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The Breast Pathology Service, led by Dr. Dennis Sgroi since 2001, provides diagnostic services to Massachusetts General Hospital and outside pathologists in the US and abroad, and to breast cancer researchers at the Massachusetts General Hospital, Dana-Farber Cancer Institute, Massachusetts Institute of Technology, and National Institutes for Health. The Breast Pathology Service is fully integrated with the breast clinical services and serves a critical consultative role in the case management of breast cancer patients. The Breast Pathology team has a broad range of expertise from classical histomorphology to molecular pathology, and the research efforts of this group reflect these diverse fields. Significant initiatives are currently underway that focus on molecular pathologic technologies as they pertain to the diagnosis and clinical management of breast cancer patients.
The Breast Pathology Service sees approximately 4,500 case accessions per year. Of these, 3,400 represent in-house breast cases; approximately 50% are excisional biopsies, 25-30% are core biopsies, and 15-20% are mastectomy specimens. Approximately 1,100 outside consultation cases per year are reviewed, including patient referrals, consultation requests from area hospitals, and private consultation material. ER, PR, and HER2 IHC and HER2 FISH are performed within the MGH Department of Pathology on all in-house breast cancer cases.
The Breast Pathology Service is split into three clinical services: Breast 1, Breast 2, and Breast 3. Residents are assigned to the Breast 1 service for their core rotations. They are responsible for 4-6 surgical specimens per day, as well as all breast core biopsies and breast skin biopsies. The Breast 2 service covers one-third of the in-house surgical cases and the outside referral cases for the Breast Center Multidisciplinary Conferences. Upper-level residents on elective and visiting fellows rotate on the Breast 2 service. The Breast 3 service covers one-third of the in-house surgical cases and the remaining outside referral cases. Individual pathologists handle private consultations that are directed to them.
Academic and Research Accomplishments
Information regarding specific research interests and links to PubMed can be found on individual faculty web pages (see above Faculty section).
Teaching and Educational Activities
Breast Pathology Weekly Conference: All breast pathologists, the breast pathology fellow, and rotating residents review diagnostically challenging cases on a weekly basis.
Resident Teaching: During daily breast signout, each breast pathology staff member teaches the principles of gross and histological diagnosis to residents. In addition, the staff actively participate in resident teaching conferences. The Breast Pathology Service has developed a comprehensive Breast Manual, reviewing educational objectives, procedural protocols, and classic papers in breast pathology.
Breast Center Multidisciplinary Conferences: A breast pathologist and/or breast pathology fellow reviews pathology slides of patients who are seen in the clinic. This activity takes places 4 times per week throughout the entire year.
Graduate Medical Education: The Massachusetts General Hospital breast pathology group, in collaboration with Memorial Sloan Kettering Cancer Center, has offered an annual breast pathology course since 2007 entitled "Solving Everyday Problems in Breast Pathology: A Morphologic Approach." The breast pathology faculty frequently teach at a number of other continuing medical education courses, both nationally and internationally.
Breast Pathology Fellowship
This fellowship seeks to prepare a trainee in pathology for an academic career devoted to the study of breast pathology. The program provides intensive training in the pathologic diagnoses of breast diseases, a concentrated experience in translational research, participation in a multidisciplinary approach to treatment planning, and opportunities for collaborative clinical research.
The program is designed as a one-year program that consists predominantly of breast pathology service work. The breast pathology fellow will have four major activities:
The breast pathology fellowship has a second optional year for those individuals who are interested in translational and/or basic science breast cancer research.
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