Anjali Kumar, MD, MPH. Photo by Thea Sakarta
UCSF Fellow Anjali Kumar, MD, MPH, is the 2006 recipient of the Association of Women Surgeons (AWS) Foundation Fellowship and the AstraZeneca Young Investigator Award at the 28th Annual San Antonio Breast Cancer Symposium (SABCS).
Kumar submitted three abstracts for the SABCS, the largest annual international, multidisciplinary breast cancer conference, all of which were accepted. One project, which she designed through UCSF's Training in Clinical Research course taught each summer by Stephen Hulley, MD, MPH, professor and chair of epidemiology and biostatistics at UCSF, was chosen for oral presentation. Of the 43 abstracts selected for oral presentation, Kumar's was one of 18 presented by researchers from the United States - one of two from West Coast universities. Some 6,000 participants registered for the conference, and roughly 3,000 people attended her talk.
Kumar also was selected from a national pool of applicants for the AWS fellowship, which is granted to a female surgeon for an original research topic on breast cancer or minimal access surgical/endoscopic techniques. She received a $25,000 grant for her project titled "Randomized Phase II Pilot Trial of Statin Use in Women with Early Breast Cancer."
The AWS was founded in 1981 as an offshoot of the American College of Surgeons, the largest professional body of surgeons in the country. The AWS mission is to inspire, encourage and enable women surgeons to realize their professional and personal goals.
Research on Statins
Kumar is a fourth-year resident in surgery completing a two-year midresidency research fellowship under Laura Esserman, MD, MBA, director of the UCSF Carol Franc Buck Breast Care Center. Kumar joined Esserman to research the possibility of breast cancer prevention by administering statins. Together, they wrote a proposal to give patients with the earliest form of breast cancer (DCIS) a statin for three to six weeks before their surgery to record possible anti-tumor effects.
Statins are a widely prescribed class of drugs used to lower cholesterol and reduce the risk of death from heart attacks and strokes. The risk reduction may be related to the effect statins have on different cell pathways. Esserman and UCSF Breast Care Center colleagues Christopher Benz, MD, and Michael Campbell, PhD, have made significant strides in determining the molecular pathway by which statins block cancer cell growth.
Although there is increasing epidemiologic evidence suggesting overall breast cancer risk reduction among statin users, to date there is no clinical evidence linking statins with reduction in breast cancer of any specific type. To determine whether prior statin use among breast cancer patients altered development of a receptor-specific type (estrogen receptor [ER] negative or positive) relative to statin nonusers, Kumar performed a retrospective cohort analysis of 2,141 breast cancer patients in the Kaiser Northern California Cancer Registry.
Kumar found that among patients who used statins prior to their diagnosis of breast cancer, the odds of developing an ER-negative tumor was 35 percent less than for statin nonusers.
UCSF heads a perioperative randomized clinical trial of statins given to breast cancer patients. The trial is underway in four cities (San Francisco, Boston, Chicago and New York) and will explore the impact of two different doses of statins on tumor cell activity.
"Some statins work better than others, and some types of breast cancer cells are more strongly affected. The ER-negative cell lines seem to be most sensitive. This is important because we can prevent and treat ER-positive breast cancers with anti-hormone agents, such as tamoxifen, but we don't yet have drugs that prevent or treat ER-negative cancer," says Kumar, who tends to tissue culture in the Brunn Institute laboratory at the Mount Zion campus.
Kumar offers surgical perspectives to Kimberly Topp's anatomy students at the UCSF School of Medicine, volunteers at the Women's Options Center at Mount Zion under the mentorship of Karen Meckstroth, and sings in Vox Dilecti, a community chamber chorus. She will complete her research at UCSF this year and return to her chief residency at the UCSF East Bay Surgery Program in June.
