School Notes: School of Public Health
July/August 2010

Breakthrough method predicts risk of invasive breast cancer

Scientists for the first time have discovered a way to predict whether women with ductal carcinoma in situ (DCIS)—the most common form of non-invasive breast cancer—are at risk of developing more invasive tumors in later life. The finding will allow women with DCIS to be more selective about their course of treatment and, potentially, to avoid aggressive forms of treatment such as complete mastectomy or radiation.

The study, accessible online in the Journal of the National Cancer Institute, followed the medical histories of 1,162 women who had been diagnosed with DCIS. It found that a diagnosis of DCIS based on a lumpectomy specimen was more predictive of a high risk of subsequent invasive cancer than was a DCIS diagnosis by mammography. Different combinations of biomarkers were also associated with various levels of cancer risk. Women diagnosed with DCIS have historically had an inaccurate perception of their risk of developing invasive cancer, and as a result have chosen fairly aggressive treatments. “This separation into risk groups will assist in determining an appropriate treatment regimen, tailored to an individual woman’s clinical profile,” said Annette Molinaro, an assistant professor of biostatistics at the YSPH and one of the study’s lead authors.

Advocate of better health for all visits Yale

An outspoken advocate of better health and health care for the world’s poorest people visited the School of Public Health in March with a hopeful message that many of the glaring health disparities found in England, the United States, and elsewhere can be changed—if societies have the will. Sir Michael Marmot, whose well-known Whitehall studies in England have clearly established a link between an individual’s social class and health, said that health inequalities between rich and poor are “morally unacceptable” and that this divide gets at the very heart of what is a good, fair, and compassionate society. There is no biological reason for the glaring health disparities that are found in the world today, he added. The good news is that these disparities can change dramatically and quickly—improvements can be seen within the span of years—if a society deems it important enough, Marmot said.

Noted medical researcher receives Winslow Award

Sir Iain Chalmers, recognized as one of the leading health researchers of his generation, is the 2010 recipient of the C-E. A. Winslow Award, which was presented April 26. The award commemorates the contributions of Charles-Edward Amory Winslow to public health—he established the Yale School of Public Health in 1915, one of the country’s first public health programs—and is given to those who exemplify Winslow’s ideals, particularly his concern for social factors affecting health. It is bestowed by the school every several years to recognize outstanding contributions to the field of public health. Chalmers is only the third recipient since the award’s creation in 2000. Sir Iain Chalmers’s career in medicine and public health spans more than four decades. Much of his work focuses on health research, particularly on assessing the effects of health interventions and addressing medical uncertainties.