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RESEARCH

Through the Breast Tissue BioBank and Clinical Database CTCR is able to initiate and perform number of projects. The broad heads of the type of projects are shown in the graphical representation. Apart from clinical, translation and patient-centric research, PCCM-CTCR is also very active in capacity building.

Graphical Representation: Cornerstones of Research at PCCM-CTCR: The in-house resources developed at the centre, Breast Disease Biobank and Breast Disease Clinical Database and associated projects

PCCM-CTCR Breast Disease Biobank

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. 

CTCR Breast Disease Clinical Database:

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.

Details of the Research Projects

Breast Cancer Clinical Research

  • Therapeutic Mammoplasty a “Wise” Oncoplastic choice – Lessons from the largest Asian cohort
  • Perforator Flaps: A Versatile Arrow in the Oncoplastic Quiver
  • Use of a new sensitive and cost-effective detection methods to identify sentinel node identification and involvement: an audit. 
  • Breast density and tumor stiffness co-relation with disease subtype and progression course. 
  • Post Mastectomy breast reconstruction outcomes in breast cancer from a single institutional clinic in India. 
  • TNBC surgery audit
  • A single institutional retrospective and prospective analysis of surgical options and their outcome for central quadrant tumours in patients with carcinoma breast 
  • Extreme Oncoplasty Audit 
  • Study of Influence of Neo-adjuvant Chemotherapy on Breast Oncoplasty Surgery Outcomes 
  • Margin positivity rates in oncoplastic surgery, an audit 
  • Assessing Allopathic and Homeopathic interventions for Granulomatous Mastitis- A single Institutional Study

Breast Cancer Translational Research

  • Molecular Profiling of Indian Triple Negative Breast Cancers
  • YAP signature in HER2+ and Triple Negative Breast Cancer
  • Immune Cell Profiling of Indian Triple Negative Breast Cancer 
  • Neo adjuvant response rate in Her2 and TNBC – Audit 
  • Role of Microbiome in ER/PR positive breast cancer (collaborative project)

Breast Cancer Genetics

  • Clinical management and genetic testing
  • Investigation of Germline Mutations in Triple Negative Breast Cancers
  • Familial Risk Assessment for Hereditary Breast Cancer in Indian Patients

Patient Centric activities and Research

  • Setting up of complementary onco-psychology counselling for breast cancer patients at a single surgeon unit in India
  • Setting up of complementary Nutrition counselling for breast cancer patients at a single surgeon unit in India
  • Breast-Q BCT Module Translation And Linguistic Validation To Hindi And Marathi Languages 
  • Assessing the perception and impact of Genetic Counseling in Breast Cancer Patients 
  • An evaluation of Patient Reported Outcomes using BREAST-Q – A Single Institutional Study

Academics

  • Research Publications
  • Dissertation students for Masters in Oncoplasty course by International School of Oncoplastic Surgery
  • Journal by BreastGlobal
  • Proceedings of various conferences and events
  • Survey Development and Analysis related to clinical management, capacity building, Patients’ treatment perception

Capacity Building

  • BreastGlobal – elearning platform : 
  • International School of Oncoplastic Surgery (ISOS) – Masters in Surgery with Principles in Oncoplasty course run in association with the University of East Anglia (UEA), UK
  • Research Training Program for Clinicians and Residents (RT-PCR)- Course for clinicians for enabling the development of research aptitude. The first module of the course is very recently initiated as is a 12-week course on the basics of molecular and cellular biology (virtual lectures). Long term goal of this program is to teach clinicians how to enable biomedical research that ranges from basic science to translational and patient-oriented investigations in an Indian scenario. 
  • Organisation of various conferences/workshops/educational events.