A breast cancer diagnosis often leaves people anxious and adrift in a world of uncertainty. After the initial shock wears off, the quest for answers begins.

Inevitably, questions mount. Which kind of cancer is it? Is it treatable? What does the future hold?

To support people battling breast cancer, the North Texas philanthropic community has teamed up to support breast cancer research at UT Southwestern Medical Center’s Harold C. Simmons Comprehensive Cancer Center, enabling patients to live fully during and after treatment.

“UT Southwestern has been a basic science powerhouse for decades, which adds to the breadth and depth of the breast cancer team’s acceleration and progress,” said Carlos Arteaga, M.D., Director of the Simmons Cancer Center, Associate Dean of Oncology Programs, and Professor of Internal Medicine at UT Southwestern. “Philanthropy helps us identify the biggest obstacles hindering our ability to treat the deadliest breast cancers and pursue transformative solutions to address these obstacles.”

Formidable Foe

Heather McArthur, M.D., M.P.H., directs the Breast Cancer Program at the Simmons Cancer Center and oversees clinical care for breast cancer patients at UT Southwestern. She has specialized in breast cancer research and leads several clinical trials.

Despite notable progress made in cancer discovery, prevention, and care over the past three decades, researchers and clinicians like Dr. McArthur acknowledge further innovation is required to improve outcomes for many breast cancer patients.

One of the most formidable forms of breast cancer is triple-negative breast cancer (TNBC), which lacks three key receptors commonly found in other types of breast cancer. The cancer cells test negative for receptors for two hormones, estrogen and progesterone, as well as a protein called HER2.

Because TNBC tumors grow and spread with alarming rapidity, physicians have to act quickly and treat aggressively. Adding to the challenge, this form of breast cancer has a higher risk of recurrence. According to the American Cancer Society, TNBC accounts for about 10%-15% of all breast cancer cases and is more common in women under age 40, who are Black, or who have a mutation in the BRCA1 gene, which is associated with an increased risk of breast and ovarian cancers.

When TNBC metastasizes to the brain, the prognosis is typically poor. Patients often survive only about six months. Current treatments combine focused radiation therapy and surgery. However, this is not a formula for a cure.

Simmons Cancer Center has assembled many of the most dedicated minds in breast cancer research collaborating across different disciplines to further science and advance treatments. The Center is one of only 56 National Cancer Institute-designated Comprehensive Cancer Centers in the nation and the only one serving North Texas.

“Research innovation is impossible without philanthropy,” said Dr. McArthur, an Associate Professor in UT Southwestern’s Department of Internal Medicine. “The only way we can improve outcomes for women with breast cancer and for men and women with any type of cancer is through thoughtful scientific and rigorous clinical trials. Philanthropic gifts allow us to move quickly in our pursuit of innovative ideas that could have a huge impact on patients.”

Searching for Cures

Isaac Chan, M.D., Ph.D., an Assistant Professor of Internal Medicine and Molecular Biology at UT Southwestern and in the Simmons Cancer Center, is also working to find new breast cancer treatments. Internationally recognized for his efforts to use the body’s defenses to treat the disease, his research attracted the interest of Cindy Weber, a Dallas philanthropist who has supported efforts to build the Chan Lab Individualized Immunotherapy Program. Dr. Chan’s lab made breakthrough discoveries on powerful cancer-killing immune cells – called natural killer cells – that can help more effectively diagnose and treat TNBC.

Considered paradigm-shifting by many other scientists, his approach also caught the eye of Dallas community leaders Dawn and Todd Aaron.

“After our daughter was diagnosed with stage 4 breast cancer at 28 years old, we immersed our time and energies into better understanding the disease and necessary research needed to debilitate this aggressive form of breast cancer,” Mrs. Aaron said.

The Aaron family’s experiences with cancer and their gratitude for the care their daughter received at the Simmons Cancer Center have underscored their philanthropic support.

“With very slim chances of survival, our outstanding team of doctors took a no-holds-barred approach to beat the odds,” Mrs. Aaron said. “We are humbled and grateful to say that they succeeded. Our daughter is healthy and thriving.”

The family has supported Dr. Chan’s pioneering work with mini-tumor models, or 3D structures grown from human cells that mimic the characteristics and behavior of actual tumors. Developed for research, these models help scientists better understand the tumor’s biology, test potential treatments, and personalize treatment plans. Dr. Chan hopes the approach helps uncover new ways to activate the immune system to kill tumor cells, leading to a new generation of immunotherapies.

Cancer immunotherapy is a form of treatment that supports the immune system’s natural ability to fight cancer. While the treatment has dramatically improved overall cancer patient survival rates over the last decade, it has not been as successful in improving outcomes for breast cancer patients.

Jump-starting UT Southwestern’s collaborative Clinical Organoid Imagination Lab, the Aarons’ generosity has also accelerated Dr. McArthur’s and Dr. Chan’s research into new immunotherapy approaches into active clinical trials. Equally concerning is cancer metastasis, or the spread of cancer cells from the primary tumor to other parts of the body, which often results in death. Cancer researchers want to understand why certain breast cancers grow and metastasize, resisting otherwise effective therapies. Researchers look for ways to predict whether specific therapies will succeed and how they can detect metastases before they happen.

