Overview

The Duke Consortium for Inflammatory Breast Cancer was started in 2014 to identify innovative ways to address the unique aspects of inflammatory breast cancer and drug discovery. The multidisciplinary center brings together investigators and clinicians to better understand, prevent, and treat inflammatory breast cancer. It is a springboard for multi-PI program project initiatives and grant applications with local universities, including North Carolina Central University, the University of North Carolina at Chapel Hill, and North Carolina State University. The Consortium works with advocates and community health providers as well as the World IBC Consortium investigators across many institutions.

No Specific Treatment Regimens

Currently there are no therapeutic regimens developed specifically for the treatment of inflammatory breast cancer. It is critical to recognize that many aspects of treating inflammatory breast cancer – including staging, diagnosis, and therapy – are vastly different than other breast cancers.

Designated a Cancer Health Disparity

Inflammatory breast cancer tends to be diagnosed at a younger age when compared with other types of breast cancer. In the United States, African Americans appear to be at higher risk of developing inflammatory breast cancer. The disease is particularly aggressive in African American patients, irrespective of hormonal status or molecular subtype. Reports in the last two decades show a high incidence of this cancer in the Mediterranean area in North Africa. No risk factors have currently been defined, but epidemiological studies reveal an increase in the global incidence of inflammatory breast cancer.

Goals

The goals of the Duke Consortium for Inflammatory Breast Cancer are to:

• Identify the molecular determinants underlying the distinct biological features and aggressive progression observed in patients with inflammatory breast cancer.
• Develop innovative preclinical models and methods that will improve diagnosis, imaging, and development of therapeutic approaches specifically for the treatment of inflammatory breast cancer.
• Evaluate the effectiveness of treatment for inflammatory breast cancer patients.
• Provide educational tools to our research and clinical trainees in aspects of translational research, health disparity, and clinical outcomes.
• Collaborate with patients, advocates, and local community health care providers to increase awareness of inflammatory breast cancer

Research Focus Areas

IBC Tumor Biology and Drug Discovery Platforms
Area Leaders: Greg Palmer, Ph.D., Kevin Williams, Ph.D.

Clinically, inflammatory breast cancer is characterized by redness and swelling of the breast which can spread rapidly and diffusely within the breast. This is in contrast to many other cancers that present with a solid mass/lump, making imaging and the diagnosis of inflammatory breast cancer difficult. Skin symptoms (redness, dimpling of skin) are secondary to tumor cell invasion into the dermal lymphatic channels. Given this unique method of cancer spread, our multidisciplinary investigators are working with external collaborators to develop innovative in vitro and in vivo patient-derived models that reflect the clinic-pathological features of IBC, with the potential to accelerate drug discovery.

Determinants of Population Health, Environmental Factors that Impact Clinical Outcomes
Area Leader: Anh Tran, Ph.D., MPH

Inflammatory breast cancer (IBC) is particularly devastating in minority women who have both a higher incidence of IBC and worse cancer survival. Disparities in IBC incidence, progression, and outcomes are likely multifactorial, including socioeconomic factors, treatment-related disparities, and biological differences. We are focused on addressing each of these individual factors and their impact on inflammatory breast cancer outcomes.

Community Outreach and Education

We work with our patient advocates and partners to help guide community engagement through outreach and education with a focus on cancer prevention and control. In addition, NIH- and Duke School of Medicine-supported educational activities in the form of didactic courses, workshops, and seminars train the next generation of researchers and physician-scientists.

The Duke student-led Rare Cancer and Health Disparity Coalition aims to form a lasting connection among Duke, NCCU, the Durham community, and beyond, bridging the gap between the research lab, the clinic, and the community. The Coalition hopes to provide students and community members affected by rare cancers (themselves or through family and beyond), and those interested in rare cancers a platform to engage in rare cancer advocacy, research, and science communication work.

The Awareness of Rare Cancers: Hearing and Engaging Rural Communities (ARCHER-C) Project
Team: Gayathri Devi, Ph.D.; Anh Tran, Ph.D., MPH; Lawrence Greenblatt, MD, Lisa Davis, Ph.D., Rashmi Saincher, MBBS, Beau Blass, Sarah Weaver, MPH

Captures the experiences of rural primary care providers, patients, and caregivers with rare cancers and health disparities. Ensuring that experiences are heard will advance future efforts in education, advocacy, treatment, and research to better create new initiatives to improve IBC and other rare cancer awareness, detection, treatment, and outcomes. 

