22 October, 2021

Less than 1% of breast cancer diagnoses occur in men, making it a largely understudied disease. But more male-specific breast cancer research is crucial so we can understand the causes of breast cancer in men and what we can do to treat it.

We met up with Bonnie Chatterji, a PhD student at the University of Aberdeen, who received a grant from BCUK to help update our brief on breast cancer in men. Under the supervision of Prof Val Speirs, one of our research grant recipients, she is trying to understand the biology of male breast cancer and find ways to improve personalised treatment strategies.

We asked Bonnie to give us the low down on her research. Here’s what she had to say.

Why have you chosen to enter the field of scientific research? And what in particular drew you to male breast cancer research?

I come from a family of academics, and scientific curiosity has been strongly encouraged for as long as I can remember. My biggest inspiration is my father. He is a consultant physician with a PhD and an indomitable enthusiasm for lifelong learning. I get my love for medicine and medical research from him.

I’ve wanted to do medical research for so long that any other career was never really an option for me. (Except maybe becoming a clinician – which may still happen!). I also think that people who work in medicine contribute to society and influence people’s lives in a very intrinsic manner that is second to none. I feel very privileged to be a part of that.

Funnily enough, I originally applied and interviewed for a different project on female breast cancer (also with Val) and was accepted. But a few days after I got my offer. Val contacted me to say that she had another project in male breast cancer that may be more suited to my skills.

To be quite honest, I did not know a lot about male breast cancer, to begin with, except that it was rare. At the time, I was finishing my MSc research project in Molecular Pathology of Cancer at Queen’s University Belfast, and in a rather serendipitous turn of events, one of my supervisors turned out to be Val’s old post-doctoral researcher in male breast cancer!

Learning about his and Val’s work in the field convinced me that I was making the right choice in doing this project. This was especially because of the translational nature of the work Val does, which has more of an impact on actual clinical decision-making than basic research. Since male breast cancer is a rare disease, it is quite a niche area with a lot of scope for novel, impactful research.

Why is research that focuses on breast cancer in men so important?

Breast cancer in men carries a significant stigma, which can only be reduced by increasing awareness and a better understanding of the disease. The more we research the condition, the closer we will be able to move towards a gender-inclusive definition and clinical management of breast cancer.

How does breast cancer in men differ from breast cancer in women? Are the risk factors of breast cancer in men different to women? If so, how?

Some fairly common types of breast cancer in women, such as lobular breast cancer, are extremely rare in men due to the lack of lobular tissue in male breasts. Lobular breast cancer is cancer that begins in breast lobules, which are milk-producing glands found in the breast. Other differences are associated with the expression of certain receptors in breast cancer cells. Breast cancers in men almost always express the oestrogen receptor (known as ER+ breast cancer). While expression of HER2 (human epidermal growth factor receptor 2 – known as HER+ breast cancer) is very rare.

Some risk factors for breast cancer in men are shared with women, such as older age and obesity. However, they can manifest differently between the sexes. For example, men are typically diagnosed with breast cancer at a later age than women.

Similar to women, hormonal imbalance is a major risk factor as well. However, this imbalance can be brought about by certain conditions that are unique to men, such as Klinefelter’s syndrome (an inherited condition where men are born with an extra X chromosome) and testicular dysfunction.

Sometimes, we carry mutations in genes called BRCA1 and BRCA2, which are involved in repairing damage to the DNA. Carrying mutations in both genes are risk factors in both women and men. However, mutated-BRCA1 affects a higher proportion of breast cancer in women than men. This is flipped with BRCA2 mutations, which affect a greater proportion of men than women and can manifest as a more aggressive form of the disease.

When people think of a researcher, they imagine someone with a white coat, mixing liquids in the lab: Your research is mostly happening on a computer. Can you tell us about your PhD research?

To be honest, when someone says medical research, that’s my first thought as well! Initially, there were components in my project that would have involved me donning a white coat mixing liquids. But that, unfortunately, did not happen because of Covid. When I decided to pursue medical research, I did not expect to spend most of my time in front of the computer (my MSc was fully computational as well). However, I have really come to enjoy it.

It can be quite different from wet lab research in that computational work is cheaper, highly scalable, and moves at a faster pace. It can also have a very steep learning curve, especially for biologists who don’t expect to code from the get-go. However, at its core, it is simply another method of research where you have to formulate a hypothesis, and get samples (online datasets in this case). And test that hypothesis by running experiments – only all of it is virtual!

What does a typical day at work look like for you?

Right now, not very different from a desk job! I like to get to work quite early and get started before the office gets too busy. A typical workday at the moment involves reading papers and a lot of writing as I am finishing a review. Earlier in the year, I was coding a fair amount for my bioinformatics work. And I also analysed pathological sections of tumour tissue on image analysis software.

Have there been any results yet?

I have had some preliminary results from image analysis as well as bioinformatics, which I am now investigating further and building upon. I’m really glad to be back in the lab now. I can now continue looking at more pathological samples and continue my image analysis work.

What difference will your project make?

I hope my work will not only deepen the understanding of male breast cancer but also help drive further research. Along with translational research, we also need more basic research to better understand the molecular basis of male breast cancer. And how it overlaps with our current understanding of breast cancer pathogenesis in women.

How has Covid impacted your work?

I was unlucky enough to start my project only a month before the first UK lockdown. Naturally, my project was hit quite hard. All the planned wet lab training and experiments had to be put off indefinitely, and my project was front-loaded with lots of writing as well as computational work. In all fairness, this has had its benefits. I am more caught up with writing than I originally thought I would be at this point in my PhD.

Personally, the worst part about Covid was having to work from home 100% of the time for 18 months. As much as it was necessary, it was also very isolating and detrimental to my mental health. Which is why I am really glad to be able to return to campus again. I haven’t returned to the lab just yet. It is taking a while to get everything in order, but I am very excited about it nonetheless!

What do you like to do when you are not working?

I love taking care of plants (my flat is slowly turning into a jungle!), and I also love baking. Recently I have started baking my own bread, which is quite a steep learning curve, but very relaxing at the same time. I am also a keen wildlife photographer, and I especially love taking pictures of birds. Being in Aberdeenshire is fantastic for that, with its massive colonies of iconic birds such as Atlantic puffins and Northern gannets along the coastline. On weekends, I accompany my ornithologist friend (also a PhD student at Aberdeen) to birdwatching spots all over Aberdeenshire. Trying to capture these beautiful animals in action!

Where do you see yourself in five years’ time?

I am very interested in the use of spatial biology and artificial intelligence-based imaging techniques for biomarker detection in cancer. These techniques, combined with bioinformatics, are proving to be fast, inexpensive, and scalable to a degree previously unprecedented in medicine. Since both my postgraduate degrees have been based around these techniques, I would very much like to continue developing my skills in a suitable post-doctoral position. I have not thought too much about the specifics yet. But that is roughly what I want to do in 5 years’ time!

What scientist living or dead, do you most admire?

My most admired scientist of all time is Rosalind Franklin. I find her life and work fascinating. Her discoveries have made most modern medical research (and biological research in general) possible.

On a more contemporary note, I very much admire the work of Peter Bankhead. The creator of the image analysis software QuPath. Even though I have never met him! He has had a substantial impact on my research and interest in artificial intelligence-driven spatial biology. I would very much like to meet him one day!

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