The Aaron family has also supported three UT Southwestern researchers working to better understand how metastases survive in the brain. Robert Timmerman, M.D., is Chair of the Department of Radiation Oncology and Professor of Radiation Oncology and Neurological Surgery at UT Southwestern. He’s collaborating with fellow faculty members Toral Patel, M.D., an Associate Professor of Neurological Surgery, Neurology, and Radiation Oncology, and Siyuan Zhang, M.D., Ph.D., an Associate Professor of Pathology and in the Simmons Cancer Center. The trio hope to develop a treatment regimen that combines radiation and immunotherapy for TNBC patients whose cancer has metastasized to the brain.

In partnership with the V Foundation for Cancer Research, the Aarons have also thrown their collective support behind the research of Angelique Whitehurst, Ph.D., Associate Professor of Pharmacology and in the Simmons Cancer Center. Dr. Whitehurst’s team is investigating how TNBC cells acquire the capacity to grow uncontrollably and metastasize. Their research has uncovered a mechanism that cancer cells use to turn on genes that promote growth or turn off genes that inhibit growth. Most recently, the team has investigated how this same mechanism prevents tumor cells from being recognized and attacked by a patient’s immune system. Understanding how these tumors work can be a first step in designing treatments that intervene and prevent tumor growth.

“With more research, it is our fervent hope that TNBC will no longer pose a threat to the livelihood of those diagnosed with the disease,” Mr. Aaron said. “We must all pull together to pay it forward for the next generation of breast cancer patients so that they may live to tell their stories of hope and healing.”

Second chances

Lily Zucker, Ph.D., believes there is purpose to everything in life. A Professor of Education at Dallas College, she finds immense joy preparing her students for careers in classrooms across the state and nation. In the spring of 2021, she was wrapping up the school year and preparing for her wedding when life took an unexpected turn.

After receiving a call from her UT Southwestern care team about a suspicious mammogram, she underwent additional tests and was diagnosed with stage 2 breast cancer. Her treatment regimen included a double mastectomy and additional surgeries, four months of chemotherapy, and a five-year course of hormone therapy. She remains grateful for the treatment she received at the Simmons Cancer Center.

“Trust is a huge word,” she said. “This was my life, and breast cancer is a serious disease. I trusted my doctors and always felt encouraged and supported by my care team.”

Her husband, Brian Zucker, was her biggest supporter throughout her illness.

"There were agonizing decisions to make in deciding a course of treatment,” he said. “You are gambling with your life and playing the odds, making decisions to preserve quality of life after treatment versus limiting the chances of recurring cancer. But Lily is a fighter. When challenged, she always comes out on top.”

Not even Dr. Zucker’s second chemotherapy treatment could get in the way of the couple’s wedding that fall, which was celebrated at home with an intimate group of family and loved ones. Hoping to boost the odds of survival for others facing the same fight, the couple created an endowment at UT Southwestern for advanced breast cancer research.

The Zuckers invested their support in the research of Suzanne D. Conzen, M.D., Chief of the Division of Hematology and Oncology and Professor of Internal Medicine. Dr. Conzen’s team has discovered ways that the human stress hormone receptor – or glucocorticoid receptor – plays a key role when expressed in triple-negative breast cancer cells.

The body produces the stress hormone cortisol daily to help our cells and organs respond to various environmental challenges. The glucocorticoid receptor is like a switch that responds to these stress hormones by turning on and off many important genes. Cancer cells can use this receptor’s function for their own purposes, increasing their resistance to chemotherapy and making it more likely for the cancer to spread to other organs.

Dr. Conzen is working to determine which of these cortisol-regulated genes are required by TNBC tumors in order for them to use the effects of the glucocorticoid receptor to their advantage. Being able to limit some of the cancer’s more aggressive features should make it easier to treat these tumors more effectively and reduce the likelihood of metastases.

Early detection and effective treatment were two of the Zuckers’ biggest motivators.

“When treatment was over, we thought, ‘What’s next?’ How do we know if Lily is cancer-free, and how do we detect it in the future? The answer is – you don’t,” said Mr. Zucker. “Cancer either comes back or it doesn’t, and it could come back at a late stage. We want to put our money toward helping research to find a way to detect and treat cancer before it’s too late.”

In addition to her generosity, Dr. Zucker was determined to make a difference for others. She volunteered to participate in a research study that is exploring how to use an MRI scan to detect breast cancer early. She also joined an online support group, where she met a 29-year-old cancer survivor from rural Missouri who went through treatment while caring for three young children. The mother’s story made Dr. Zucker realize how fortunate she had been during her treatment at UT Southwestern.

“This woman didn’t have access to Velcro belts for drains. She didn’t even know they existed,” she said. “I sent her everything – my wigs, shirts, and freezer gloves – and she was so appreciative.”

Forever the optimist, Dr. Zucker savors each day, finding love and support from her family and friends.

“Cancer has strengthened me spiritually,” she said. “It reminds me that we are all mortal, and one day we won’t be here. I don’t take the little things for granted.”

To support UT Southwestern's Breast Cancer Translational Research Program, contact Michele Meyers at 214-648-1669 or michele.meyers@utsouthwestern.edu.

• Dr. Arteaga holds The Lisa K. Simmons Distinguished Chair in Comprehensive Oncology.
• Dr. Conzen holds the Andrea L. Simmons Distinguished Chair in Cancer Research.
• Dr. McArthur holds the Komen Distinguished Chair in Clinical Breast Cancer Research.
• Dr. Timmerman holds the Effie Marie Cain Distinguished Chair in Cancer Therapy Research.