084244; PMCID: PMC400669]. The WECARE II utilized near- identical study methods as described in the following publication, as many of the analyses combine data from both studies when available [Langballe R, et al 2016, PMID: 27400983; PMCID: PMC4940926].
Study participants were interviewed by telephone using a structured questionnaire aimed at evaluating known or suspected breast cancer risk factors, including personal demographics, medical history, menstrual and reproductive history, family history of cancer, use of hormones, smoking, and alcohol intake. Risk factor status was assessed during the period prior to first diagnosis, as well as between first diagnosis and reference date (i.e., the at-risk period for CBC). Detailed data on treatment and tumor characteristics were obtained directly from cancer registry records or by abstracting medical records, including pathology and surgical reports, radiation oncology clinic notes, and systemic adjuvant treatment data. Complete medical treatment history information was collected, and for all women who received radiotherapy, the radiation dose to the contralateral breast was reconstructed using radiotherapy records and radiation measurements. Biospecimens were collected from study participants for genotyping: blood collected from WECARE I women; and saliva collected from WECARE II women.
Analyses continue to utilize this valuable data resource. The overall goal of this study is to examine the interaction of radiation exposure and genetic susceptibility in the etiology of second primary breast cancer. The global hypothesis is that women who are carriers of certain genetic mutations will be more susceptible to radiation-induced breast cancer than are non-carriers.
