Graduate School of Medicine, Hokkaido University

vol.46 Department of Breast Surgery

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Introduction of Academic Staff and Research Fields.
Advanced Research Activities Supporting the Development of Breast Cancer Diagnosis and Treatment

Department of Breast Surgery, Graduate School of Medicine, Hokkaido University

Masato Takahashi M.D., Ph.D.Surgery

[Academic & Professional Experience]
  • Mar. 1989 Graduated from Asahikawa Medical College
  • Mar. 1998 Completed from Graduate School of Hokkaido
  • "From Apr.1989 To May 1990 Resident, Hokkaido University Hospital "
  • "From Jun.1990 To May 1991 Resident, Teine Keijinkai General Hospital"
  • "From Jun.1991 To Mar.1994 Surgeon, Megumino Hospital"
  • "From Apr.1994 To Mar.1998 Graduate School of Hokkaido University"
  • "From Apr.1998 To Mar.2001 PostDoctor fellowship, Chiba Cancer Center"
  • "From Apr.2001 To Mar.2002 Breast Surgeon, Hokkaido Cancer Center"
  • "From Apr.2002 To Mar 2010 Breast Surgeon, First Department of Surgery, Hokkaido University Hospital."
  • "From Apr.2010 To Mar.2013 Head Physician, Department of Breast Surgery, NHO Hokkaido Cancer Center "
  • "From Apr.2013 to Dec.2021 Deputy Director, NHO Hokkaido Cancer Center"
  • "From Jan.2022 to Now Professor, Department of Breast Surgery, Hokkaido University Hospital"

Commitment to breast cancer treatment and research in basic and clinical practice

▲ “My encounter with breast surgery was by chance,” Professor Takahashi says. “The more I learned about it, the more I was fascinated by its depth and the diversity of its research themes. I think it is a challenging field for young people.”

The Department of Breast Surgery at Hokkaido University Hospital is the only clinical department in Hokkaido specializing in breast cancer treatment, and the Department of Breast Surgery at the Graduate School of Medicine is the organization responsible for training of young breast surgeons and conducting groundbreaking research of both clinical and basic aspects. Professor Masato Takahashi was appointed as professor of the department in January 2022. He had previously been at the Hokkaido Cancer Center, where he led the Department of Breast Surgery for approximately 12 years.
“Despite the fact that the number of breast cancer patients is very large and continues to grow, there is a shortage of physicians specializing in breast surgery,” Professor Takahashi says. “Due in part to the small number of breast surgery courses offered at medical schools, its systematization as a discipline has also lagged behind. In addition to surgery and drug therapy, breast cancer treatment includes many challenging areas such as genetic testing and diagnosis, employment support, appearance care, and support for the AYA generation, and there is a strong need to train specialists in breast surgery.”

Currently, the three main research themes at the department are (1) clinical trials for breast cancer therapeutics development, (2) biomarker research for prediction of breast cancer prognosis, and (3) basic research on breast cancer development and the acquisition of malignant traits. Concerning (1) and (2), translational research is conducted from cell sampling to the field of basic research at the molecular level in view of the proximity of the clinical practice.
In particular, we have achieved much success with our research on HER2 (human epidermal growth factor receptor 2, a protein related to cancer cell proliferation). Breast cancer is considered to be a disease that responds to drugs, most notably the drug trastuzumab (HERCEPTIN®) for the treatment of HER2-positive breast cancer. Trastuzumab deruxtecan (ENHERTU®), which was developed and commercialized in 2019, was touted as a drug that would significantly change the way breast cancer is treated.

Professor Takahashi says, “HER2-positive breast cancer is said to account for 15 to 20% of all breast cancers, but a small number of other cancers, such as stomach and lung cancer, are also HER2-positive, and trastuzumab deruxtecan has been found to be effective in the treatment of these cancers as well. The fact that HER2 research in breast surgery is expanding into the treatment of other cancers too is one of its major contributions.”

In September 2023, BostonGene (headquartered in Boston, USA) and Hokkaido University Hospital agreed to promote the development of innovative diagnostic technologies for HER2-positive breast cancer patients. Through the application of BostonGene’s gene expression analysis pipeline, genetic biomarkers that define the characteristics of the immune microenvironment and therapeutic response in breast cancer tissue will be clarified. Professor Takahashi will lead this joint research with Professor Ichiro Kinoshita of the Division of Clinical Cancer Genomics, the Department of Medical Oncology at Hokkaido University Hospital[1].

Graduate studies to develop logical thinking and objectivity

▲ The Department of Breast Surgery contributes to breast cancer treatment in Hokkaido from both research and clinical perspectives and focuses on the teaching and training of future breast specialists.

At the department, physicians who have been involved in breast cancer treatment at Hokkaido University Hospital and other hospitals in Hokkaido and elsewhere continue their research activities with their respective goals. Professor Takahashi describes the graduate studies as follows: “Graduate students are asked to choose a research topic from the perspective of how to solve a clinical problem. Writing a paper means that the student is subjected to data-based analysis and objective evaluation of the research they are conducting. Such training can develop logical thinking. By acquiring a researcher’s perspective, students also learn to critically assess the reliability of currently available papers and data, and the position of their own data on the spectrum. Students can objectively assess their position, both in terms of research and clinical practice.”

Tomohiro Oshino, a fourth-year doctoral student, is working on diagnostic imaging of breast cancer using artificial intelligence (e.g., deep learning and decision tree models).
Dr. Oshino says, “In the process of gaining clinical experience at the Department of Breast Surgery at Hokkaido University Hospital, I realized that clinical practice is supported by basic medicine and state-of-the-art technology. I joined the Department of Breast Surgery at the Graduate School of Medicine to contribute to the development of medical care and treatment methods while making use of the cases at my institution on which I had compiled data by that time.” In addition to artificial intelligence, he conducts joint research with departments in various fields, such as neoplastic pathology and orthopedics, to develop a wide range of profound research.
He says, “The goal is to use artificial intelligence to make more universal and predictive diagnoses in clinical practice. I hope that artificial intelligence diagnosis will help to reduce the burden on the physicians who have to make a diagnosis, improve treatment plans based on high diagnostic performance, and enhance treatment outcomes.”

▲ “It is very difficult for doctors to conduct artificial intelligence research on their own. Joint research with various departments through Professor Takahashi allows us to conduct diverse research while communicating with people in different fields,” says Dr. Oshino.

(Interviewed in August 2023)

In the department, students can grow within a free and open enjoyable atmosphere.

The Department of Breast Surgery is a self-directed place where students manage their own activities. Members are free to study, run marathons, or play golf on their off days. Fun events such as (non-mandatory) social dinners for drinking together, fruit parties, and eel parties are also held. Breast doctors in Hokkaido form a close-knit community who interact with each other beyond the boundaries of medical offices and universities. There are also many opportunities to exchange information through seminars where one can learn a lot.

▲ In September 2023, 5th and 6th year students were invited to give presentations at the Hokkaido Organization of Professional and Educational Surgical Societies. A joint reception was afterwards held with breast surgery staff from three universities and the students who gave presentations on breast surgery.