Current Research Interests

Dr. Bernstein is the PI of the WECARE Study (Women’s Environmental, Cancer, and Radiation Epidemiology) which examines genetic susceptibility and risk of contralateral breast cancer, especially relating to treatment. Current investigations involving this resource include studies of the role mutations in candidate genes, including ATM, BRCA1, BRCA2, Palb2, Chek2, 53BPI, MDC1, Rad50, and MRN genes, DNA repair pathways, tumor molecular biomarkers and risk of developing contralateral breast cancer. Also, within the WECARE Study, Dr. Bernstein is examining whether mammographic density is an important risk factor for contralateral breast cancer, and she is currently leading an investigation focused on non-cancer outcomes following treatment for breast cancer. Lastly, with other WECARE Study investigators, she is in the field collecting the tumor tissue from the WECARE Study participants in order to examine the molecular pathoepidemiology of contralateral breast cancer. Notably, in their 2020 publication in JNCI, Dr. Bernstein and colleagues examined radiation sensitivity and risk of contralateral breast cancer among those who carried ATM, BRCA1/2, and CHEK2*1100delC pathogenic variants. They found no minimal evidence among carriers as their background risk was high, however, among carriers of rare ATM variants there was a large increase risk of radiation-associated contralateral breast cancer. These clinically relevant findings provided the motivation for an R01 application of genetic susceptibility to radiation-associated breast cancer within the WECARE Study. Across all endeavors, the WECARE Study involves collaboration from over 75 investigators from over 25 different institutions in the US, Canada, Denmark, the UK, Norway, and Sweden. The WECARE Study population includes 1500 women with contralateral breast cancer who serve as cases and 2200 women with unilateral breast cancer matched to the cases.  All participants answered detailed questionnaires, provided biospecimens and medical records, and for those women treated with radiation, detailed location-specific dose estimates were calculated.  Dr. Bernstein with Drs. Malcolm Pike, Elizabeth Morris, Janice Sung and others, are leading the tri-institutional IMAGINE (for IMAGINg and Epidemiology) Study examining background parenchymal enhancement as seen on MRI as a biomarker of breast cancer risk. A 2020 publication, led by post-doctoral fellow, Gordon Watt, demonstrated the association of breast cancer with MRI background parenchymal enhancement. As a follow-up the team is now examining the risk of background parenchymal enhancement in contrast enhanced digital mammograms, and they received an MSK Population Sciences Research Program Interdisciplinary Award to support this extension. Dr. Bernstein, with Dr. Jung Hun Oh from MSK Medical Physics, was awarded an R21 from the NCI to apply machine learning techniques to identify radiation-associated breast cancer.  Dr. Bernstein continues to work with Drs. Melissa Bondy (Stanford University) and Jason Huse (MD Anderson) to examine tumor characteristics from the NIH-funded, multi-center GLIOGENE (Genetic Epidemiology of Glioma) Study of familial and sporadic glioma cases. She continues to serve as a member of the U.S. EPA Radiation Advisory Committee, as a Scientific Advisory Board Member for both the Radiation Effects Research Foundation (in Hiroshima) and as both a Board Member and Council Member of the National Committee Radiation Protection and Measurement. She is Past President of the American College of Epidemiology and a member of the American Epidemiological Society. At MSK, Dr. Bernstein is proud to serves as co-Leader for the institution-wide Population Sciences Research Program.