RESEARCH

The number of patients visiting PCCM’s Clinic has been rising since its inception in 2010 due to its excellent track-records and its efforts in increasing awareness. The tissue biobank was established in 2018 at CTCR to build a retrospective cohort of breast cancer patients that have been diagnosed and treated at PCCM. The biobank holds clinical history, diagnostic images, treatment and follow-up information along with FFPE tissue specimens of tumour, adjacent normal and in few cases, contralateral normal breast tissue as well as recently as started collection of fresh frozen tumour tissue. Detailed family history and germline mutational profiles of eligible and consenting patients and their relatives are deposited in the biobank. The clinical data and tissue sample collection is done with appropriate patient consent following ethical guidelines and approval. The trained staff has meticulously worked with the patients through their yearly follow-ups and direct contact to emphasize the value of their contribution to the biobank and have obtained informed and willing consent from over 1500 patients. In addition, germline mutation profiles of 182 patients and their family members are available. Majority of the records (80%) are of patients with infiltrating ductal carcinoma (IDC), the most common and deleterious form of breast cancer.  The tissue bank has been a tremendous source to further our translational research. The biobank has been instrumental in initiating cutting edge translation research to assess the association between immune cells infiltration and therapy response which hold a direct translatable potential. The biobank holds a high proportion of patient data with TNBC; the most aggressive subtype of breast cancer profile. 

A comprehensive breast disease database was required to support a retrospectively established tissue biobank. Critical treatment and diagnostic modules and data points in the workflow of breast disease patients from presentation through treatment and follow up were identified. A tool was built in base python with a command line interface and SQLite backend for data entry of these data points. Each module was evaluated and refined for clinical and translational research data collection. Individual data management tools, workflows and systems were created to digitize, classify and manage available data resources. The most critical aspect of any cancer patient biobank is the follow-up clinical information of the patients, which provides valuable information on disease progression and recurrence as well as effectiveness of the treatment on relapse and increase in lifespan. PCCM biobank has such follow-up information available for 82% of the IDC patients with average follow-up of 3 years. This data and tissue source has been very valuable to screen over 100 triple negative breast cancer tissue for novel targetable markers with the aim to target this aggressive disease. To further this study, we are profiling somatic and germline mutation landscapes for Indian cohorts to understand India-specific genetic patterns. These projects will make a valuable contribution to our understanding of breast cancer in India.