Posted on Jan 19, 2023
Professor Abeer Shaaban is a specialist consultant breast pathologist at Queen Elizabeth Hospital Birmingham and Honorary Professor at the University of Birmingham. She has led a number of research studies and contributed to landmark breast cancer trials. Dr Shaaban recently led a study with a team of researchers from the UK and Egypt comparing MammaTyper® ® RT-qPCR and immunohistochemistry (IHC) assessment on needle core biopsies of breast cancer.
We spoke to Professor Shaaban about her life-saving work and her role in this piece of research.
Tell us some more about what your role involves.
I am a breast pathologist, so I report pathology for breast cancer screening and symptomatic cases. I'm also the academic lead for pathology training and professor of Cancer and Genomic Sciences at the University of Birmingham. So, research and development are part of what I do day-to-day.
I think that pathology is a very evolving field, and we can relate that to patient outcomes and how they respond to therapy. It's a fascinating field to focus on, particularly breast cancer: you can make a real difference for patients.
How did you become involved with research into MammaTyper®?
We are always looking for new predictive and prognostic tests in breast cancer. We already have a few, but we wanted to look for something even better.
There has recently been a burst of energy in breast cancer research and development. For a few years we had the same tests and treatments and then suddenly we have an explosion of new tests, molecular markers and genome sequencing. It is also nice that these are available for patients, and many are or will be free through the NHS, so patients don't have to go abroad and don't have to pay for them.
So, in collaboration with the breast MDT team and Dr. Anthony Kong, an oncologist, we decided to look at MammaTyper® as a new test.
What did you find through your research?
The study was a prospective audit of MammaTyper® versus immunochemistry. Immunochemistry (IHC) is our standard assay to look at the protein expression within tissues. We look under the microscope to assess that.
So, in this research we looked at how the new test compared to IHC, which is considered the gold standard for assessment of oestrogen receptor, progesterone receptor, HER2 and we also added Ki67. Although Ki67 is not currently being done routinely in UK labs.
We were really happy to find that IHC and MammaTyper® correlated brilliantly, a lot more than we expected from a PCR test. I think this is one of the best concordances that we've seen and the turnaround time was quick too. It was really reassuring that it correlated well with what we saw using immunochemistry. This was particularly true when we assessed KI67 immunochemistry using a digital platform.
Why else do you think diagnostic developments could be important?
In the pathology field we are really struggling with staffing issues. We have a big backlog and diagnostics and treatment are becoming more complex, you need a lot more effort and time per patient. We are still trying to catch up on the breast screening side following the Covid-19 backlog.
The number of pathologists is decreasing. Many have retired, particularly after the pandemic people have different priorities in their lives. So many have left, and the remainder are trying to catch up.
One of the uses of the new tests is to hopefully support pathologists and the limited workforce. Maybe to do things quicker and more accurately.
In our hands MammaTyper® is a very accurate method and correlated well with immunochemistry. We think this can have a role in classifying cancers accurately and quickly to inform management.