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A/Prof Mikael Hartman

Designations:
  • Head & Senior Consultant, Division of General Surgery (Breast Surgery), Department of Surgery, National University Hospital
  • Senior Consultant, Division of General Surgery (Trauma), Department of Surgery, National University Hospital
  • Senior Consultant, Division of General Surgery (Breast Surgery), Department of Surgery, Alexandra Hospital
  • Senior Consultant, Division of Surgical Oncology, National University Cancer Institute, Singapore
  • Associate Professor, Saw Swee Hock School of Public Health, National University of Singapore
  • Associate Professor, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore
  • Adjunct Staff, Department of Medical Epidemiology, Karolinska Institute, Sweden
Qualifications:
MD (Stockholm), PhD (Karolinska Institute)
Specialties:
Surgery, Surgical Oncology
Sub-Specialties:
Breast Surgery, Chronic Programme (Live Better), FAST Programme (Get Better), General Surgery, Surgical Oncology (Breast Surgery)
Special Interests:
Breast cancer etiology, Breast cancer prognostication, Inheritance of prognosis, Pharmacogenomic, Clinical epidemiology, Trauma

Biosketch

"As surgeons, we can treat breast cancer to the best of our ability according to the stage that it presents, but to truly maximise outcomes, we must exit the hospital and focus on screening and detection. Breast cancer is a silent epidemic – and it is doubling every generation – so it is critical that we highlight this issue and drive understanding on how we can make sure women walk through the door earlier to seek help, when the chance of cure is high."

In a bid to highlight the importance of early detection for breast cancer, A/Prof Mikael Hartman and Dr Philip Lau went on an epic motorcycle journey from Singapore to Sweden in 2014. During the ride, they met breast cancer patients across 17 countries to understand how cultural factors shape attitudes to the disease. The duo also spoke with their medical counterparts in various countries along the route and teamed up with anthropologists to study help-seeking behaviour and drivers that can maximise the chance of early detection and treatment.

Trained at the renowned Karolinska Institute in Sweden, A/Prof Hartman received his medical board certification in General Surgery in 2005 and went on to complete his doctoral studies in the field of epidemiology in 2007, specialising in the field of breast cancer etiology and prognostication as well as inheritance of cancer prognosis. He was co-recipient of the Breast Cancer Concept Award, US Army, in 2002 and 2006.

In 2009, he began practising in Singapore at NUH. Seeing more breast cancer cases in six months than in his past ten years at Karolinska, he quickly recognised the disease presentation for breast cancer in Singapore and Southeast Asia was very different from Stockholm. Women were presenting later, which decreased the chance of a good outcome. He also noted that overall, breast cancer rates in Southeast Asia were rising.

These factors drove him to embark on The Long Ride with Dr Lau, an awareness campaign to highlight breast cancer screening and gain deeper insight into the cultural and societal nuances that could be tapped into so as to increase detection rates.

Precision screening for better breast cancer detection

As part of his extensive work in breast cancer etiology and prognostication, A/Prof Hartman has led numerous studies on breast cancer as the lead investigator of the Saw Swee Hock School of Public Health's Breast Cancer Prevention Programme (BCPP). BCPP focuses on enhancing breast screening, understanding the different stages of breast cancer and genomics and driving personalised medicine.

One of its most recent studies is the BREAst screening Tailored for HEr (BREATHE) programme, part of a precision medicine drive to identify the genetic and non-genetic risk factors of breast cancer. BREATHE aims to recruit 5,000 women to undergo a risk screening survey and cheek swab. With this data, the team provides a risk report to help women understand and act on their risk, such as undergo a mammogram.

The BREATHE Study strives to better tailor screening schedules according to risk profiles. This targeted approach will mean optimising healthcare resources to screen women-at-risk more regularly and at an earlier age, while screening women who at low risk less.

Tapping into AI for faster, more accurate diagnoses

With a scarcity of radiologists around the world and particularly in the Asian region, the accurate and timely reading of mammogram is a challenge. To overcome this, A/Prof Hartman has started a company to look into the use of artificial intelligence to assess mammograms. This technology has the potential to act as an adjunct assistant to radiologists and support the early detection of breast cancer.

A spray of protection against COVID-19

Beyond his work in breast cancer, A/Prof Hartman was also part of a team of NUH clinician-scientists to prove that using a povidone-iodine throat spray three times a day, or the oral drug hydroxychloroquine once daily, reduced the likelihood of getting infected by Sars-CoV-2. The study recruited over 3,000 healthy young migrant workers who quarantined. Conducted in May 2020 during the height of the pandemic in Singapore, this discovery proved a useful and practical way to curb the spread of the virus through the repurposing of accessible existing drugs at a time when infection was widespread and when vaccinations were not yet available.

