An interconnected laboratory system for cancer diagnosis and treatment is a dream for many health care systems. However, for patients in some settings, it can be the difference between receiving treatment or not. In low and middle-income countries (LMIC’s), patients referred for biopsy often must travel from great distances at significant costs. Delays between biopsy, diagnosis, and treatment often mean patients are lost to follow-up before treatment is initiated. Travel distances and costs often make follow-up visits prohibitive.

Dianna Ng, MD, Assistant Professor in the Department of Pathology at UCSF, aims to change this situation for breast cancer patients in LMIC’s. As the recipient of the first Global Cancer Program Pilot Award, administered through the UCSF Resource Allocation Program, Dr. Ng aims to validate the GeneXpert® Breast Cancer Assay for rapid analysis of breast cancer biomarkers from fine needle aspiration (FNA) biopsies in Tanzania. FNA is a minimally invasive biopsy procedure. Tissue obtained by FNA can be immediately processed onto a slide and prepared with a low-cost stain. These slides can then be read by a pathologist with the overall procedure resulting in rapid on-site evaluation (ROSE) and, in many cases, diagnosis. After a confirmed diagnosis of malignancy, the next step is to identify the appropriate treatment. The GeneXpert® techonology has been previously implemented for point of care diagnosis and determination of antibiotic resistance for tuberculosis. Dr. Ng hypothesizes that the GeneXpert® assay can be implemented with FNA for breast cancer biomarker status determination, thereby facilitating a point-of-care diagnosis. The integration of ROSE and the GeneXpert® assay can lead to an interconnected workflow for diagnosis and treatment of breast cancer. The ability to provide a patient with both a diagnosis and an appropriate treatment plan in a single trip could potentially transform breast cancer care in LMIC’s. This project is a collaboration between Muhimbili University of Health and Allied Science (MUHAS) and the Ocean Road Cancer Institute in Tanzania, the UCSF Helen Diller Family Comprehensive Cancer Center Global Cancer Program, and Cepheid.