The Intersections of Career Direction and Personal Connections

Ann H. Partridge, MD, MPH, grew up visiting the hospital where her father worked as a surgeon, watching how he used his profession to shape his patients’ lives. She reflects fondly on the countless times throughout her childhood when she and her sister and brother would talk with their father about “the work that he loves,” remarking that “being brought up by a physician was very impactful.” Partridge’s father’s passion for his career inspired his children to follow the medical path as well, with Partridge’s sister becoming a surgeon and Partridge, ever fascinated with both science and people, diving headfirst into oncology.

“I’ve been very lucky with mentors over the years, starting with my father,” said Partridge, a 2023 Giant of Cancer Care inductee in breast cancer. Partridge felt compelled to care for patients with serious diseases with whom she could share long-term relationships. She said the connections she creates with her patients motivate her as both a researcher and a physician. In oncology, she found a niche where she could both investigate and implement ways to improve her patients’ outcomes and personal experiences to “make both a medical difference and an emotional difference in their lives.”

With the entire oncology field before her, Partridge briefly pursued hematology before realizing her interest in solid tumors and her desire for a research mentor. Eric Winer, MD, of Yale Cancer Center in New Haven, Connecticut, answered the call. As the then-head of the Breast Division at the Dana-Farber Cancer Institute in Boston, Massachusetts, Winer helped Partridge discover her dual passions for treating patients with solid tumors and furthering the field of women’s health.

By narrowing her oncologic focus to breast cancer, Partridge saw her career interests expand to encompass the entire experience of women with cancer, from supportive care efforts and quality-of-life assessments to psychosocial considerations and survivorship initiatives. Winer, a 2019 Giants of Cancer Care inductee in breast cancer, encouraged Partridge to dive deeper into these interconnected aspects of patient care, guiding her to understand that patients with breast cancer could uniquely benefit from her commitment to see them as individuals with needs and desires that transcend their disease.

Unexpected Intersections

In an effort to carve her own path in a family of medical professionals, Partridge tried not to be a doctor despite the constant pull she felt from the sciences throughout high school and college. Although alternative career paths remained unclear, she knew she would be satisfied only if her life path led her to connect with people, opportunities she sought beyond medicine. However, her interest in science only intensified and school subjects such as anatomy, physiology, and molecular biology remained the topics she was always most excited to learn about, leading her to pursue a bachelor of science in biology at Georgetown University in Washington, DC.

Through deep dives into a broad spectrum of topics in college, Partridge learned the value of adopting multiple points of view and inviting multifaceted approaches to identifying problems and seeking solutions, noting, “I think I’ve been that way all along.” To this day, she said the critical thinking skills she gained in college allow her to think beyond the rigid structures of science and see her patients as complex people with concerns and desires distinct from, yet entwined with, the diseases they face.

“I very much like integrating other aspects of the world into my work,” Partridge said. For instance, when conducting clinical trials, although she studies the mechanisms and efficacy of the investigational treatments, she also considers the emotional and social effects of the diseases, treatments, and study parameters, which she describes as “para-oncology.”

Stemming from her own interests in “enjoying the tangents and trying to learn from the things on the side,” delivering comprehensive patient care is a fundamental feature of Partridge’s philosophy as a doctor and researcher.

Compassion Turned Action

Early in her career, Partridge’s relationship with cancer hit close to home when one of her closest friends from high school was diagnosed with breast cancer at age 30 years. Although Partridge lent her support as a friend and offered insights as an oncologist, she couldn’t ignore the overwhelming gaps she saw in clinical research and supportive care that made her friend feel isolated as a young woman with this disease. This was a turning point for Partridge, who emphasized that at the time, “there were so many holes in the available evidence for decision-making and support, as well as how to care for these patients and implement the evidence we had.”

Her friend’s experience increased her sensitivity toward all young women with breast cancer, compelling her to sculpt her career around raising awareness about the unique struggles of patients in this population and improving their disease outcomes and quality of life. In her clinic, Partridge noticed her younger patients having a particularly difficult time with their breast cancer diagnoses and treatments. Medically, their disease tended to be more aggressive and advanced than that of older patients. Physically, they were “suffering out of proportion” to women their age without cancer, experiencing symptoms from their treatments, such as hot flashes, that other women their age were years away from encountering. Emotionally, these patients felt distanced from their peers as they found themselves needing to make sacrifices regarding their bodies, lifestyles, and future plans.

In particular, Partridge realized that many patients diagnosed with early-stage, hormone-sensitive breast cancer in their 20s or 30s were suddenly faced with a clinical dilemma regarding their ability to have children. At diagnosis, not only do many of these patients need chemotherapy, which can threaten fertility, but most of these patients are advised to take several years of adjuvant endocrine therapy, which disrupts their fertility for its duration. Moreover, by the time they complete this therapy, they may be at an age when their fertility window has closed.

