PROF. STEVE BIRRELL

Name: Stephen Birrell

Department: Flinders Breast Cancer and Lymphoedema Unit

Major project: Management of early breast cancer

How long have you worked at Flinders?
20 years

What led you to this area of research?
I was one of the early graduates from the new Flinders University Medical School and one of my first tutors was Dr Elizabeth Cant, the first breast cancer surgeon at FMC. The passion she demonstrated for her work was inspirational to myself as a young medical student and it was a great honour to take over the breast cancer unit from her many years later.

What other collaborations are you working on?
I am currently involved in close collaboration with Prof Neil Piller and Lymphoedema education. Later this year we are going to embark on a WHO funded educational program in India. Additionally I'm in the process of establishing a close collaboration with the Mayo Clinic to undertake a combined evaluation of a new therapeutic intervention in early breast cancer.

Approximately when could we see your work in the mainstream health system?
Our current project that has been funded by FMC Foundation will have an immediate impact on patient care. This study is evaluating whether radiotherapy can be omitted in the treatment of ductal carcinoma insitu. This is an early form of breast cancer that we believe can be treated adequately with surgical intervention only.  In order to have wider acceptance of this concept we need to expand our current retrospective analysis to a prospective evaluation of our technique. If this is more broadly accepted it will have an immediate national and international impact.

What does an average day in your job at Flinders entail?
I see more than 100 patients a week many who have breast cancer and this is the overriding component of my work. However I have managed to integrate into this process research and teaching components to ensure the academic rigour of my professional life. In order to do this it requires tremendous productivity through the availability of ancillary staff to ensure that my job does not just become mechanical nature.

Have you had a Eureka moment or ever discovered anything by accident?
20 years ago I discovered that a protein in breast cancer cells may be pivotal in ensuring the response of the tumour to specific hormonal therapy. At the time, although I believed in my discovery, most thought it was of no value. However time has proven my original discovery to be correct and this was recently recognised by being published in the prestigious journal Nature.

How would extra funding support your research?
Unfortunately, despite working between 70 and 90 hours a week, I still cannot achieve the objectives of my research. The only way that my productivity can be enhanced is to have high-level research associates capable of independent activity only requiring broad directional management. These types of what we call “soft” positions are difficult to fund through classical mechanisms. However the immediate benefit from these positions is easily discernible and it is a great pity that the easy clinician researchers such as myself are not able to easily obtain access to this type of help. Fortunately institutions such as the FMC Foundation have the ability to envisage the benefit to researchers such as myself and fund these types of extra mural positions. $25,000 would fund a research associate for two days a week which would be invaluable.