A lifelong love of solving puzzles led Dr Jingmei Li into a career searching for new ways to prevent the most common cancer in women.
When the COVID-19 pandemic interrupted Li’s groundbreaking research into breast cancer prevention earlier this year, she took it in her stride. Li’s laboratory, like those of many other senior researchers at the Genome Institute of Singapore (GIS), readily answered the call to find solutions to COVID-19. And solving such critical problems was one reason why she originally studied science.
“I’m a puzzle person,” Jingmei explains. “In science you set up by asking a question, you think about different solutions and you try to find answers to a problem. Science is all about tackling problems that are relevant. Whatever expertise we have, we help.”
Although COVID-19 has interrupted the day-to-day routines of many labs, Jingmei’s computational data work on cancer prevention continues. “We still analyse whatever data we have; it’s just a bit slower,” she says. “But it’s not like cancer research is a sprint.”
Jingmei explores genetics to help define risk factors for breast cancer. Although many gains have been made in this area during the past 40 years, her focus has been on combining different genetic markers to identify an individual’s risk. She has won several prestigious awards for this work, including a Singapore Young Scientist Award, in 2017, and a L’Oréal-UNESCO For Women in Science International Fellowship, in 2014.
Her career in breast cancer research began with a PhD at the Karolinska Institute in Sweden. It was, she says, a long way from her blue-collar family background in Singapore.
My mum and dad didn’t go past primary school,” Jingmei says. “Mum maybe got three years of education. But they pretty much let me do whatever I wanted to do. They bought me all the books that they didn’t have.”
Jingmei’s insatiable curiosity and love of people led her to science, and later to breast cancer research when she found out her research supervisor used to be an oncologist. He said that as a doctor he could only ever help one patient at a time. “If I do breast cancer research, if I study the risk factors, if I can prevent breast cancer, then I’m not just helping one person, I am helping so many, so many more,” he told her.
Jingmei found his enthusiasm for research infectious. “I simply love working with people with so much passion,” she says. “They want to make lives better for people. Finding a job is very easy, but to be happy in a job, I think that’s very important to me.”
As a senior research scientist, Jingmei has two permanent staff and various students and interns working for her. She struggles, however, to find top statisticians interested in healthcare. “We don’t have enough data scientists,” she says. “I’m assuming we’re losing all these people to higher-paying jobs – you know, analysing market trends.”
Jingmei quotes studies that show research into drug development receive up to 40 times more funding than research into prevention. “There are some people, especially the clinicians, who are into treatment,” she says. “They want to find treatments and extend the lives of patients. But then the other camp is like, ‘Why don’t we just prevent breast cancer altogether?’ That’s where my training in genetics comes in.”
Much research and knowledge of breast cancer genes focuses on a few well-known factors, she says, and the traditional approach to prevention treats everyone the same. “When you talk about breast cancer genes, people always immediately think of Angelina Jolie and BRCA1. But there are so many other genes we have found that are connected to breast cancer. BRCA1 is very rare in the population. Maybe one in 2000 people would get that mutation which makes a person susceptible to breast cancer,” Jingmei says. “So, my work is focused on looking for common variants of breast cancer, which can be present in the general population from anywhere between 1% and 50%.”
By studying many different genetic markers simultaneously, Jingmei is able to determine that one individual’s risk of getting breast cancer might be five times higher than that of someone else.
We have found so many markers for breast cancer by combining all these different markers – the sum of all these tiny differences,” Jingmei says. “It’s actually something like a personal jigsaw puzzle.”
Additional risk factors can include body mass index and breast density. Ethnicity is also important and Jingmei is quick to point out that most genetic research on breast cancer has been done on European participants. Only 14% of genetic breast cancer studies have involved Asians, who overall tend to have quite different lifestyles and risk factors to Europeans.
Jingmei says screening programs should move away from a one-size-fits-all regime, such as giving mammograms to all women older than 50 every two years. “I think what we can aim to do is actually change this screening program, so that it’s more efficient,” she says. “I’m following people who, if they are at high risk, should go for screening when they are younger. Some of the categories are women who are very low risk who maybe can be screened every three years.”
Jingmei says she has learned that as well as the research, there are other very important aspects to reducing the incidence of breast cancer. These include networking and increasing awareness. “I’ve done three TEDx talks,” she says, adding that’s she not entirely comfortable with public speaking. “I get nervous breakdowns before every time, but I think it’s a must.”
Her former oncologist-turned-researcher PhD supervisor taught her that to achieve change through science you need to grab the interest of people and make a message relatable.
“When I first joined the lab as a science student, this professor was like, ‘Well, when are you teaching her how to play golf?’.” she recalls. “I was like, ‘Huh? What has playing golf got to do with it?’ But he gets all these multi-million-dollar grants by playing golf with well-to-do private donors and gets them interested in breast cancer prevention.”
Jingmei says another way of increasing prevention of breast cancer would be to redesign mammogram screening so it is more friendly for women.
Mammograms are painful. They’re clearly designed by men.”
“Is this the best way to examine women’s breasts?” she asks, suggesting they could even be done in a non-clinical environment. “Perhaps somewhere where you could get a pedicure or manicure at the same time. Maybe getting a massage after the machines crush you on a very sensitive part of your body. Maybe then people would want to go because it’s a once-a- year nice outing and you get all these other things.”
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Article by Ken Eastwood
Photo: NUS AlumNUS