For Our Patients

Military Relevance

An article published in Cancer Epidemiology Biomarkers and Prevention in June of 2009 finds that the incidence rates of breast cancers were significantly higher in the military among Whites and Blacks. (Zhu,K et.al. Cancer Incidence in the U.S. Military Population: Comparison with Rates from the SEER Program,18(6). June 2009) Refer to the Publications link to read the entire article.

Breast cancer is the most common non-skin cancer in women. It is the single greatest cause of cancer deaths among women under 40, and is a significant cause of mortality for women in the United States Armed Forces. Breast cancer mortality among women <50 years accounts for >40% of years of life lost due to this disease. The economic, social and emotional cost to families are far greater when a young woman dies than when an older woman dies of breast cancer. The more aggressive nature of the disease in young patients along with the attendant costs underscores the importance of early detection of breast cancer in young women. Breast cancer is a curable disease if it is detected early; as such early detection is related to survivorship, cost of treatment and quality of life for the affected woman.

The majority (>90%) of women in active military service are < 40 years of age. The Department of Defense (DOD) with its high percentage of young women and its commitment to health care is particularly concerned about breast cancer. When discovered at a later stage, treatment of breast cancer is expensive, aggressive and results in considerable disruption to the woman’s ability to contribute to society. Cost and disruption to life are considerably less when the carcinoma is discovered at an earlier stage. Furthermore, the DOD has a high percentage of African-American (~40%) and Hispanic (~10%) women. Death rates from breast cancer tend to be particularly high in these ethnic groups owing in part to later stage of detection and to the more aggressive nature of breast cancer in these groups.

The active duty military force is approximately 20% female. Most of these service members are in the age range (30-40 years) where routine screening for breast cancer consists only of clinical breast examination. Both mammography and clinical breast examination have a very poor accuracy in the young active duty force in determining which breast abnormalities require treatment, and which are benign and can be left alone. The immense scale and impact of this problem for the military can be assessed by the fact that there were over 2,000 cases of breast cancer diagnosed in active duty service members over the last ten years (source: ACTURS DoD Tumor Registry data). Furthermore, there were over 8,000 unnecessary breast biopsies done on active duty women during this time because it takes 4 breast biopsies of normal non-cancerous lesions to find each individual breast cancer. Hence, women often need to take lengthy amounts of time off from duty in order to undergo multiple tests leading up to the biopsy as well as time off from duty because of the biopsy itself. This translates into approximately 10,000 weeks, or 30 person-years, of time lost in the evaluation of normal, benign breast lesions in active duty service members. This would be unacceptable for any other healthcare issue, and should be so for this one. Unfortunately, at the present time there is absolutely no screening tool currently available to diagnose breast cancer in the early, curable stages for women under the age of 40, who make up the vast majority of women in military uniform.

As indicated, approximately 20% of the active duty military force is female, most under the age of 50. Breast cancer strikes one in eight women in her lifetime, and there is a documented change in breast cancer incidence in recent years, such that breast cancer is being detected and diagnosed more often in younger women under the age of 50, and the same is true in our military members. In the same way that diagnostic and therapeutic efforts through the military and US Army are carried out in infectious disease care and research, eg. Malaria, Typhoid, etc., so too must the military address the effects of the scourge of breast cancer and breast diseases on the 20% of total active duty force who are women.

Moreover, CBCP developed and to this day maintains the only specialty breast cancer evaluation and treatment center in the US Army, which is at the CBCP Comprehensive Breast Center at Walter Reed AMC.

Additionally, CBCP is the only Army facility that financially supports direct genetic testing of active duty (all Services) women who are identified in our Center as being in a high risk category of carrying a BRCA genetic mutation, which when present can signify an up to 90% increased risk of breast cancer development.

CBCP Breast Center is the Army-recognized specialty referral center for active duty personnel from around the globe with medical disorders related to all breast diseases and breast cancer. CBCP Breast Center routinely cares for women on active duty Army from places such as Iraq / OIF, OEF, Korea, Europe, and the Far East. CBCP annually cares for over 5,000 patients at its site at Walter Reed.

Public Purpose:

The CBCP has been in existence for over nine years now. Its uniqueness is well known and attested to by numerous world-class cancer experts, from innumerable public and private presentations we have given over the years, as well as the extensive publication and scientific communication record of the CBCP and its researchers. Some specifics of CBCP uniqueness include:

CBCP has the world’s largest biorepository from breast patients of human breast tissues, lymph nodes, sentinel nodes, sera, bone marrow aspirates, cancers, benign tumors, pre-malignant disease, and other biospecimens, now numbering close to 40,000 specimens from more than 4000 donors. This unique resource is tapped for both internal (CBCP and WRI) scientific research in the general realms of genomic and proteomic research, as well as for targeted collaborations with extramural collaborators from academia, governmental organizations, and corporate entities, in order to fully leverage the power of this unique international resource.

CBCP’s biorepository is unique in that it is powerfully characterized by clinical, demographic, and pathologic information gleaned from its originating patients through robust IRB-approved and fully HIPPA-compliant protocols that exceed all existing regulatory requirements for patient consent, privacy, and oversight.

CBCP has one of the few fully integrated genomic and proteomic molecular biology research programs in the nation devoted exclusively to research in breast diseases. We have an established track record of publication and scientific communication in this field, to include publication in THE LANCET Oncology in December 2004 on our unique discovery of genomic changes in pathologically non-neoplastic breast tissues.

CBCP has developed and is ready to deploy a unique biomedical informatics database system that uniquely integrates clinical, pathologic, and molecular data on breast research subjects, allowing for the novel discovery pathway of in-silico biology.

CBCP is a true translational research-clinical care environment, where there actually exists an organizationally-driven and structured collaborative effort between basic scientists, clinical scientists, clinicians, nurses, patients, and multiple other personnel.

CBCP has successfully expanded gradually into other clinical sites, as well as other research collaborations with world-renowned lab researchers.

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