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Only by studying thousands of breast tumors did researchers discover that about 25 percent carry extra copies of a gene called HER2. This type of breast cancer, known as HER2-positive, behaves differently from other types. After analyzing HER2-positive tumors, scientists were able to develop diagnostic tests that are now commonly used to determine whether a breast tumor is HER2-positive. They also designed a targeted drug that slows the growth of these tumors and improves outcomes for patients.
Much of the work that led to the HER2 discovery began with a young, energetic surgeon at Duke University who collected human tissue samples for the scientists to study. Today, that surgeon, J. Dirk Iglehart, MD, chief of surgical oncology and director of the Susan F. Smith Center for Women's Cancers at Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC), says human tissue is a critical component of cancer research.
"If you're going to determine what causes cancer, you have to study human cancer tissue," says Dr. Iglehart. "Everything we know about genes that cause cancer or predispose one to cancer comes from the study of patient material — tissue, fluid, and blood."
Tissue samples donated by patients are among medical researchers' most precious resources. Both basic and translational research depend on it: investigators can identify genetic mutations and abnormal cell proteins, and gather valuable new information about the pathways involved in cancer development — all from tissue samples.
Until recently, however, tissue removed from consenting patients during surgery and other procedures was not preserved. In fact, outside of Dana-Farber and other research centers, tissue banking is not a part of routine medical practice, largely due to the special, costly storage requirements and detailed protocols for collecting and preparing cancer tissue samples for study.
At Dana-Farber, the Tissue Resource for Research (TRR), made possible with generous gifts from the Susan F. Smith Center's Executive Council, significantly expands the Institute's ability to collect and bank samples of tissue, blood, fluid, and other biologic materials donated by consenting patients with breast or gynecologic cancer. Tissue that has been extracted from both primary and metastatic tumors can be frozen, stored, and made available for study. The breast bank now contains several thousand specimens from more than a thousand patients, and holdings of ovarian and endometrial tissue continue to increase.
Before the TRR was established, "scientists had little or no access to fresh human tissue, so activities such as cancer stem cell research, sorting cell types, and studying the tissue around tumors were all limited," says Andrea Richardson, MD, PhD, a DF/BWCC surgical pathologist who oversees the TRR. Today, the TRR allows basic scientists to take their exploration of the roots of breast and gynecologic cancers to the next level, when their findings help create new treatments to test with patients.
Turning Point 2013 Table of Contents