Key Partnerships

The Inflammatory Breast Cancer International Consortium (IBC-IC)  was founded to foster collaboration among inflammatory breast cancer researchers and clinicians. The focus of our collaboration is to advance the leading research, education and information that will lead to the best outcomes and cures for IBC throughout the world.

The IBC Network Foundation is dedicated to funding research regarding Inflammatory Breast Cancer, and to providing an avenue to network proactive education to the general population as well as the medical community regarding Inflammatory Breast Cancer.

The IBC Research Foundation is dedicated to improving the lives of those touched by inflammatory breast cancer through the power of action and advocacy, and to fostering innovative inflammatory breast cancer research, educating stakeholders, and tirelessly advocating for both patients and survivors.

The Union Baptist Church of Durham has been a spiritual home for Durham community members since its founding in 1897. The church’s ministries include health and wellness, cancer support, and caregiver support.

Sunflower DPC provides direct primary care, a model of care where for a low monthly fee patients can enjoy high-quality and lower-cost healthcare without surprise per-visit fees. For many with no health insurance coverage or high deductibles, having this kind of access to a primary care provider without copays makes it easier to decide to see the doctor when needed.

LATIN-19 provides a critical space for leaders and allies in North Carolina to create collaborative and interdisciplinary solutions to address the health disparities in the Latina community in a trusting and committed environment. Piedmont Heath works to improve the health and well-being of the community by providing high-quality, affordable, and comprehensive primary health care. They provide medical services, dental care, on-site pharmacy, behavioral health, and nutritional help.The 

University of Antwerp and Sint Augustine Hospital, Antwerp, Belgium Steven Van Laere, PhD, Dr. Peter Van Dam

MD Anderson Morgan Welch Inflammatory Breast Cancer Center

Precision Oncology and Translational Oncology, Marseille Cancer Research Center

Indian Institute of Science North Carolina Central University

• Biomanufacturing Research Institute and Technology Enterprise (BRITE) meets the changing workforce needs of the North Carolina life science industries and clinical research sectors, supporting job creation and economic growth. BRITE focuses on health-related research and degree-based workforce development.
• Julius L. Chambers Biomedical and Biotechnology Research Institute (JLC-BBRI) conducts multidisciplinary and interinstitutional research focused on health issues that disproportionately affect minority and underserved populations.
• Research Centers in Minority Institutions Center for Health Disparities conducts cutting edge research for addressing health disparities, with a focus on basic and behavioral biomedical research.

The Duke NCCU Bridge Office at Duke Clinical and Translational Science Institute connects Duke and NCCU with opportunities for multidisciplinary collaborations and ensures that faculty, investigators, and trainees at all career levels have access to core resources and services to do innovative research.

Duke Advanced Practice Leadership Institute is a one-year experiential leadership development program trains advanced practice nurses, physician assistants and other non-physician providers who have graduate-level education and training) and their team members to be health equity leaders who thrive in interprofessional teams and are able to lead transformational projects to improve the health of patients, the resiliency of providers, the efficacy of health care systems, and the strength of communities.

The Cancer and Environment Program
Emerging evidence suggests the role of environmental chemicals, in particular endocrine-disrupting chemicals (EDCs), in breast cancer incidence, progression, and treatment resistance, which can impact survival outcomes. The Cancer and Environment Program employs a multi-scale approach - using tools from epidemiology, exposure analysis, and molecular cell biology - to study the interactions between breast cancer and the environment toward an integrated analysis.

Clinical Management

Area Leaders: Jeremy Force, DO, Rachel C. Blitzblau, MD, Olga G. James, MD, Karen S. Johnson, MD, Laura H. Rosenberger, MD

The Inflammatory Breast Cancer Clinic at the Duke Cancer Center promotes multidisciplinary care and supports women being treated for this rare cancer. The clinic includes breast cancer surgeons, medical oncologists, radiation oncologists, and breast pathologists who have specific expertise in diagnosing and treating the nuances related to IBC.