Having undertaken a number of studies27, 28, 29, 30, 31, 32, 33, 34, 35, 36 that generated experience and data from genomic and GEX‐based classification of primary breast cancers, in 2009 the academic group in Lund and the SSBCG formed SCAN‐B, an initiative to move these analyses closer to today's patients and eventually into routine clinical practice37. The mission was that all patients with newly diagnosed breast cancer would be offered these analyses within the clinical context, and that the analysis should be performed on the most modern platforms (NGS) using fresh (not formalin‐fixed) tumour tissue samples in order to utilize the full potential of deep sequencing (Fig. 1). To be clinically meaningful, sampling and shipping of fresh tumour specimens was proposed to be continuous and in real time, and fully integrated into ordinary surgical and pathological practices, with delivery of the results from the analysis to the clinician at the time of the postoperative conference. The initial research programme for the SCAN‐B initiative included consecutive retrieval of fresh tissue, and preoperative and postoperative blood samples.
The SSBCG acknowledged the initiative in 2009. The initiative had to be considered as a research project open to all patients with breast cancer. Ethical approval was given in 2009 and all (now centralized to 7) surgical departments in the South Swedish Health Care Region agreed to put necessary resources at hand for the project. Funding of technical equipment and reagents was granted by the Mrs Berta Kamprad Foundation, which provided a stable basis for the initial years of operation.
In the same interval, six regional cancer centres (RCCs) were established in Sweden to improve cancer care and clinical development38. In 2010, the counties within RCC South, identical to the catchment area of the SSBCG, reached a decision and economic agreement that systematic biobanking of blood and unfixed tumour tissue from all consenting patients with cancer should be implemented as a support for clinical cancer research. To support this, an infrastructure for blood and tumour tissue collection and storage was established at all major hospitals in southern Sweden. This infrastructure was not limited to breast cancer research, and has also been implemented for other cancer diagnoses such as lung cancer39. The decision and support of the regional governing body were instrumental in implementation of the same routines across a large geographical area, encompassing seven major hospitals and covering a population of 1.8 million (Fig. 1).
The start of this project was thus a fruitful partnership between enthusiastic researchers, an established collaborative group, seven hospitals, an important funding body and the regional governing body.