Partridge notes that for many young women with breast cancer, the struggles of their cancer journey are exacerbated by the news that they must wait to have children until after treatment.

Energized by this, Partridge became the US primary investigator of the POSITIVE trial (NCT02308085), which aimed to determine the risk of disease recurrence among women with hormone receptor–positive early breast cancer who had received adjuvant endocrine therapy for 18 to 30 months and temporarily interrupted this therapy to attempt pregnancy. Among the 516 women enrolled in the trial, almost three-quarters had at least 1 pregnancy, and over half had at least 1 live birth. Additionally, after a median of 41 months post-treatment interruption, 44 patients had experienced a breast cancer event. In patients who interrupted treatment, the 3-year incidence of breast cancer events was 8.9% compared with 9.2% in patients from an external control cohort.¹

Partridge said POSITIVE’s confirmation of the safety of pausing endocrine therapy and the feasibility of pregnancy in young women with hormone receptor–positive disease is “really great news for patients who are often itching to [attempt pregnancy] for understandable reasons.”

Scientific Advances Reflected in Social Change

Partridge’s commitment to helping her patients achieve their dreams of having children is reflected in her commitment to caring for her own children. Inspired by her father’s dual dedication to his family and his patients, Partridge has built a successful medical career while supporting her husband, Jon Mitchell; daughters, Grace, Natalie, and Lauren; and dog, Arya.

When Partridge is not making the 60-mile commute to fulfill her clinical, research, and administrative roles at the Dana-Farber Cancer Institute in Boston, she is “entrenched in the community” of New Bedford, Massachusetts, where her husband has served as mayor since 2012. She commended her husband for striving to improve their hometown, “a city steeped in history that has a lot of need and also a lot of beauty.”

Partridge noted the gratitude she feels for the opportunity to live in a city where she can work with her husband to enact change, such as supporting his efforts in the school system and working alongside local health care providers. Her role as the mayor’s wife affords her an inside glimpse at the needs of her community and reminds her to stay aware of the disparities many patients face.

In the clinic, Partridge’s desire to inspire change has always been patient focused. Her early days as a clinical trial investigator revealed that enrolled patients rarely received adequate, accessible information regarding the trial results. Furthermore, there was no systematic approach to garnering patient interest in and sharing these results. So, in 2003, she became the principal investigator of a study that aimed to determine whether and how patients wanted to receive the results of the trials they participated in.²

Partridge’s passion for the para-oncologic aspects of cancer research extends beyond her desire for further knowledge. After finding that many clinical trial participants expressed interest in receiving study results, she has worked to improve patient access to plain-language data summaries, collaborating with patient advocates to make this practice more widespread across oncology research and cultivate a better experience for the patients who dedicate their time, finances, bodies, and sometimes their lives to furthering the possibility of improved cancer care.

Another way in which Partridge strives to improve health equity is through her research regarding the behavioral aspects of cancer care, such as treatment adherence. Partridge knows that not all patients follow their doctors’ treatment and lifestyle recommendations, and she acknowledges the importance of considering socioeconomic barriers and emotional hesitations that may prevent these patients from accessing or choosing potentially life-saving therapies. Much of her research involves developing interventions to improve supportive care and treatment adherence, as she notes that equally as important as drug development is optimizing how patients access and tolerate their prescribed regimens. For instance, the POSITIVE trial was inspired by her investigation into the correlation between fertility concerns and patients’ choices to forgo or discontinue hormone therapy.

“I personally see it as our moral responsibility as doctors, as researchers, and as educators of both the next generation of doctors, providers, and researchers, and the patients we care for and their loved ones to try to figure out how to get optimal care to everybody,” Partridge emphasized.

Foundations For Future Generations

Even more than bolstering breast cancer research across the country and participating in civic responsibilities at home, Partridge’s main priority is her children, whom she and her husband “have tried…to steer in the best way possible, along with a lot of help.” The 3 daughters she and her husband are raising have further ignited Partridge’s passion for improving the field of women’s health so she can contribute to a world that supports their well-being.

As her daughters explore interests such as film, politics, and business, Partridge hopes to “be their cheerleader” and provide them with a strong, supportive foundation from which they can grow into successful, smart, but, most of all, reasonably well-adjusted individuals. “My hope for them is that they can find something that they’re as passionate about as I am about improving cancer care, taking care of patients, and learning for future generations.”

References

1. Partridge AH, Niman SM, Ruggeri M, et al. Interrupting endocrine therapy to attempt pregnancy after breast cancer. N Engl J Med. 2023;388(18):1645-1656. doi:10.1056/NEJMoa2212856
2. Partridge AH, Burstein HJ, Gelman RS, Marcom PK, Winer EP. Do patients participating in clinical trials want to know study results? J Natl Cancer Inst. 2003;95(6):491-492. doi:10.1093/ jnci/95.6.491