ACS Awards Help Surgeon-Scientist Build a Sustainable Breast Cancer Research Program

As Jacqueline S. Jeruss, MD, PhD, FACS, gazed at the photographs of children lining her desk, she recalled a time when young breast cancer patients avoided taking the recommended treatment course of chemotherapy or long-term antihormonal therapy because it could significantly delay, if not permanently end, their opportunity to start a family.

These heartwarming images of children, sent by former patients, continue to inspire Dr. Jeruss, a breast surgical oncologist and one of the initial members of The Oncofertility Consortium. (“Oncofertility” refers to the field of medicine that links oncology to reproductive health.)

“Patients would say to me, ‘I’m able to go through treatment with chemotherapy now because I was able to cryopreserve embryos—my future hope is being preserved,’” reflected Dr. Jeruss.

Breast cancer is one of the most common malignancies found in women of childbearing age, with one study suggesting that approximately 11,000 cases are diagnosed each year in patients under the age of 40.¹ A diagnosis of breast cancer for this cohort can be particularly challenging when considering the potential for fertility loss associated with specific gonadotoxic therapies. In 2009, Dr. Jeruss and Teresa K. Woodruff, PhD, coauthored the article, “Preservation of Fertility in Patients with Cancer,” published in The New England Journal of Medicine, which has been cited more than 700 times and continues to be a primary resource on this topic.²

In 2012, Dr. Jeruss was named the eighth recipient of the ACS Joan L. and Julius H. Jacobson II Promising Investigator Award, which was established to recognize surgeons “demonstrating early promise in contributing to the practice of surgery.” Dr. Jeruss’s research interests focused on the role of novel therapeutics for the treatment of aggressive breast cancer subtypes and examining new approaches to manage cancer metastasis. Eventually, her translational research efforts expanded to include developing a clinical path for the fertility preservation of young patients with cancer, as well as the management of pregnancy-associated breast cancer.

In a 2023 article published in the Journal of the American College of Surgeons (JACS), Dr. Jeruss described the award as a “wonderful honor that served to buoy and motivate my academic career.”² Stated simply, the Jacobson Award helped to validate Dr. Jeruss’s research focus.

“The intentionality around the Jacobson Award is designed to support a surgeon-scientist who is at the tipping point in their academic career,” said Dr. Jeruss. “It is a time of great and also cautious optimism. Through mentorship, resources, and protected time, a tremendous investment was made to help catalyze my research program. Receiving the Jacobson Award helped to recognize that my work could have a positive impact, and that there would be a return on the generous investment I had been granted.”

Beyond confirming the career trajectory for a young surgeon-scientist, the Jacobson Award provides funding of up to $30,000, which is supported through an endowed fund established by donors and administered by the ACS Surgical Research Committee.

“Building a lab is a very busy time, when obtaining funding and also attracting graduate students and personnel to help run the lab are occurring simultaneously. It is a certain leap of faith when the lab is just getting started, to take on the responsibility of educating students and say, ‘I’ll be able to support you.’ It’s almost like starting a small business,” she shared.

10 Years Post Jacobson Award

“I remain committed to the meaningfulness of the research that I’ve participated in related to fertility preservation, TGFβ signaling and cyclin-dependent kinases inhibition, and cancer progression. The work continues to be challenging, interesting, and inspiring,” said Dr. Jeruss. “I am grateful to have the opportunity to be involved in ongoing research that can help patients diagnosed with breast cancer.” Her approach a decade ago (and today) was to consider novel approaches to cancer care through the study of targeted therapeutic approaches and new treatments that could potentially mitigate off-target effects of therapy to improve quality of life.

After receiving the Jacobson Award, Dr. Jeruss’s career path also led to key leadership roles, including director of the University of Michigan Breast Care Center and the Dr. Polly Suk-Yee Cheung Breast Surgical Oncology Fellowship, and codirector of a long-standing NIH T32 Surgical Oncology Research Training Program in the Section of General Surgery at the University of Michigan in Ann Arbor. Today, she is serving as associate vice president for Research Integrity and Compliance and associate dean for Regulatory Affairs; she also is the Alfred E. Chang, MD Professor of Surgical Oncology, with appointments in pathology and biomedical engineering, at the University of Michigan.

“Through my work as a surgeon-scientist and the support I have received from mentors and colleagues, I have been so fortunate that I can continue to learn and identify new ways to make a contribution to medicine, science, and education,” she said. “I support the approach to maintain a diverse research portfolio and remain open to many different experiences, allowing for the identification of passions that ultimately prove to be the most rewarding, sustainable, and meaningful throughout life.”

Significance of a Solid Base

As an undergraduate attending Brandeis University in Waltham, Massachusetts, Dr. Jeruss worked as a laboratory technician studying neurogenetics in the lab of Jeffrey C. Hall, PhD, who would receive the Nobel Prize in 2017 for his research on circadian rhythms.

