Research Interests
Oncologic surgery, administration of chemotherapy and the supportive care of women with a gynecologic cancer are challenging and stimulating tasks that provide tremendous benefit for the patients and oncologist. That said, the current methods of
treatment of gynecologic cancers can only be described as barbaric. Further the disparities in delivery of these services even within the United States makes treatment more toxic for some and less effective for others. The solution is prevention and early
detection. When prevention and early detection are not feasible we must be certain that equal care is delivered. I am committed to the development of population-based prevention and early detection strategies in gynecologic cancers particularly those that
have the most burdensome and toxic treatment regimens. My research investigations focus on the molecular and epidemiological profiles of women with gynecologic cancers that may facilitate prevention/early detection or that modify survival. I have participated in many ovarian cancer early detection projects that focus on women with susceptibility to ovarian cancer because of the presence of high penetrance genes. The hypothesis of my primary research is that functionally relevant sequence variants of genes in the ovarian steroid hormone metabolism and transport
pathways modify the risk profile for borderline and invasive ovarian cancers after exposure to well-known hormonally related risk factors. The aims of this project are to complete a population based analysis of the sequence of reproductive events that
determine the predisposition for women to develop invasive ovarian cancer versus ovarian tumors of low malignant potential. This effect will be correlated to selective genes in the estrogen pathway involved in the biosynthesis, transactivation and
metabolism of ovarian steroid hormones. This proposal presents a novel approach for studies of risk of ovarian cancer because it investigates the importance of the sequence of hormonal events. This project is important because it assesses estrogen metabolism
and hormonal exposures that promote susceptibility to the development of a borderline ovarian tumors or invasive epithelial ovarian cancer. This study will provide insight into the etiologic mechanism and carcinogenesis of ovarian cancer.

I am a Co-Investigator for several projects designed to identify populations at risk for disparate treatment and poor outcomes in endometrial, colon, ovarian and cervical cancers. For example, the standard of care for cervical cancer requires multiple visits
for the evaluation of an abnormal pap test and the subsequent treatment. This precludes effective evaluation of the most susceptible women because of the high loss to follow-up rates. In a large randomized study, I demonstrated that severe cervical
dysplasia can be treated in a single visit with resultant higher treatment rates, acceptability of the process and higher compliance with follow-up visits than women who treated with the standard of care. This study received editorial comment in JAMA
and numerous citations in national newspapers and media outlets because it demonstrated that a radical and new paradigm for treatment of cervical cancer could be successfully applied to special populations. It clearly demonstrated that the obstacles to
treatment of precancerous lesions of the cervix can be overcome if tailored to the groups at highest risk. The greatest impact of this study is that it clearly presents a successful strategy for reducing cervical cancer in poor countries and areas with limited resources.
The most rewarding aspect of academic attainment is the extent to which the scientific and lay communities benefit from these endeavors. I have functioned under a variety of conditions, not always optimal, and have been able to adjust to them in a manner that has produced reasonably successful results. This adaptability, my penchant for building bridges for cooperation among academicians and colleagues with professional
sensitivities has been in large measure responsible for my success to date. This is underscored by my involvement in various institutional, professional and community activities where I have accepted leadership roles in several instances. This demonstrates my readiness to undertake responsibility for guiding the affairs and
fortunes of situations under my charge.

Training
Rutgers University, New Brunswick, NJ B.A. 5/1987 Mathematics

University of California, Los Angeles, Los Angeles, CA M.D. 6/1991 Medicine

Harbor-UCLA Medical Center, Los Angeles, CA Residency 1991-1995 Obstetrics & Gynecology

University of California, Irvine Med Ctr, Irvine, CA Fellowship 1999-2000 Gynecologic Oncology

