The impact of USask research on the future of breast cancer care

If you are among the one in eight Canadian women who confronts a breast cancer diagnosis, you would want Dr. Mita Manna (MD) on your care team.

Manna is a medical oncologist and assistant professor at USask, and her days include a combination of medical education, patient care and research. She is a clinician at the Saskatchewan Cancer Centre providing care, teaches at USask's College of Medicine, and is the Saskatoon research site lead for the Canadian Cooperative Trials Group.

In addition, Manna serves as the provincial disease site lead for breast malignancies. She also hosts an annual breast cancer symposium that fulfils her mission to spread the word to other professionals about new discoveries, testing methods, and innovative novel treatments.

In 2011, Manna graduated from The University of British Columbia’s Faculty of Medicine and came to USask for an internal medicine residency. Two more subspecialty residency programs followed at the University of Calgary: hematology and medical oncology. In the midst of those, she also completed a clinical fellowship at the Tom Baker Cancer Centre in Lymphoma.

“The most exciting thing about being an oncologist,” according to Manna, “is the rapid growth of treatment options and novel drugs that are coming through the pipeline; and how that has transformed our landscape in terms of treating patients, having better outcomes, and a better quality of life.”

One in 36 women will die of the disease, but the odds of beating breast cancer have improved since the mid-1980s, thanks to enhanced screening and treatment methods.

As provincial site lead, Manna oversees clinical trials related to breast cancer at USask's Clinical Trial Support Unit (CTSU), the current site for 16 breast cancer clinical trials. Manna serves as the principal investigator of four of the clinical trials.

Many of these investigations are Phase 3 clinical trials that involve large groups of people, often national or global in scale. Phase 3 trials monitor side effects compared to commonly used treatments and collect information about the drug that will allow it to be used safely.

Clinical trials are a wonderful option for eligible patients, Manna said. These trials enable patients to participate — and access therapy — that they otherwise would not receive as part of standard care.

“With the advances in cancer care, we wouldn’t be where we are today, without the involvement of clinical trials,” she said.

Beyond her clinical research, Manna currently leads a pilot project designed to “mainstream” or expedite, access to genetic testing.

“By providing timely and accurate information about genetic risks to women with breast and ovarian cancer, mainstreaming has the potential to improve cancer care and reduce cancer-related deaths,” said Manna.

The innovative pilot project is funded by donors to the Royal University Hospital Foundation’s Women Leading Philanthropy program, as well as additional private donations.

From 10-15 per cent of all breast and ovarian cancers are due to genetic mutations. Most of these mutations are inherited. Discovered 30 years ago, BRCA1 and BRCA2 are the best-known breast cancer genes. Approximately 72 per cent of women who inherited the BRCA1 gene, and 69 per cent of those with the BRCA2 gene, will develop breast cancer by age 80.

Manna’s pilot project enables surgeons and oncologists to order hereditary cancer genetic testing for their patients, without prior consultation with a genetic counsellor. This process streamlines access to testing. For those patients with an identified mutation, the project provides faster access to genetic counselling services.

Since February 2024, more than 150 people have received expedited tests. Manna’s team aims to finish data collection by the end of the year. The results will determine the impact mainstream testing has on patient care and health outcomes.

“We want this to be sustained so that moving forward, this will be the new standard of care,” Manna said.

The study results will be shared with health-care professionals and advocacy groups to promote best practices and further research designed to improve care and outcomes for breast cancer patients. Manna’s commitment in the field of oncology reflects the best of what modern medicine offers: compassion and scientific rigour. As for the inherent challenges of her profession, the medical oncologist takes a balanced approach.

“A lot of people say how that (oncology) must be so difficult. It must be so sad,” Manna said. “Well, yes, it is. You know there’s going to be good days and bad days … but at the end of the day my job is to help my patients understand what they are going through, and provide them with optimal treatment options and meet their wishes and goals.”