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We grateully acknowledge the support o the ollowing

organizations, the Members and Friends o the Canadian

Breast Cancer Research Alliance, in the development o the

National Breast Cancer Research Framework:

Canadian Institutes of Health ResearchHealth Canada

Public Health Agency of Canada

The ollowing individuals contributed to the development

o the National Framework:

Dr. Phil Branton, Dr. Heather Bryant, Dr. Mario Chevrette,

Dr. Elizabeth Eisenhauer, Diana Ermel, Dr. Margaret Fitch,

Dr. Christine Friedenreich, Dr. Karen Gelmon, Dr. Eva Gruneld,

Dr. Tom Hack, Dr. Claire Holloway, Dr. Tom Hudson,

Heidi Liepold, Dr. Victor Ling, Dr. Sylvie Mader, Dr. Ivo Olivotto,

Dr. Morag Park, Dr. Michael Pollak, Dr. Cathy Popadiuk,

Dr. Moira Stilwell, Dr. Jim Woodgett, Dr. Martin Yae.

Printed on Rolland Opaque50 containing 50% post-consumer fbre, certifed EcoLogo

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As the most requently diagnosed type o cancer among Canadian women,

breast cancer has received an increasingly large proportion o attention overthe last two decades. There is certainly more awareness, as well as vastimprovements in screening and treatment, but there is also consensus thatmore research is required to successully manage this complex disease.

To maximize Canada’s contribution to breast cancer research, now and inthe uture, there is a need or more eective use o resources, increasedcollaboration and agreement on a set o national research priorities.

To address this need, the Canadian Breast Cancer Research Alliance

established a broad-based consultation process to develop a strategicramework or the unding o breast cancer research in Canada.

The National Framework or Breast Cancer Research is a Roadmap orResearch. It identifes research priorities, encourages collaboration amongunders and articulates a call to action aimed at all members o the Canadianbreast cancer community.

A NEW PARADIGM IN RESEARCH PRIORITIZATION

The National Framework is unique in its ocus on research and its call orcollaboration among unders. Most signifcantly, this Framework:

• Defnes strategic research priorities, covers all aspects o the breastcancer research system and includes areas that could be relevant toother cancer sites;

• Establishes a streamlined approach or achieving and measuring highlevels o scientifc rigour and research impact;

• Is orward looking and acknowledges the importance o both short-termand longer-term initiatives.

FOCAL POINTS FOR HIGH-IMPACT RESEARCH

Research priorities were selected through a rigorous, consultative processto ensure agreement that each o these research advances would beneftCanadians and improve Canada’s global competitiveness in cancer research.

The six research themes identifed in the National Framework are:

• MechanismsofCancerDevelopment

• MolecularDetectionandPrediction

• PersonalizedMedicine

• CancerProgressionandDissemination

• Psychosocial,SurvivorshipandHealthServices

• TransferringKnowledgeintoPractice

THE NATIONAL BREAST

CANCER RESEARCH FRAMEWORK 

A Roadmap for Research

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2.

3.

1. Genetics – The genetic and epigeneticbasis o breast cancer development

Initiation – Deciphering the molecular pathwaysimplicated in breast cancer initiation

Metastasis – Understanding the cause o metastatic breast cancer and identiyingnew avenues or interventions

Biology

4.Breast Cancer Risk – The infuence o liestyle andenvironmental actors on the risk o developingbreast cancer

5. Breast Cancer Causes I – The geneticsand hormonal causes o breast cancer

6. Breast Cancer Causes II – Understanding theinterplay o multi-causal actors: genetics andenvironmental

Etiology

Prevention 7. Prevention (Interventions) – Interventions to studythe infuence o liestyle and environmental actorson the risk o developing breast cancer

8. Detection – Better approaches to earlydetection and diagnosis

9. Biomarkers I – Development and evaluationo new biomarkers (including biomarkers ordiagnosis) and the optimization o treatmentsor individual patients

10. Biomarkers II – Clinical setting/clinical trialsto assess clinical sensitivity and specicity o new biomarkers

Early Detection,Diagnosis and

Prognosis

CSO

CATEGORY 

The 17 high-impact research priorities are: 

