Authors: Craig D. Shriver MD FACS; Richard Somiari, PhD; Brenda Campbell RN; Art Hapner
Location: Clinical Breast Care Project; Walter Reed Army Medical Center, Washington, DC. Designated author: Dr. Shriver; email craig.shriver@na.amedd.army.mil
Introduction: A new paradigm for 21st century Breast Centers is “Translational Breast Care and Research”. This refers to bringing together the patients, clinicians, nurses, administrators, and basic science researchers in one conceptual and actual whole, working through the clinical breast center to effortlessly bring basic science research into the clinical arena and to be able to ask the pertinent research questions quickly, involving the patients as an integral step in the process.
Methods: Our Comprehensive Breast Center and Project was built from the beginning combining facilities for clinical care; translational research facility including a 40,000 specimen tissue and serum freezer in the breast center; a high-throughput genomics and proteomics research facility where these tissue and serums undergo automated molecular expression profiling in workflows of gene expression profiling, microarray analysis, gene sequencing, genotyping, pharmacogenomics, and protein expression profiling. This is all made possible by robust, IRB-approved protocols that enable all patients coming through the Breast Center (approximately 4,000 per year) to participate in one or more of the high-throughput translational studies. We have our own breast center specialty pathologist who protects the diagnostic integrity of all samples while enabling study samples to be derived that are of high quality.
Results: Patient acceptance of this translational approach is high as evidenced by a participation rate of over 90%. We are accruing around 50 samples per week at the present time, and this will increase markedly in the coming months as more personnel are brought in to support it. These samples are of high quality and of all types of malignant, premalignant, at-risk, and benign breast processes. The samples are associated with a robust clinical database that includes in-depth clinical, demographic, and lifestyle data on each sample. Samples are then analyzed in our associated genomic and proteomic research facility where gene and protein expression profiling and data mining take place through highly-automated processes.
Conclusion: This translational Breast Center paradigm with high-throughput automatic research capability has met with great acceptance by patients, clinicians, and researchers alike, and represents the next important step in studying and eradicating the scourge of breast disease and cancer.