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Judith A. Salerno Headshot

With Age Comes Wisdom: Middle Age for the Breast Cancer Movement

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Last week, it was my great pleasure to address one of the most important gatherings of breast cancer researchers and clinical practitioners at the 31st Annual Miami Breast Cancer Conference. My thanks to Dr. Patrick I. Borgen (chair of the medical committee of Komen's New York City Affiliate) for inviting me to share the view of a nonprofit leader about the intersection of science and society in the coming years.

My remarks focused on three key areas: the drive for results in breast cancer research funding in a time of tightening budgets; the move toward greater collaboration in the breast cancer arena, and the critical need to fund and foster the next generation of breast cancer researchers.

It's an appropriate time to take stock. We're in the fifth decade of the War on Cancer declared by President Nixon in 1971, and the fourth decade of the unofficial launch of the breast cancer movement, begun in 1982 when Nancy Brinker founded Susan G. Komen and began the national conversation about breast cancer.

This is our middle age, if you will, making it an appropriate time to look back, take stock of what we've learned, and apply those lessons to the future.

The gains are impressive. Breast cancer death rates have fallen by 34 percent in the U.S. since 1990. Five-year relative survival rates for early stage cancers are at 99 percent. Steady progress is being made against metastatic disease (although not as rapidly as we'd like), and we're increasingly turning our attention to the possibilities for preventing breast cancer.

These gains are the result of funding largesse that saw federal breast cancer research funding grow from $30 million in 1982 to almost $1 billion today. Private industry and nonprofits added to the government dollars: Komen alone has invested $804 million in research since we opened our doors, making us the largest nonprofit funder of breast cancer research outside of the federal government.

And while we expect breast cancer research funding to continue, and at significant levels, we're mindful of trends reported by the National Institutes of Health. Their budgets have grown modestly over the past decade, but their purchasing power -- when you factor in biomedical research sector inflation -- has shrunk by about 20 percent. That's translating into reduced support for grants.

Nonprofits, also working in tighter economic times, may not be able to fill the gaps as robustly as we have in the past. We'll be less able to fund high-risk projects, and less likely to invest in research that re-visits well-established territory. Komen began making the shift to translational research in 2007. We're focused on research that can bring results to patients in the shortest period of time. And we encourage collaboration across research institutions and medical disciplines, with strong participation from patient advocates.

Partnering
Another trend we're likely to see is a new era of collaboration across nonprofits themselves. For too many years, breast cancer organizations operated almost in a vacuum, raising dollars to fund research or programs that in some cases may have been duplicative. This may have grown from the mindset of nonprofits as competitors.
But with age comes the wisdom that none of us is as smart as all of us, and although different breast cancer organizations may have different charters, different priorities and even different points of view, there are areas where we can, and must, work together to achieve the results we all desire. The more collaborative and coordinated we are, the faster and more effective we will be.

We've taken some important first steps with new collaborations between Komen, the Dr. Susan Love Research Foundation and the Young Survival Coalition to work together on Dr. Love's Health of Women Study. Weeks after we announced that partnership last October, we announced as founding partners of the new Metastatic Breast Cancer Alliance -- a consortium of 16 breast cancer organizations working together on the most deadly form of the disease.

Young Researchers

We consider it critical to partner not just across organizations, but across generations, too. Ensuring a continuity of breast cancer research by supporting the next generation of researchers is one of our most critical responsibilities. To that end, about a quarter of Komen's research grants since 1990 have been specifically directed to researchers just starting out. More than 80 percent of the grantees we surveyed tell us that these grants not only got them into breast cancer research, but kept them in the field.

For that reason, Komen is declaring 2014 the Year of the Young Researcher and directing $30 million in our grants slate this year to the work that young investigators are doing, while continuing to fund established scientists.

Our reasoning is simple: we simply can't allow cancer researchers to become an endangered species. We must enlist our best and brightest, and hold them close.

And as we sharpen our focus on the researchers who will deliver tomorrow's breakthroughs, we in the breast cancer movement must remain committed to supporting the women and men affected by breast cancer today, and especially the low-income, uninsured and medically underserved people who need our help.

Millions of people benefit each year from the work of community health agencies (many funded by Komen), that provide financial and psychosocial support, along with screenings and education, for people facing breast cancer. Komen alone has supported $1.7 billion for community health programs across the country.

I encouraged the scientists at the conference to become partners in the community outreach, as advocates for their own research and the larger research enterprise. It's crucial, going forward, for these two realms -- science and society -- to be connected and engaged with one another. That connection has driven significant progress in just three decades. It can be the catalyst for exponential progress as our movement moves through middle age.

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