Patient Recruitment

Study Population

Recruitment sites include the Ponce School of Medicine Outpatient Clinic, Auxilio Mutuo Hospital (San Juan), Damas Hospital (Ponce), St. Lukes Hospital (Ponce) and Tito Mattei Hospital (Yauco). Participants (cases and controls) are all of Hispanic origin since this represents the majority of the population of Puerto Rico. Controls are women without breast cancer. Cases and controls are compared regarding their DNA repair capacities (DRC) in peripheral blood lymphocytes. 


  1. Women have to be 21 years or older.
  2. Only cases with primary and metastatic breast carcinoma tumors, rather than secondary to other type of cancer are recruited.
  3. Pathology report from each patient is obtained to know the tumor grade, tumor size, presence of axillaries’ lymph node metastasis, and other clinically relevant information.
  4. Fill an epidemiological questionnaire soliciting information and variables that are related to breast carcinoma risk is provided to each participant.

Selection of cases and controls

  1. Incident cases are recruited consecutively from all the participating clinical practices throughout Puerto Rico (convenience sample of newly diagnosed BC patients residing in the Island).
  2. Controls are recruited consecutively from individuals visiting gynecological and primary care medical offices in Puerto Rico for their routine mammography and other types of screening.
  3. DNA repair capacity (DRC) data is analyzed including controls with and without familial history of breast carcinoma. There is the possibility that controls will have more weight than cancer cases, that potential confounding factor as well as any other confounding factors that became apparent were carefully analyzed and properly adjusted for.. These selection procedures minimized selection bias due to differences in mode of recruiting cases and controls. 
  4. The three main criteria for selecting all controls are that all participants within the last six months prior to enrollment:
  • Had been examined by their primary physicians (normal clinical breast examination) and have received a normal mammogram within the last six months.
  • Controls consist of women recruited from the same population (clinics, physician offices and hospitals) where the cases came from, and in the eventuality that they developed breast carcinoma; they would be treated in the same clinics where the cases were recruited.

***Women that have received chemotherapy, radiotherapy, and blood transfusions within the last five years, or have any genetic or acquired immunodeficiencies, unfortunately can not participate in the study.