In the JACS article, Dr. Jeruss wrote about her formative experiences in Dr. Hall’s lab, noting that she learned “fundamental premises of hypothesis-based thinking, meticulous scientific documentation, and the perseverance that comes with the scientific process.”

“What I took from that initial research experience was what it meant to be an outstanding scientist and mentor and identify the kind of environment I hoped to foster. During this early experience, there was an opportunity to be exceedingly exacting and strive for excellence, but I was also shown compassion on the days when I was not at my best and to allow for a growth mindset. Working in the Hall Lab helped me understand how I might aspire to one day run a lab and how to populate the lab with outstanding people,” explained Dr. Jeruss.

After graduating from Brandeis, Dr. Jeruss attended medical school at The University of Vermont in Burlington, where she was mentored by multiple medical educators, including Ann Thor, MD, and Donald Weaver, MD, who introduced Dr. Jeruss to the field of breast cancer research. After Dr. Thor moved to Northwestern University in Chicago, Illinois, Dr. Jeruss applied to surgical residency at the same institution.

During this time, she received an ACS Resident Research Scholarship, which is a 2-year award that aims to “encourage residents to pursue careers in academic surgery anywhere on the research continuum.”

“While at Northwestern, Dr. Thor served as my initial research mentor for the ACS Resident Research Scholarship,” she said. The proposal was based on epigenic factors that could influence the more aggressive trajectories of creatin breast cancer subtypes.

After receiving the ACS Resident Research Scholarship (2000–2002), Dr. Jeruss pursued a doctor of philosophy degree in the labs of Drs. Thor and Woodruff, examining TGFβ superfamily signaling in mammary gland development and breast oncogenesis.

“Receiving the ACS Resident Research Scholarship, provided me with the opportunity to pursue PhD-level studies,” said Dr. Jeruss. “That scholarship also helped to generate support from the Northwestern Department of Surgery Chairs—Richard H. Bell Jr., MD, FACS, and David P. Winchester, MD, FACS—and the graduate school at Northwestern.” After completing her PhD, Dr. Jeruss returned to Northwestern Memorial Hospital to finish her surgical residency. A short time later, she moved to MD Anderson Cancer Center in Houston, Texas, where she completed a fellowship in breast surgical oncology.

Advice for Young Investigators

In early 2024, the National Cancer Institute’s (NCI) payline for competing R01 and R21 grants for new and established investigators is at the 10th percentile.³ (A payline is a percentile that represents a conversative funding cutoff point.)

“This means that 90% of people who have novel ideas to approach cancer research and treatment are not getting funded,” explained Dr. Jeruss. “The pressure is very high for young physician-scientists to identify the important questions, write outstanding proposals, publish in high-tier journals, and mentor students to ultimately develop a sustainable research program.”

When applying for funding, be it for an NIH proposal or the Jacobson Promising Investigator Award, Dr. Jeruss suggests a straightforward approach. “Do the good work that is meaningful, intentional, and problem focused. Be observant in the clinical setting and take that clinical experience back to your research program to guide and drive the work forward.”

A combination of many factors, including maintaining optimism, a rigorous focus, a diligent commitment to excellence, and perseverance are key to thriving in the dual role of surgeon-scientist.

“Physician-scientists who maintain a clinical practice are competing against PhDs and MD-PhDs who are solely focused on their work in the lab,” said Dr. Jeruss. “Clinician-scientists are always wishing for another hour on the clock, another moment to think about a research idea and read another paper. And yet, at the same time, I personally believe there’s really no better way to develop novel ideas than by being in the clinic. The connection to patient care is a critical way to remain relevant and facile and also observe the trajectory of disease. Implementing this approach, surgeon-scientists can be responsive to key clinical observations through their research in a way that is meaningful.”

Many scholarships and programs administered by the College are supported by funding from the ACS Foundation. To learn more about the ACS Foundation, the programs it supports, and how to contribute, go to facs.org/foundation. For more information about ACS scholarships and awards, visit facs.org/awards.

Tony Peregrin is the Managing Editor of Special Projects in the ACS Division of Integrated Communications in Chicago, IL.

References

1. Shah NM, Scott DM, Kandagatla P, Moravek MB, et al. Young women with breast cancer: Fertility preservation options and management of pregnancy-associated breast cancer. Ann Surg Oncol. 2019;26(5):1214-1224.
2. Jeruss J. The promise of ongoing discovery and growth: 10 years after receiving the Jacobson Promising Investigator Award. J Am Coll Surg. 2023;237(5):788-792.
3. Rathmell WK. Fiscal year 2024 appropriation brings clarity to difficult choices. National Cancer Institute. April 4, 2024. Available at: https://www.cancer.gov/grants-training/nci-bottom-line-blog/2024/nci-fy-2024-appropriation-brings-clarity-and-difficult-choices. Accessed June 14, 2024.