# Project 1: BRAVE Strategy (Breast cancer risk assessment achieved)

> **NIH NIH U54** · TENNESSEE STATE UNIVERSITY · 2022 · $30,502

## Abstract

PROJECT SUMMARY: FULL PROJECT 1
Each year ~12,000 women ages 18-45 are diagnosed with breast cancer in the United States (US).
Overrepresentation of aggressive cancers, advanced stage disease at diagnosis, and inferior outcomes are seen
in this population of young women. Further, breast cancer mortality disparities in young women result in
increased early loss of life amongst women from low socioeconomic status (SES), those dwelling in rural areas,
and those from racial minority groups. Access to care, delays in diagnosis and treatment, and differences in
tumor biology partially explain these disparities. Identifying racially, geographically, and socioeconomically
diverse young women at high risk for breast cancer offers an opportunity to reduce cancer disparities
through early screening and detection of breast cancer. Integrating the use of existing breast cancer risk
assessment (RA) tools into clinical care is a means to identify these young women.
While RA is recommended for all women no later than age 30, this has not yet been translated to clinical practice
and thus women are not receiving RA prior to the age of 50 years when screening is recommended for those at
average risk. Women at high risk, in contrast, should start screening as young as age 25 (e.g., for those identified
to have a BRCA1 or BRCA2 mutation). As most women ages 25-49 years of age do not now receive RA, and
breast cancer in these women presents with a more aggressive phenotype at later stage associated with inferior
outcomes, implementation strategies for RA in this age group should be developed. If women ages 25-49 receive
RA and are identified as high-risk, they can be screened earlier than age 50 to diagnose cancer at an earlier
stage, when the disease is most successfully treated.
The central goal of the Breast cancer Risk Assessment: achieVing Equity (BRAVE) study is to reduce breast
cancer disparities by testing strategies to implement evidence-based breast cancer RA in a state-level public
health program that serves a racially and ethnically diverse population of low-income women. The BRAVE study
aims to assess the feasibility, reach, acceptability, and appropriateness of select customized strategies to
increase uptake of breast cancer RA. We will achieve these aims through conducting a novel, stepped-wedge
trial employing a mixed methods study design. The primary outcome is the proportion of women aged 25-49
having RA. Secondary outcomes include the numbers of women: 1) identified as high-risk; 2) pursuing risk-
adherent screening; and 3) diagnosed with breast cancer. Implementation outcomes include reach, feasibility,
acceptability, and appropriateness. Data collected will inform a future multi-site cluster randomized clinical trial
to test the implementation strategies on a larger scale over a longer duration, enriched for underserved
populations such as minority and rural dwellers.

## Key facts

- **NIH application ID:** 10493437
- **Project number:** 5U54CA163066-12
- **Recipient organization:** TENNESSEE STATE UNIVERSITY
- **Principal Investigator:** Rebecca Selove
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $30,502
- **Award type:** 5
- **Project period:** 2011-09-23 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10493437

## Citation

> US National Institutes of Health, RePORTER application 10493437, Project 1: BRAVE Strategy (Breast cancer risk assessment achieved) (5U54CA163066-12). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10493437. Licensed CC0.

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