Awards

  • Breast Cancer Concept Award 2002, US Army, Congressionally Directed Medical Research Programs 
  • Breast Cancer Concept Award 2006, US Army, Congressionally Directed Medical Research Programs 
  • Best Poster Presentation International Surgical Society (ISS) Meeting 2009, Adelaide, Australia 
  • Recipient of NMRC Clinician Scientist Award

Journals & Publications

  1. Breast cancer risk variants at 6q25 display different phenotype associations and regulate ESR1, RMND1 and CCDC170. Dunning Am,…, Hartman M,…, Edwards Sl. Nat Genet. 2016 Feb.
  2. Familial Risk and Heritability of Cancer Among Twins in Nordic Countries. Mucci LA,…, Hartman,…, Kaprio J. JAMA. 2016 Feb.
  3. Genomic landscapes of breast fibroepithelial tumors. Tan J,…, Hartman M,…, Teh BT. Nat Genet. 2015 Nov.
  4. Polymorphisms in a Putative Enhancer at the 10q21.2 Breast Cancer Risk Locus Regulate NRBF2 Expression. Darabi H,…, Hartman M,…, Chenevix-Trench G. Am J Hum Genet. 2015 Jul.
  5. Female breast cancer incidence among Asian and Western populations: more similar than expected. Sung H,…,Hartman M,…, Yang XR. J Natl Cancer Inst. 2015 Apr.
  6. Genome-wide association analysis of more than 120,000 individuals identifies 15 new susceptibility loci for breast cancer. Michailidou K,…, Hartman M,…, Easton DF. Nat Genet. 2015 Apr. 
  7. Fine-scale mapping of the 5q11.2 breast cancer locus reveals at least three independent risk variants regulating MAP3K1. Glubb DM,…, Hartman M,…, French JD. Am J Hum Genet. 2015 Jan. 
  8. Evidence that breast cancer risk at the 2q35 locus is mediated through IGFBP5 regulation. Ghoussaini M,…, Hartman,…, Dunning AM. Nat Commun. 2014 Sep.
  9. Genome-wide association analysis in East Asians identifies breast cancer susceptibility loci at 1q32.1, 5q14.3 and 15q26.1. Cai Q,…, Hartman M,…, Zheng W. Nat Genet. 2014 Aug. 
  10. Exome sequencing identifies highly recurrent MED12 somatic mutations in breast fibroadenoma. Lim WK,…, Hartman M,…, Teh BT. Nat Genet. 2014 Aug.
  11. Mammographic density phenotypes and risk of breast cancer: a meta-analysis. Pettersson A,…, Hartman M,…, Tamimi RM. J Natl Cancer Inst. 2014 Apr.
  12. Genome-wide association studies identify four ER negative-specific breast cancer risk loci. Garcia-Closas M, …, Hartman M,…, Kraft P. Nat Genet. 2013 Apr.
  13. Multiple independent variants at the TERT locus are associated with telomere length and risks of breast and ovarian cancer. Bojesen SE,…, Hartman M,…, Dunning AM. Nat Genet. 2013 Apr.
  14. Large-scale genotyping identifies 41 new loci associated with breast cancer risk. Michailidou K,…, Hartman M,…, Easton DF. Nat Genet. 2013 Apr.
  15. Incidence and outcome of male breast cancer: An international population based study. Miao H,…, Hartman M, Yip CH. J Clin Oncol. 2011 Jun.
  16. Molecular epidemiology and its current clinical use in cancer management. Hartman M, Loy EY, Ku CS, Chia KS. Lancet Oncol. 2010 Apr.
  17. Breast cancer onset in twins and women with bilateral disease. Hartman M, Hall P, Edgren G,…, Czene K. J Clin Oncol. 2008 Sep.
  18. Familial concordance in cancer survival: a Swedish population-based study. Lindström LS, Hall P, Hartman M,..., Czene K. Lancet Oncol. 2007 Nov.
  19. Incidence and prognosis of synchronous and metachronous bilateral breast cancer Hartman M, Czene K,…, Hall P. J Clin Oncol. 2007 Sep.
  20. Genetic implications of bilateral breast cancer: A population-based cohort study Hartman M, Czene K,…, Hall P. Lancet Oncol. 2005 Jun.

Professional Memberships

  • Head, Singapore Breast Cancer Cohort
  • Head, Singapore-Malaysia Breast Cancer Working Group
  • Lead Investigator, Breast Cancer Prevention Programme in the Saw Swee Hock School of Public Health (SSHSPH)
  • Deputy Director, Initiative for Research and Innovation in Surgery – NUHS
  • Research Director of the University Surgical Cluster Research Committee – NUHS
  • Head of Surgical Clinical Epidemiology Unit - NUHS, Deputy Head of Breast Services in Department of Surgery – NUH
  • Member, SSHSPH Senior Management Committee and Faculty Promotion and Tenure Committee
  • Senior Consultant, FAST Programme (Get Better), Alexandra Hospital
  • Senior Consultant, Chronic Programme (Live Better), Alexandra Hospital


 

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