The Brisbane Breast Bank

The Brisbane Breast Bank (BBB) was established in 2005 with a view to collecting surplus tissue from every breast surgery patient at the Royal Brisbane and Women’s Hospital. This not-for-profit biobank provides resources on a collaborative basis, supporting local, national and international studies. The resource prides itself on its comprehensive clinico-pathology sample annotation. Since its inception, the remit of the BBB has expanded to the prospective collection of serial blood samples from patients at high risk of recurrence, and the collection of blood and tumour tissue from metastatic patients.


Project description
The Brisbane Breast Bank (BBB) was initiated to support high quality clinical research projects in the breast cancer field.The bank operates from the University of Queensland Centre for Clinical Research (UQCCR), located alongside the Royal Brisbane and Women's Hospital (RBWH) on the Metro North Health Services campus in Herston.The RBWH is the largest tertiary referral hospital in Queensland, providing specialist services to patients throughout the State (current population 4.84 million, approximately 20.3% of the Australian population, of which approximately 48.5% resides in the greater Brisbane area [1]).The RBWH also receives referrals from northern New South Wales, the Northern Territory and neighbouring countries in the South West Pacific.
The BBB aims to collect samples from every consenting breast surgery patient undergoing treatment at the RBWH.To this end, tumour tissue surplus to diagnostic requirements is snap frozen and banked, as well as being formalin-fixed and paraffin-embedded (FFPE) for longerterm storage and detailed histopathology annotation.This includes samples with benign, pre-invasive and invasive diagnoses.A blood sample is also taken at the time of surgery, and processed into various derivatives (serum, plasma, whole blood, buffy coat, Guthrie card).We also collect breast tissue from healthy donors undergoing reduction mammoplasty (cosmetic cases from The Wesley Hospital) and prophylactic mastectomy.
The BBB is unique in that it provides highly detailed curation of the banked tissue samples.Indeed, from each banked piece of tissue a section is cut and the histology reviewed by a pathologist.To this end, we can provide reliable information about a sample's tumour cellularity, and true content of the specific piece of tissue to be supplied for research.
The BBB has supplied tumour samples to a host of targeted projects (e.g.[3][4][5][6]), as well as a significant body of ongoing work.Importantly, BBB samples made up 10% of the total breast cancer samples studied by the International Cancer Genome Consortium (ICGC), resulting in several landmark studies ( [2] and refs therein).Its growing normal breast tissue resource has been used in large consortia-based studies (e.g.[7]) as well as normal breast biology projects (e.g.[8]).The recent expansion to collection of metastatic deposits has underpinned ground-breaking work characterising the genome and transcriptome of brain metastases [9].The BBB is currently conducting a longitudinal, prospective study (Circ.BR, Circulating Biomarkers of Relapse in Breast Cancer), involving the collection of serial blood samples, primary tumour tissue and a Quality-of-Life survey from selected RBWH patients at a high risk of disease recurrence or spread.Finally, it also operates as the Brisbane node of the National Breast Cancer Foundation (NBCF)funded BROCADE (BReast Origin CAncer tissue DonatEd after death) rapid autopsy program.

Species
Homo sapiens.

Classification (2)
biological samples and clinical data (where possible), including pathology, therapeutic intervention, disease recurrence and outcome.

Temporal coverage
The start date of the collection period for the bioresource was 2005, and the collection is ongoing.

Steps
• BBB donors are recruited at the time of diagnosis of breast cancer, through the breast cancer clinic at the RBWH; or by surgeons in either the normal (reduction mammoplasty) or metastatic setting.Informed consent is required, and consent forms are managed and retained by the BBB according to standard operating procedures (SOP).• Hospital staff or BBB staff collect blood, which is processed and stored according to a SOP.• Tissue is couriered by BBB staff from surgical theatre to the pathology department, and where there is tissue surplus to diagnostic requirements, the BBB will collect and bank according to SOPs.• Patient information, clinical and pathology data is collected from pathology reports and medical records, and this data is stored alongside sample information in a secure SQL database (Caisis).Unique de-identifying codes are applied to the specimens; and are also recorded in the limited-access database.Data management and auditing occurs according to SOPs.• Experimental data is recorded for each sample, and thus integration of layers of information is possible, especially for those samples subjected to genomic analysis.• Samples are shipped by licensed providers in accordance with I.A.T.A., UN and CASA standards.• The BBB is integrated with other biobanks nationally through The Australian Breast Cancer Tissue Bank (ABCTB) ( [10]).

Stabilization/preservation
Blood is collected in 2 × EDTA and 1 × clot activator tube.Tissue is collected and couriered in sterile pots, then frozen in barcoded cryovials.
All frozen samples are barcoded and de-identified; and stored in temperature monitored freezers and liquid nitrogen dewars protected by swipe card access.

Quality assurance measures
Detailed pathology review performed on each banked piece of tissue, affording the BBB of level of histological curation unmatched by other local and international banks.
Standard methods of nucleic acid extraction, qualification and quantification, including by Qubit analysis and Bioanalyser, where appropriate.
The BBB's standard operating procedures have been submitted to ISBER (International Society for Biological and Environmental Repositories), and to the Australasian Biospecimen Research Network.The BBB is certified through the NSW Biobanking certification program, which is based on the Canadian process developed by the Office of Biobank Education and Research (OBER), University of British Columbia (UBC) and the Canadian Tissue Repository Network (CTRNet).

Source of associated data
Associated data is manually collected from hospital medical records, AUSLAB (pathology information database), MOSAIQ (radiology oncology database), and CHARM (oncology database) and the Queensland Cancer Registry.Data is audited by cross-referencing, and regular manual checks.