On Friday, November 10^th of last year, the KTB held its third Think Tank at the Sheraton Indianapolis Keystone at the Crossing, attended by almost 50 breast cancer researchers, scientists, and other interested parties from across the United States. Some had already conducted studies using KTB samples, and some came looking for more information about the bank, the available samples and data.

Think tanks are gatherings focused on conducting scholarly research, establishing a space for debate, producing ideas, and providing scholarly resources to the public. In an effort to make it easier on researchers, and to lean on attendance convenience, the KTB’s first two think tanks (in 2013 and 2016) were held during the AACR Annual Meeting. This time, however, the choice was made to invite everyone to Indianapolis on the same weekend as one of our tissue collection events.

Below is a detailed summary of the many discussion points and ideas that resonated throughout the day. As you will see, suggestions ranged from relatively simple to extremely complex:

• It was suggested that in the future, it might be helpful for the KTB to start collecting other types of biospecimens in addition to tissue and blood. Suggested additions were lactating breast tissue, fecal samples, chemical exposed tissue, urine, hair, nails, and saliva.
• Additional storage and/or handling methodologies were suggested (currently our blood aliquots are 750 ul or less, can we collect more)? Use best practices for plasma collection, liquid biopsy tissue level metrics, and low pass genome sequencing.
• To increase utilization of mammograms, data, and H&Es, we could work to improve the quality, enable bulk download in the cloud, and send updates to collaborators to notify of new Virtual Tissue Bank data updates.
• The following items could be added to the KTB participant medical questionnaire: insurance coverage, year of comorbidity diagnosis, whether they needed an ultrasound before age 30; recent viral infections; recent vaccine status; lead & heavy metal exposure; time of last meal; how much time spent sitting; sleep information; and middle eastern race/ethnicity. Additionally, puberty questions and physical activity information could be deleted.
• There are other “special” cohorts we could/should consider, such as people who are/have had: father and daughter, siblings, multiple donations, pre- and post-lactation, rheumatoid disease, osteoporosis, thyroid disorder, more than one benign breast disease biopsy, radial scarring, weight reduction therapy before or after, couples, targeted males, and gender transformed populations.
• Collecting as many samples as possible from men.

• How are KTB samples best used to examine questions at the intersection of environmental health science and carcinogenesis? Can we ask participants to wear silicone bracelets for a time, then check silicone exposure levels?
• How do we encourage work that isn’t completely focused on people who develop breast cancer; in other words, how to promote doing work, for example, looking at how elderly women make it to their 80s and 90s cancer-free.
• Some new/innovative outreach strategies suggestions included: more advertising, communicating with participants on special occasions, holding webinars every quarter to ask and answer questions, holding short talks.
• Other Think Tank attendee interests included prostate cancer work and registry linkage.
• Suggested studies included: pathogenic germline mutation, metabolic health (collect info on fasting sugar?), approaching states with largest minority populations, connections between prostate and breast cancers, and full workups of families.
• Suggested topics to study included examining effect of: social determinants of health, ancestry biomarkers, self-reported mutations, RNA studies.
• Final questions were:
  • How can we increase data accuracy?
  • How do we handle multiple proposals of collaboration of tissue?
  • Do we provide clean or raw data on the Virtual Tissue Bank?

Any guests who wanted to do so were invited to stay overnight and attend the KTB healthy breast tissue collection event the following day, and several did so. They were able to tour the facility, observe and speak with participants, and ask as many questions as they wanted about any of the different stations and procedures.

The 2023 KTB Think Tank was a huge success! We thank everyone who attended and helped generate feedback and ideas that will assist in helping to expand the KTB’s offerings to the science of breast cancer.