We are proud to announce that Sister Study Co-Investigator, Dr. Clarice Weinberg, received the NIEHS award for outstanding research. Read more here.

Although the Sister Study is first and foremost a breast cancer study, the information you have shared about your experiences and health gives us the opportunity to study other topics that are important for women's health. Over the years, we have written papers about the impact of early life exposures on age at menarche and menopause or risk for uterine fibroids or autoimmune diseases. More recently we have used Sister Study data to evaluate both the impact of obesity and diabetes on breast cancer risk but also to study factors that increase or decrease the chances of developing these conditions. In the future we may study other conditions that are important for women like osteoporosis and endometriosis. Some questions require collaborations across more than one study. A recent example of this is a new initiative focused on better understanding the association between residential air pollution and cardiovascular disease, specifically heart attack (myocardial infarction), stroke, and heart failure in women. We have joined forces with one of the foremost experts on this topic, Dr. Joel Kaufman, a colleague at the University of Washington. We have already worked with him to evaluate the possible link between air pollution and breast cancer. Cardiovascular conditions are leading causes of death and disability in women. Breast cancer and heart disease appear to share some risk factors. Findings from this new study may help us to identify new questions we can ask about breast cancer risk or the impact of heart disease on breast cancer risk or survival. Soon, some Sister Study participants will be asked to assist in this effort by providing permission for us to obtain their medical records relating to any heart disease or strokes that they reported on Sister Study follow-up questionnaires. Just as pathology reports and medical records are an important source of information to classify subtypes of breast or other cancers, medical records are needed to confirm and accurately classify specific types of heart disease and strokes. Thank you again for helping us make the most of the information you provide to advance women's health research!

Dr. Chandra L. Jackson, a new investigator in the Epidemiology Branch of the NIEHS, has joined the Sister Study research team. At NIEHS, she will lead research on social and environmental determinants of health equity. Chandra has a Master's degree from the Harvard T.H. Chan School of Public Health and a PhD in Epidemiology from The Johns Hopkins Bloomberg School of Public Health. Before coming to NIEHS she was a Postdoctoral Fellow in the Nutrition Department at the Harvard T.H. Chan School of Public Health and a Research Associate in the Harvard Catalyst Clinical and Translational Science Center. With nearly 5,000 African-American participants and over 2,500 Latinas, Dr. Jackson is excited to use the Sister Study data to investigate how the physical and social environments impact disparities in the relationship between sleep health and chronic diseases such as diabetes and cardiovascular disease. She will also collaborate with Dr. Sandler and others who are studying how sleep health affects risk for breast cancer and other aspects of health and well-being.

We are inviting some Sister Study participants to join a new initiative studying changes in and loss of sense of smell. Our ability to smell is the result of many complex brain activities. Scientists have shown that changes in sense of smell may be associated with neurodegenerative brain disorders such as Parkinson's disease. Our sense of smell may also be a general marker of overall brain health. While some diseases may affect our sense of smell, environmental exposure to chemicals and pollutants may also play a role. To better understand this, we are collaborating with Dr. Honglei Chen, a colleague at Michigan State University (and previously a Sister Study partner at NIEHS) to examine whether air pollutants impact sense of smell. This initiative is one of our new collaborations to study other diseases besides breast cancer in the Sister Study since you provided such in-depth information on potential environmental exposures and health.

You may recall that when you enrolled you answered many questions about your food choices, portions and how often you ate certain foods. The Sister Study has a team of diet researchers now using the data you contributed in new and innovative ways. Past research has focused on single nutrients—like fats, fruits and vegetables, or meats—one at a time. But diets are more complicated and people who eat a lot of one thing may eat less of another. Thus focusing on dietary patterns is a promising new approach. In addition to looking at dietary patterns many of us are familiar with, such as the Mediterranean diet, our team will be looking at a number of recently developed dietary patterns. One of these is the dietary inflammatory index (DII), an index based on a body of research showing that some foods are generally pro-inflammatory—that is, they promote inflammation in the body—and other foods are anti-inflammatory. Chronic low-level inflammation, which is also linked with obesity has also been associated with a number of chronic diseases, including cardiovascular disease and some cancers. Another promising dietary pattern focuses on the estrogenic potential of foods, including soy. When evaluating diets, there are many other factors to consider such as exercise, weight, and other lifestyle choices. We are in the beginning stages of this work but look forward to sharing findings shortly. It is exciting to be in a position to fully evaluate these new hypotheses and take advantage of all the diet information you shared when you enrolled!

Scientists are always looking for new ways to predict who is more likely to get breast cancer. Breast or mammographic density is one factor of interest because women with dense breasts are more likely to develop the disease, although the pathway is not clearly understood. In collaboration with Sister Study investigators, two projects have been funded to look at breast density, environmental exposures, and breast cancer. Dr. Lexie White, a Sister Study fellow, is looking at the link between environmental air contaminants and breast density. The hypothesis she is investigating is that women with higher exposures to these pollutants will have higher breast density, which may also result in women being more likely to develop breast cancer. The second project is a collaboration with Columbia University in which we are studying changes in mammographic density over time among Sister Study participants. Breast density is higher in premenopausal women and decreases with age. Investigators want to learn if the amount of change in breast density, especially during the menopausal transition, is tied to breast cancer risk. We are inviting some women with and without breast cancer in the Sister Study to join in this effort by giving us permission to retrieve previous mammograms.

The Sister Study data that you contribute is going further by contributing to larger pooling studies that want to look for new risk factors for breast cancer. Pooling studies pull together data from multiple studies and can look at possible risk factors or cancer outcomes that are too rare to investigate in the Sister Study alone. For example, Sister Study PI Dr. Dale Sandler and Dr. Hazel Nichols, a former Sister Study fellow and current assistant professor at the University of North Carolina, are leading an effort to evaluate risk factors for breast cancer among premenopausal women. Specifically, they are exploring risk factors that may behave differently in premenopausal breast cancer. For example, it is well known that obesity contributes to risk of postmenopausal breast cancer. This may not be the case for premenopausal breast cancer. Of special interest is an apparent increase in breast cancer risk that occurs shortly after pregnancy. While pregnancy is well-recognized as being associated with reduced risk of breast cancer, there is some evidence that risk increases shortly after pregnancy before it declines many years later. Because breast cancer is rare after pregnancy, the existence and timing of this risk cannot be studied in a single study alone. The Sister Study has also contributed data to look at antimüllerian hormone (AMH), a biomarker of ovarian reserve that is highest in late childhood/early adulthood and begins to decline around age 25 until menopause. Higher levels of AMH levels have previously been related to breast cancer risk in a subset of premenopausal women participating in the Sister Study. A combined study gives us more ability to fully evaluate this association. In addition, Sister Study data is contributing to multiple projects looking at genes related to breast cancer risk and tumor characteristics which gives researchers a greater ability to identify environmental and genetic risk factors for breast cancer and survival.