Comparison of the Breast Tumor Microenvironment

Study Overview
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Brief Summary
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The goal of the project is to identify a molecular signature of tumor stroma from normal adjacent breast tissue obtained prospectively at the time of breast conserving surgery before and after receiving intraoperative radiation therapy (IORT) in subjects that have luminal A and triple negative breast cancer. IORT is considered as being standard of care.

Detailed Description
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There is evidence that the normal tissue around a tumor plays a role in determining how the tumor behaves, including how it will respond to treatments and how likely it is to recur. In breast cancer, radiation is used to decrease the chance of recurrence in the area where the tumor is removed. This risk of recurrence varies between different types of breast cancer. The investigators seek to study the proteins produced in normal tissue surrounding breast tumors. The tissue will be taken from women who are receiving radiation to the breast at the time of their surgery (known as intraoperative radiation), one specimen taken before radiation and one after. A new process will be used to stabilize the tissue rapidly and allow the proteins to be identified before they break down. This will allow us to identify differences in the proteins produced by cells before and after radiation and between two types of breast cancers, luminal A (less likely to recur) and triple negative (more likely to recur). Identifying these differences in proteins may allow them to be used in the future as markers to predict the likelihood of tumors recurring.

Official Title
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Differential Comparison of the Breast Tumor Microenvironment Between Luminal A and Triple Negative Breast Cancer With and Without Radiation Treatment

Conditions
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Triple Negative Breast Cancer, Hormone Receptor Positive Malignant Neoplasm of Breast

Intervention / Treatment
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* Other: Breast tissue collection
* Other: Blood sample collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female, age greater than or equal to 40 Core biopsy proven invasive breast carcinoma or ductal carcinoma in situ (DCIS), all subtypes excluding invasive lobular carcinoma due to increased risk for multifocal disease Human epidermal growth factor receptor 2 (HER2) negative regardless of hormone receptor status Clinically less than or equal to 3cm unifocal lesion Clinically node negative Must have diagnostic mammogram performed within last 6 months Eastern Cooperative Oncology Group Performance Status (ECOG PS) less than or equal to 1 Appropriate renal, liver, and hematologic lab values Ability to give informed consent Exclusion Criteria: Multifocal disease Clinically N1 disease at diagnosis Invasive lobular carcinoma Metastatic disease Patients for whom RT would be contraindicated (e.g., connective tissue disorder or prior ipsilateral breast radiation) Patients with known BRCA1/2 mutations Pregnant or nursing

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Luminal A Breast Cancer<br>Luminal A Breast cancer subjects will have tissue specimens and blood collected before and after IORT during the Breast conserving surgery. | Other: Breast tissue collection<br>* During Breast Conservation Surgery, one sample will be collected before and after IORT.<br>Other: Blood sample collection<br>* Blood will be collected before and after IORT, and at the two week follow-up.<br>|
| Triple Negative Breast Cancer<br>Triple Negative breast cancer subjects will have tissue specimens and blood collected before and after IORT during the Breast conserving surgery. | Other: Breast tissue collection<br>* During Breast Conservation Surgery, one sample will be collected before and after IORT.<br>Other: Blood sample collection<br>* Blood will be collected before and after IORT, and at the two week follow-up.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of subjects with significant mean percent change in Tumor Infiltrating Lymphocytes (TILs) | This outcome measure is designed to measure the amount of TILs in newly diagnosed luminal A and Triple Negative Breast Cancer (TNBC) tumors. The mean percent change in TILS in tumor tissue from initial core biopsy samples will be compared with pathology samples from definitive surgery after IORT between the two different breast cancer sub-types. | Two weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Triple Negative Breast Cancer, microenvironment, IORT, Hormone Receptor Positive, HER 2 negative