FISHing with the real-life laboratory experts

Dr. Theresa C. Brown, Tulane University School of Medicine, answer questions around her AGT 2017 presentation 'FISHing with the real-life laboratory experts.'

Dr. Brown, PhD, FACMG, CG(ASCP)^CM began her career in cytogenetics as a technician in the bone marrow cytogenetics lab at IUPUI. She then received a PhD from UAB, and did a postdoctoral fellowship and cytogenetic fellowship at the NIH and Georgetown University. In addition to working as a cancer cytogeneticist at large reference labs, Dr. Brown has grown and started cytogenetics labs in Atlanta and Buffalo, was a director at City of Hope and is currently enjoying working at a much smaller lab at Tulane University.

Hi Dr. Brown. You recently spoke at the AGT 2017 annual meeting as part of a FISH workshop, “FISHing with the real-life laboratory experts.” It was a great presentation. You spoke about FISH validation and people were very interested. Can you call out one or two of the biggest obstacles in FISH validation? Any tips?

I believe everyone’s biggest obstacle is getting enough samples to perform the validation.  With blood, you can beg co-workers to donate, but with bone marrows and tissue you must rely on your stellar personality to beg from colleagues and when that doesn’t work, be patient and wait for the samples to come to the lab.  As I said at the workshop, documenting what you have done and what you will do once samples are available is very important for regulatory agencies.

You also said that you’ve started up a couple of FISH labs. Can you highlight a couple of lessons you’ve learned from starting up new FISH labs?

The most important lesson I have learned is that your techs must understand cancer, that there are so many different result possibilities, and that cancer doesn’t read the textbooks.  Constitutional FISH is black and white, while cancer FISH is 50 different shades of grey.

Have you seen FISH change or evolve over the years?

Of course! Like most scientific techniques, FISH has gotten easier to perform over the years.  The best thing, I feel, is commercial competition for probes.  This has led to better products and more choices for laboratories.

What else should people look out for in the future of FISH – like Sky FISH? Are there other things to look out for?

While FISH is a wonderful technique, I think it has reached its pinnacle.  It is a quick, easy diagnostic tool, if you know what you are looking for and it will continue as such.  SKY is a fun and useful research tool, but I don’t feel it is a good choice in diagnostic, prognostic, or theranostic utility.

When you were introduced in St. Louis, you said that you enjoy working at smaller FISH labs. Why is this?

To be totally honest, I don’t sit in front of my computer and sign out patient results all day.  I am in the laboratory working with the techs, trouble shooting, validating, and teaching.  I do not have time to get bored with one task.

And you are currently teaching a master’s course and medical students? What do you most enjoy teaching the medical students about FISH?

I teach the students, residents and fellows what they should know to give me all the information I need to do the proper testing for their future patients and what the results mean. The time invested now, means better patient care in the future.