Institute scientist awarded $100K grant to investigate discrimination’s impact breast cancer patients

Leena Hilakivi-Clarke , PhD, Professor at The Hormel Institute, University of Minnesota, has received the Masonic Cancer Center’s (MCC) 2023 CRTI Exceptional Translational Research Award. The award will provide $100,000 over two years to support a pilot study led by Drs. Hilakivi-Clarke at The HI and Anne Blaes at MCC that will investigate the effects of racial discrimination on the gut microbiome and heart failure risk among Black, Native American, and White breast cancer patients who have been treated with aromatase inhibitors.

Minnesota has the fourth-highest rate of breast cancer incidence among U.S. states, and the majority of these patients receive aromatase inhibitor therapy to prevent breast cancer recurrence. Aromatase inhibitors target an aromatase enzyme in multiple cell types located not only in the ovary and breast, but also in blood vessels, bones, skin, and the brain to lower the body’s estrogen levels, since estrogen can fuel the growth of breast cancer cells.

However, aromatase inhibitor therapy also increases the risk of heart failure, especially among patients who already have increased heart failure risk due to myriad factors, one example being having gut dysbiosis (an imbalance of healthy and harmful gut bacteria), which can arise due to numerous causes, including stress due to racial discrimination.

“Breast cancer patients are more likely to die of adverse cardiac events than of breast cancer recurrence. Particularly vulnerable might be Black and Native patients who suffer from health disparities, which include increased risk of heart failure and cancer mortality,” Hilakivi-Clarke said. “It is important to determine if discrimination related to structural racism further increases the risk of developing heart failure among breast cancer patients taking aromatase inhibitors, and if racial discrimination also induces gut dysbiosis, which, in turn, is linked to heart failure.”

Racial discrimination is a major causative factor for health disparities, but little is known of its impact on the gut microbiome. Other factors increasing health disparities include access to healthcare, health professionals’ bias towards BIPOC ( Black , Indigenous, and people of color), poverty, socioeconomic status, and lack of access to green spaces.

To ensure better health outcomes and longer lifespans for all, it is essential to build a better understanding of how racial discrimination impacts BIPOC individuals so that additional risks can be properly mitigated. That’s where this research comes in.

“Although elimination of structural racism is the ultimate societal goal, it is critical to discover ways to reduce its impact on health,” Hilakivi-Clarke said. “If we find that racial discrimination causes gut dysbiosis and increases the risk of heart failure in breast cancer patients treated with aromatase inhibitors, we could attempt to reverse gut dysbiosis by suppressing biological changes induced by stress linked to discrimination, such as activation of beta-adrenergic signaling of the autonomic nervous system.”

It is anticipated that this pilot study will lead to a project that will be submitted for external funding. That future project will investigate whether successful reversal of gut dysbiosis will prevent heart failure linked to aromatase inhibitor therapy.

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