University of California, Irvine, Irvine, CA Ph.D. 3/2000 Epidemiology

Board Certification
Diplomat, American Board of Obstetrics & Gynecology 2001

Diplomat, American Board of Obstetrics and Gynecology, Gynecologic Oncology 2002

Publications
1. Moayeri SE, Allen RB, Brewster WR, Kim MH, Porto M, Werlin LB Day-3 embryo morphology predicts euploidy
among older subjects. Fertil Steril. 2008 Jan 89(1):118-23.
2. Hunter MI, Ziogas A, Brewster WR. Epithelial Ovarian Cancer and LMP Tumors Associated with a Lower Incidence of
Second Primary Breast Cancer. American Journal of Clinical Oncology. 2007 Feb;30(1):1-7
3. Maxwell GL, Brown C, Rose GS, Thigpen TJ, Fleming G, Gallion H, Brewster WR. Racial Disparity in Survival Among
Patients with Advanced/Recurrent Endometrial Adenocarcinoma: A Gynecologic Oncology Group Study. Cancer 2006
Nov 1;107(9):2197-205.
4. Melgoza F, Brewster WR, Wilczynski S, Rutgers J.p16-Positive small cell neuroendocrine carcinoma of the
endometrium. Int J Gynecol Pathol. 2006 Jul;25(3):252-6.
5. Theurer CP, Taylor TH, Brewster WR Anton-Culver H. Gender and race/ethnicity affect the cost-effectiveness of
colorectal cancer screening. J Natl Med Assoc. 2006 Jan;98(1):51-7.
6. Brewster WR Commentary: Temporal trends in ovarian cancer incidence across Europe. Nature Clinical Practice
Oncology 2005 Jun;2(6):3.
7. Brewster WR, Hubbell A, Largent J, Ziogas A, Lin F, Anton-Culver H, Howe S, Ganiats TG, Manetta M. Feasibility of
management of high-grade cervical lesions in a single visit: a randomized controlled trial. JAMA. 2005 Nov 2;294(17):2182-
7.
8. Yessaian, A, Mendivile AA, Brewster WR Population characteristics in cervical cancer trials: Search for external
validity. Am J Obstet Gynecol. 2005 Feb;192(2):407-13.
9. Kurtzman JT, Jenkins SM, Brewster WR. Dynamic cervical change during real-time ultrasound: prospective
characterization and comparison in patients with and without symptoms of preterm labor. Ultrasound Obstet Gynecol 2004
Jun;23(6):574-8.
10. Chan JK, Loizzi V, Lin Y, Osann K, Brewster WR, DiSia PJ. Stage III and IV invasive epithelial ovarian carcinoma in
younger versus older women: what prognostic factors are important? Obstet & Gynecol 2003 Jul,102(1):156-61.
11. Brewster WR, Anton-Culver H, Ziogas A, Largent J, Howe S, Hubbell FA, Manetta A. Recruitment strategies for
cervical cancer prevention study. Gynecol Oncol 2002 May, 85:250-254.
12. Theuer C, Taylor T, Brewster WR, Campbel B, Becerra J, Anton-Culver H. The topography of colorectal cancer varies
by race/ethnicity and affects the utility of flexible sigmoidoscopy. The American Surgeon 2001 Dec, 67:1157-1161, 2001.
13. Keefe KA, Schell MJ, Brewer C, McHale MT, Brewster WR, Chapman JA, Rose GS, McMeekin DS, Lagerberg W,
Peng YM, Wilczynski SP, Anton-Culver H, Meyskens FL, Berman ML. A randomized, double blind, phase III trial using oral
beta-carotene supplementation for women with high grade cervical intraepithelial neoplasia. Cancer Epidemiology,
Biomarkers & Prevention 2001 Oct 10(10):1029-1035, 2001.
14. Theurer CP, Wagner JL, Taylor TH, Brewster, WR, Tran D, McLaren CE, Anon-Culver H. Racial and ethnic colorectal
cancer patterns affect the cost-effectiveness of colorectal cancer screening in the United States. Gastroenterology, 2001
Mar120(4):848-856.
15. Brewster, WR, Monk, BJ, Ziogas, A, Anton-Culver, H, Yamada, SD, Berman, ML. Intent to treat analysis of stage IB
and IIA cervical cancer in the United States: Radiotherapy or surgery 1988-1995. Obstet Gynecol, 2001 Feb 97:248-54.
16. DiSaia PJ, Brewster WR, Ziogas A, Anton-Culver H. Breast cancer survival and hormone replacement therapy. Breast
cancer survival and hormone replacement therapy: a cohort analysis. Am J Clin Oncol, 2000 Dec 23(6):541-5.
17. Garite TJ, Weeks J, Peters-Phair K, Pattillo C, Brewster WR. A randomized controlled trial of the effect of increased
intravenous hydration on the course of labor in nulliparas. Am J Obstet Gynecol, 2000 Dec 183;1544-8.
18. Yamada SD, Anton D, Brewster WR, Kohler MF, Monk BJ, Burger RA. Pathologic variables and adjuvant therapy as
predictors of recurrence and survival in surgically staged malignant mixed mesodermal tumors of the uterus. Cancer
88:2782-6, 2000.
19. Brewster WR, Monk BJ, Burger RA, Bergen S, Wilczynski SP. Does human papilloma virus have a role in cancers of
the uterine corpus? Gynecol Oncol, 75: 51-54, 1999 Oct;75(1):51-4.
20. Brewster WR, DiSaia,PJ, McGonigle KF, Grosen EA, Kuykendall JL, Creasman WT. An experience of estrogen
replacement therapy in breast cancer survivors. Int J Fert Wom Med, 1999 Jun-Aug 44(2).
21. Theuer CP, Nastanski F, Brewster WR, Butler JA, Anton-Culver H. Signet ring cell histology is associated with unique
clinical features but does not affect gastric cancer survival. Am Surg, 199 Oct 65(10):915-21.
22. Brewster WR, DiSaia PJ, Ziogas, A, Monk BJ, Yamada SD, Anton-Culver H. Young age as a prognostic factor in
cervical cancer: results of a population based study. Am J Obstet Gynecol, 1999 Jun 180(6 Pt 1):1464-7.

E-mail: wendy_brewster@unc.edu
Telephone: 919-966-5967
FAX: 919-843-9680
Address: B103 Physicians Office Bldg. Chapel Hill, NC 27599

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