title: The Pathways Study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California.
abstract: OBJECTIVE
  With 2.3 million breast cancer survivors in the US today, identification of modifiable factors associated with breast cancer recurrence and survival is increasingly important. Only recently new studies have been designed to examine the impact of lifestyle factors on prognosis, including Pathways, a prospective study of women with breast cancer in Kaiser Permanente Northern California (KPNC).
  
  
  METHODS
  Pathways aims to examine the effect on recurrence and survival of (1) lifestyle factors such as diet, physical activity, quality of life, and use of alternative therapies and (2) molecular factors such as genetic polymorphisms involved in metabolism of chemotherapeutic agents. Eligibility includes any woman diagnosed with invasive breast cancer within KPNC, no previous diagnosis of other invasive cancer, age 21 years or older, and ability to speak English, Spanish, Cantonese, or Mandarin. Newly diagnosed patients are identified daily from electronic pathology records and are enrolled within two months of diagnosis. An extensive baseline interview is conducted, blood and saliva samples are collected, and body measurements are taken. Women are followed for lifestyle updates, treatment, and outcomes by self-report and query of KPNC databases.
  
  
  RESULTS
  Recruitment began in 9 January, 2006, and as of 16 January, 2008, 1,539 women have been enrolled along with collection of 1,323 blood samples (86%) and 1,398 saliva samples (91%).
  
  
  CONCLUSIONS
  The Pathways Study will become a rich resource to examine behavioral and molecular factors and breast cancer prognosis.
authors.affiliation: Division of Research, Kaiser Permanente, Oakland, CA 94612, USA. marilyn.l.kwan@kp.org
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Kwan
authors.forename: Christine B
authors.initials: CB
authors.lastname: Ambrosone
authors.forename: Marion M
authors.initials: MM
authors.lastname: Lee
authors.forename: Janice
authors.initials: J
authors.lastname: Barlow
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Krathwohl
authors.forename: Isaac Joshua
authors.initials: IJ
authors.lastname: Ergas
authors.forename: Christine H
authors.initials: CH
authors.lastname: Ashley
authors.forename: Julie R
authors.initials: JR
authors.lastname: Bittner
authors.forename: Jeanne
authors.initials: J
authors.lastname: Darbinian
authors.forename: Keren
authors.initials: K
authors.lastname: Stronach
authors.forename: Bette J
authors.initials: BJ
authors.lastname: Caan
authors.forename: Warren
authors.initials: W
authors.lastname: Davis
authors.forename: Susan E
authors.initials: SE
authors.lastname: Kutner
authors.forename: Charles P
authors.initials: CP
authors.lastname: Quesenberry
authors.forename: Carol P
authors.initials: CP
authors.lastname: Somkin
authors.forename: Barbara
authors.initials: B
authors.lastname: Sternfeld
authors.forename: John K
authors.initials: JK
authors.lastname: Wiencke
authors.forename: Shichun
authors.initials: S
authors.lastname: Zheng
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Kushi
mesh_terms: D001943:Breast Neoplasms / Q000178:diet therapy / Q000453:epidemiology* / Q000401:mortality*; D002140:California; D015331:Cohort Studies; D004032:Diet; D005260:Female; D005843:Geography; D006801:Humans; D008019:Life Style; D009043:Motor Activity; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D015996:Survival Rate