WINDBER – Medical advances that are improving outcomes for breast cancer patients are creating new challenges for those trying to study cancer cells.
Specimen samples are becoming smaller or not available, said Stella Somiari, senior director of the tissue repository at Windber Research Institute.
“They are finding the tumors early,” Somiari said.
“When it gets time to remove it, it’s too small. It is a good thing for the patient, but not for the scientist.”
There are now more that 60,000 blood and tissue samples from 6,500 patients in the Richard Mural Memorial Tissue Repository at Windber.
The freezers at WRI contain nearly 15 years of specimens collected during biopsies and surgeries at Joyce Murtha Breast Care Center, Walter Reed National Military Medical Center in Bethesda, Maryland, and its predecessor, Walter Reed Army Hospital in Washington, D.C.
It was expanded a few years ago to become the repository for all Walter Reed cancer specimens, not just breast cancer.
But even though the joint Clinical Breast Care Project with Walter Reed has added Anne Arundel Medical Center in Annapolis, Maryland, as a collection site in recent years, there will be a need for more locations to collect enough breast cancer samples, Somiari said.
“You may not get material but you have not solved the problem,” Somiari said.
“We have to discover more things. It is not going to be easy.”
At least patients volunteering to donate blood and tissue samples for Windber’s tissue bank can have confidence their generosity will be useful.
Windber had more than a 90 percent acceptance rate supplying specimens for the breast cancer portion of the Cancer Genome Atlas project.
In fact, 25 percent of the specimens studied in the national project came from Windber’s freezers.
“They were very specific about what they wanted,” Somiari said.
“They pre-examined, every specimen. They cross check everything (tissue banks) give them.”
Windber has been recognized for its meticulous protocols for accepting, cataloging and storing the specimens.
Some larger organizations’ samples were not as high quality.
“A large part of what they got was useless.” Somiari said.
“That brought everybody back to (reviewing) the life cycle of the specimens.”
New standards were established for the first bio-repository accreditation program.
Windber is in the process of becoming accredited through the College of American Pathologists, based on the International Society for Biological and Environmental Repositories’ best practices.
Looking to the future, Windber’s team is examining new ways to study cancer with smaller specimens.
One idea is to have the pathologist make an imprint of the tumor by touching it to a microscope slide before taking the tiny sample for the diagnostic testing needed for treatment planning.
A few cells attach to the slide and researchers are trying to study if that will be enough for some projects.
Somiari said it is possible to duplicate the DNA, but the RNA is more difficult.
“It degrades very fast,” she said.
Windber is not alone with the issue, so researchers everywhere are exploring new solutions.
“Our hope is technology is advancing,” she said.
“We have to think ahead.”