Minimizing inequality in access to precision medicine in breast cancer by real-time population-based molecular analysis in the SCAN-B initiative
Open accessAbstract
Background: Selection of systemic therapy for primary breast cancer is currently based on clinical biomarkers along with stage. Novel genomic tests are continuously being introduced as more precise tools for guidance of therapy, although they are often developed for specific patient subgroups. The Sweden Cancerome Analysis Network – Breast (SCAN-B) initiative aims to include all patients with breast cancer for tumour genomic analysis, and to deliver molecular subtype and mutational data back to the treating physician. Methods: An infrastructure for collection of blood and fresh tumour tissue from all patients newly diagnosed with breast cancer was set up in 2010, initially including seven hospitals within the southern Sweden regional catchment area, which has 1.8 million inhabitants. Inclusion of patients was implemented into routine clinical care, with collection of tumour tissue at local pathology departments for transport to the central laboratory, where routines for rapid sample processing, RNA sequencing and biomarker reporting were developed. Results: More than 10 000 patients from nine hospitals have currently consented to inclusion in SCAN-B with high (90 per cent) inclusion rates from both university and secondary hospitals. Tumour samples and successful RNA sequencing are being obtained from more than 70 per cent of patients, showing excellent representation compared with the national quality registry as a truly population-based cohort. Molecular biomarker reports can be delivered to multidisciplinary conferences within 1 week. Conclusion: Population-based collection of fresh tumour tissue is feasible given a decisive joint effort between academia and collaborative healthcare groups, and with governmental support. An infrastructure for genomic analysis and prompt data output paves the way for novel systemic therapy for patients from all hospitals, irrespective of size and location.
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Cancer whole-genome sequencing is feasible, and thousands of matched tumor-normal pairs have been sequenced, revealing novel biological insights.
“Cancer whole genome sequencing (WGS) is now feasible, with thousands of matched tumor-normal pairs successfully sequenced to date, revealing novel biological insights2–4.”
From Whole-genome sequencing of triple-negative breast cancers in a population-based clinical study (2019) · cites this paper as [4]
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Self-citationChanging Landscape of Clinical-Genomic Oncology Practice
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Self-citationKataegis in clinical and molecular subgroups of primary breast cancer
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Self-citationCancer surgery in the genomic era
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Self-citationHomologous recombination deficiency in primary ER-positive and HER2-negative breast cancer
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Self-citationAdditional file 1 of Molecular analyses of triple-negative breast cancer in the young and elderly
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Self-citationAdditional file 4 of Molecular analyses of triple-negative breast cancer in the young and elderly
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Self-citationAdditional file 3 of Molecular analyses of triple-negative breast cancer in the young and elderly
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Self-citationAdditional file 6 of Molecular analyses of triple-negative breast cancer in the young and elderly
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Self-citationAdditional file 5 of Molecular analyses of triple-negative breast cancer in the young and elderly
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Self-citationAdditional file 7 of Molecular analyses of triple-negative breast cancer in the young and elderly
Aine, M., Boyacı, C., Hartman, J., Häkkinen, J., Mitra, S., Campos, A. B., Niméus, E., Ehinger, A., Vallon‐Christersson, J., Borg, Å., et al. (2021) · Figshare · doi:10.6084/m9.figshare.13889254
Self-citationInterplay between AIB1 genotypes and radiotherapy in a Swedish population-based breast cancer cohort
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Serum Levels of Thyroid Hormones in Relation to Breast Cancer Prognosis: A Multicentre Cohort Study
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Self-citationESR1 mutations are associated with enhanced MTORC1 signaling in a context-dependent manner
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Self-citation
- Authors
- Rydén, L., Loman, N., Larsson, C., Hegardt, C., Vallon-Christersson, J., Malmberg, M., Lindman, H., Ehinger, A., Saal, L. H., & Borg, Å.
- Affiliations
- Lund University (SE)
- Department of Clinical Sciences Lund, Oncology and Pathology, Lund University, Lund, Sweden
- Uppsala University (SE)
- Corresponding author
- Rydén, L
- Venue
- British Journal of Surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-01
- Volume
- 105
- Issue
- 2
- Pages
- e158-e168
- ISSN
- 0007-1323 (ISSN-L)
- 1365-2168
- PMC
- PMC5817401
- OpenAlex
- W2787188812
- Cited by
- 62
- References
- 47
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 10 · 2023: 9 · 2022: 4 · 2021: 10 · 2020: 7 · 2019: 6 · 2018: 2
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British journal of surgery (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Swedish Cancer Foundation
- Biltema Foundation
- Lunds Universitet (2014/354)
- Akademiska Sjukhuset
- Institut National Du Cancer
- Uppsala Universitet
- Centralsjukhuset Kristianstad
- Region Skåne
- Skånes universitetssjukhus
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Keywords
- breast cancer, precision medicine, population-based cohort, RNA sequencing, molecular subtypes, somatic mutations, health disparities
- MeSH terms
- Breast Neoplasms, Humans, Mutation, Patient Acceptance of Health Care, Sweden, Biomarkers, Tumor, Healthcare Disparities, Precision Medicine, High-Throughput Nucleotide Sequencing
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