# Project 3: Inter-Relationships and Prognostic Significance of Breast Cancer Radiomic Risk Features, Tissue Microenvironment, and Adiposity

> **NIH NIH P20** · UNIVERSITY OF HAWAII AT MANOA · 2024 · $256,152

## Abstract

SUMMARY / ABSTRACT
The risk of breast cancer among U.S. women dramatically differs across racial and ethnic populations.
Nonetheless, Asian American and Native Hawaiian/Pacific Islander (AANHPI) ethnic minority women have been
historically underrepresented in breast cancer research. Consequently, there are major gaps in understanding
the basis of disparities in these populations including high incidence and mortality among Native Hawaiians and
a steadily rising incidence with comparatively favorable outcomes among Japanese Americans. Obesity and
breast density, established breast cancer risk factors, vary widely across AANHPI women and have direct
implications for mammographic screening and primary prevention. Our research to date provides strong
evidence that body fat distribution, including visceral adipose tissue (VAT), is an important predictor of breast
cancer risk. The influence of adiposity on breast density and other aspects of breast architecture that can be
discerned through mammographic screening (e.g. radiomic features) is not well understood. Our long-term goal
is to elucidate the breast cancer disparities seen in understudied minority AANHPI subgroups (Native Hawaiian,
Micronesian, Japanese, Chinese, Filipina) that can be translated to improved prevention, early detection, and
therapeutic strategies. Our central hypothesis is that established radiomic risk features have unique
associations with breast cancer incidence in AANHPI subgroups and that they are correlated with tissue
biomarkers of risk and prognosis and with obesity, especially VAT. Study resources include the statewide
Hawai`i Pacific Islands Mammography Registry linked to the SEER Hawai`i Tumor Registry and its Residual
Tissue Repository (RTR), and to the Hawai`i component of the Multiethnic Cohort Study (MEC). Our study is
focused on the minority health of AANHPI, with the following aims: 1) Characterize the relationships of
established breast imaging radiomic risk features with tissue protein biomarker expression profiles reflecting
the tissue microenvironment and breast cancer prognosis and with disease-specific survival; 2) Characterize
the joint relationships of breast radiomic risk features and different measures of adiposity, including VAT, with
post-menopausal breast cancer risk among Native Hawaiian, Japanese American, and White MEC
participants. 3) Calibrate commonly used risk prediction models for breast cancer by including established
breast radiomic (AI and machine learning) risk features from 2D and 3D mammography in AAPHI and White
women overall and by estrogen/progesterone receptor and HER-2 status. The expected outcome of the
proposed study is to further our understanding of unique relationships between imaging biomarkers derived
from advanced machine learning approaches and race/ethnicity, tissue molecular characteristics and adiposity
phenotypes, which will improve risk and prognosis model accuracy and better identify high risk women for further
asses...

## Key facts

- **NIH application ID:** 10931602
- **Project number:** 5P20CA275734-02
- **Recipient organization:** UNIVERSITY OF HAWAII AT MANOA
- **Principal Investigator:** JOHN Alan SHEPHERD
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $256,152
- **Award type:** 5
- **Project period:** 2023-09-19 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10931602

## Citation

> US National Institutes of Health, RePORTER application 10931602, Project 3: Inter-Relationships and Prognostic Significance of Breast Cancer Radiomic Risk Features, Tissue Microenvironment, and Adiposity (5P20CA275734-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10931602. Licensed CC0.

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