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Tissue & Outcomes

Director - Britt-Marie E. Ljung, MD
Clinical Co-Director - Karla Kerlikowske, MD

Overview
The Tissue and Outcomes Core is responsible for identifying women diagnosed with breast cancer at the University of California, San Francisco (UCSF, including San Francisco General Hospital - SFGH) and the California Pacific Medical Center (CPMC), collecting fresh tissue (at UCSF and SFGH) and paraffin blocks (at all sites), collecting and entering clinical, epidemiologic, pathology and follow-up information into a database (for all sites), and distributing breast tissue with associated clinical information to SPORE investigators.

Tissue is collected prospectively at the time of surgery and banked as fresh-frozen cassettes or formalin-fixed blocks. Fresh tissue for culture is also collected. The Core also identifies archival formalin blocks for studies and coordinates with other tumor banks to obtain additional material for investigators. Tissue is reviewed by Core pathologists for histopathologic features and to confirm the presence of tumor. Requests for tissue and clinical data are approved by a Tissue & Data Utilization Committee, which reviews requests for project feasibility and priorities. The Core extracts DNA and RNA for studies and coordinates preparation of tissue microarray blocks. In addition to collecting baseline data on women with newly diagnosed breast cancer, the Core obtains informed consent for tissue use and follow-up information to determine disease status on all women in the database by mailing women a survey every 18 months. 

Annual linkage is done with the Northern California Surveillance, Epidemiology, and End Results (SEER) program to determine vital status and disease specific mortality. Baseline and follow-up information from 4712 women with breast cancer (3684 invasive and 1028 DCIS cases) diagnosed at UCSF, CPMC, or SFGH with a median follow-up time of six years are currently in a relational database. The overall goal for the next five years is to maintain and expand the database so that it can continue to serve as a resource to conduct high quality, clinically significant translational research and to acquire breast cancer outcomes for study populations.

Resources & Services
The SPORE Tissue and Outcomes Core is available for working with individual researchers within the SPORE (or more generally within the San Francisco Bay Area breast cancer research community) and provides support for experiment and tissue array design, histology review, interpretation of sections for microdissection (on the cryostat or by LCM), etc. Core personnel act as liaison between the SPORE projects and the Cancer Center Tissue and Immunohistochemistry Cores to assure that SPORE needs are met with quality and a timely response.

Epidemiologic, clinical, and outcome information has been collected for women diagnosed with breast cancer at the UCSF, CPMC and SFGH. Records of 4,712 women diagnosed with breast cancer at CPMC or UCSF between January 1986 and June 2006 and their risk factor and initial breast cancer treatment information have been entered into the Breast Oncology Program database.  Tissue available for research according to disease status is shown here.

Facilities
The Core has laboratories in both the Mt. Zion Cancer Research Center and in the Mt. Zion Hospital Laboratory. In addition, laboratories are available for tissue processing at California Pacific Medical Center and at Moffitt-Long Hospitals and Clinics.

Major equipment for the Core includes a cryostat, single and dual-head microscopes, a laser capture microscope (Arcturus), and a tissue microarrayer (Beecher Instruments). A multiple-slide stainer (Biogenix) is available for shared use among the SPORE and other tissue-based resources. Computers are available for the PI and co-PIs, manager, and staff. Biological safety hoods are available and used routinely for tissue processing.

Tissue Distribution Protocol
All requests for tissue are reviewed by the Tissue Utilization Committee for feasibility, appropriate use of tissue, and priority. To request tissue, fill out the Tissue and Data Request Form and send it to Hubert Stoppler.  If you are also requesting outcomes data, please refer to the Outcome Core questionnaires and the California Cancer Registry web address listed below to specify variables for your study.

Priority of tissue use is as follows:

  1. Breast Oncology Program Members
  2. Other UCSF Helen Diller Family Comprehensive Cancer Center Members
  3. Other UCSF investigators
  4. Non-UCSF academic investigators
  5. Private, non-academic companies

Tissue distribution to private companies requires an approved Material Transfer Agreement. Investigators outside UCSF are strongly encouraged to collaborate with a member of the UCSF Breast Oncology Program. IRB approval is required for all tissue use.

Investigators using SPORE tissue are expected to submit a timely report on tissue use and quality. All publications resulting from tissue use must acknowledge the Breast Cancer SPORE Tissue Core. In addition, we also request that researchers consider sharing of authorship with appropriate Core individuals, and (according to emerging NIH guidelines) we expect that data will be made available to the community after a project is finished.