Monica Morrow, MD

2009-2010 BCRF Project
Co-investigators: Fatima Cardoso, MD, Jules Bordet Institute, Beldium; Julie Gralow, MD, University of Washington; Martine J. Piccart-Gebhart, MD, PhD, Jules Bordet Institute, Beldium; William Wood, MD, Emory University

On behalf of Memorial SLoan-Kettering Cancer Center, The Breast International Group (BIG) and The Breast Cancer Intergroup of North America (TBCI)
In contrast to their female counterparts, men rarely develop breast cancer. In the US, less than 1% of all breast cancers are diagnosed in men. Doctors have a limited understanding of how to approach such an uncommon disease. Most decisions regarding treatment are based upon large clinical trials involving only women with this disease. However, there are important differences regarding the age at diagnosis, underlying risk factors, and biological characteristics which suggest that male breast cancer (Male BC) may be a distinct disease. In order to develop more appropriate treatment recommendations, a better understanding of the natural history and biology of Male BC is desperately needed. Due to the rarity of this disease, such insight can only be gained through co-operation between hospitals in different countries worldwide.

The Breast International Group, the Breast Cancer Intergroup of North America and Memorial Sloan-Kettering Cancer Center have joined forces to launch a three-part International Program on Male Breast Cancer (International Registration and Biologic Characterization Program). The first part of this Program consists of a retrospective joint analysis of a very large series of men previously diagnosed with breast cancer. This initiative will gather data regarding patient characteristics, tumor features, treatment and outcome for more than 1600 men diagnosed with breast cancer over the last 20 years. Tumor specimens (both paraffin-embedded and frozen) from a large proportion of these patients will be collected and centrally analyzed, to understand the biological characteristics of this disease and to identify important potential prognostic (indicative of the good or bad outcome of the disease) and predictive (indicative of probability of response to certain therapies) markers, which will then be validated in the third part of the Program.

This important study will provide invaluable information regarding the behavior of this rare disease and, combined with the information gathered during the second part of the Program (an international Male BC registry), will form the basis and rationale for the design of an international Male BC clinical trial.

During the past year, the preparatory work needed to launch this study has been done. The full protocol and the selection of centers have been accomplished. The database for collection and analysis of both clinical and pathological data is in advanced stages of development. The central labs have started developing common protocols for the construction of TMAs, for the analysis of the different biomarkers and for the reporting of the results. The researchers plan to have centers/groups active by July and to start the collection of data and material by the fall 2009 and they are aiming at finalizing the central pathology review by the end of 2009.

Mid-Year Progress Report:
During this period the preparatory work needed to launch this study has been done. The full protocol and database development for collection and analysis of both clinical and pathological data are finished. The central labs have developed common protocols for the construction of tissue microarrays (TMAs), for the analysis of the different biomarkers and for the reporting of the results. The participant centers/groups were selected and the activation process started. The researchers plan to start the actual collection of data and tumor samples in February and are aiming at finalizing the central pathology review by the mid of 2010. The objective is to analyze the first results of the retrospective male breast cancer (Male BC) study in 2010 as well as present it in an international conference and to prepare a manuscript for publication in a peer reviewed journal. In parallel, they are continuing their efforts to obtain the much needed funds for the associated correlative translational research projects. To this end, additional grant applications will be made by the study coordinators and two central pathologists.

Bio:
Monica Morrow is Chief of the Breast Surgery Service and co-chief of the Breast Program at Memorial Sloan-Kettering Cancer Center, and will become the incumbent of the Anne Burnett Windfohr Chair of Clinical Oncology in January 2009. Prior to this she served as the G. Willing Pepper Chair in Cancer Research and the Chairman of the Department of Surgical Oncology at Fox Chase Cancer Center.

From 1993 to June 2004, she was Professor of Surgery at Northwestern University Medical School, and director of the Lynn Sage Comprehensive Breast Program at Northwestern Memorial Hospital. From 1999--2001 she also served as Director of the Cancer Department of the American College of Surgeons and Executive Director of the American Joint Committee on Cancer. A native of Bucks County, Pennsylvania, Dr. Morrow received her BS degree Magna Cum Laude from the Pennsylvania State University in 1974 and her MD in 1976 from Jefferson Medical College. She did her surgical residency at the Medical Center Hospital of Vermont from 1976-1981, followed by two years of surgical oncology training at Memorial Sloan-Kettering Cancer Center.

Dr. Morrow is the recipient of the Outstanding Professional Woman Award from the State of Illinois Federation of Business and Professional Women, the Alpha Omega Alpha Outstanding Clinical Faculty Award from the University of Chicago, Distinguished Alumni of the Pennsylvania State University, the Women Making a Difference Award for Medical Innovations from the State of Illinois, the Speaking of Women's Health Foundation Award and Distinguished Alumni of Jefferson Medical College. She was also named an Honorary Fellow of the Royal College of Physicians and Surgeons (Glasgow).

She is the editor of three breast cancer textbooks, and has published more than 250 book chapters, manuscripts, and editorials. She has served on the Board of Directors of the American Society of Clinical Oncology and the Society of Surgical Oncology and is currently the Secretary of the Society of Surgical Oncology. Her interests include the application of clinical trials data in practice, the evaluation of new technology related to local therapy of breast cancer, and surgical decision-making.