RESEARCH PRIORITY 1

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11. New Treatments – Discovery and developmento new treatments or breast cancer

12. Clinical Trials – Clinical trials o newpromising therapies

Treatment

13.Survivorship and Quality o Lie Interventions– Psychosocial and survivorship interventions

14. Health-care Issues – Analysis o the nancialand health-care delivery issues acing breastcancer patients (across the cancer continuum)

15.Knowledge Translation and Best Practices –Interventions to improve knowledge translationand disseminate best practices in breast canceracross the cancer continuum

16. Link with Clinical Data – Developingmechanisms to link clinical trial data withadministrative health databases or studieson long-term outcomes and late eects

Cancer Control,Survivorship and

OutcomesResearch

17. Animal Models – Developing new animaland cellular models to study response totherapeutics and mimic human breastcancer development

Scientic ModelSystems

CSO

CATEGORY 

The priorities have been organized using the Common Scientic Outline,a system used by most national and international research granting agenciesto classiy and categorize research.

1

RESEARCH PRIORITY 

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REALIGNING EXISTING AND NEW FUNDING

In 2007, at least $46.8M was spent on breast cancer research in Canada,with most o the investment being made in the orm o investigator-initiatedoperating grants, also known as discovery research. Although this type o unding mechanism has historically received the major share o researchunding, there appears to be a general trend toward increased support or

more targeted research.In assessing the unding needs or the National Framework’s 17 researchpriorities, a continuation o balanced support or ongoing research initiativesis endorsed. However, new thinking about research investment is alsoencouraged, given that a third o the identied research priorities are notcurrently unded in Canada.

Successul implementation o all aspects o the National Framework will

require additional unding or breast cancer research as well as someadditional investment in inrastructure and capacity development acrossCanada’s research system.

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CALL TO ACTION

All members o the breast cancer research community are invited tobecome amiliar with the National Framework document and to worktogether to achieve the ultimate outcome: a world where no person

need ear breast cancer.Breast cancer research unders across Canada are asked to adopt a set o guiding principles (below) and to mobilize support or both oundationalresearch and the identied priorities.

Policy and practice infuencers are asked to apply existing research ndingsto policy and practice as they relate to breast cancer, cancer and chronicdisease, and to engage with researchers and academics to shape uturestudies aligned with policy development.

Industry (e.g., pharmaceutical companies, biotechnology companies,sotware developers, equipment manuacturers) is encouraged to participatein new collaborative opportunities.

Provincial and hospital oundations are asked to allocate 10 per cento their unds to these national priorities.

Donors are encouraged to amiliarize themselves with the NationalFramework and to request that the organizations receiving their supportembrace these priorities and recommendations.

• Avoid duplicating research already underway when setting up local studies.Be amiliar with research results in the area o interest and leverage existingresearch ndings. Fund researchers to come together to help identiy and denehigh-leverage research questions;

• Explore possible linkages with global partners or unding collaboration withexisting global cohorts;

• Embed knowledge translation approaches within the research wheneverit makes sense;

• Integrate research and service delivery whenever possible, ensuring that thehealth-care system will support the research; e.g., by having sucient protected

clinician scientist time and salary support or administrative sta in clinicaltrials groups;

• Adopt a broad perspective across research disciplines, recognizing thatmultidisciplinary teams take time and require unding to learn to workwell together;

• Fund companion studies alongside clinical trials;

• Fund appropriate evaluation studies; e.g., the rapid assessment

o a new technology.

GUIDING PRINCIPLESproposedtofunders,tofosterexcellenthigh-impactresearch.

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CBCRA’S COMMITMENT

CBCRA is committed to leading the implementation of the NationalFramework, and to ensuring it is monitored, updated and evaluated.As part of this commitment, CBCRA will also facilitate the developmentof a network of funders aligned with the National Framework, fosteringnew collaborations aimed at ensuring the most effective use of resources.

GET INVOLVEDTo learn more about the National Breast Cancer Research Framework,and to explore the full document:

VISIT www.nationalframework.ca

To learn more about getting involved in moving the Framework forward:

E-MAIL nationalframework@cbcra.ca

CALL 416-596-6598