The Breast Pathology Service provides a range of up to date, high quality diagnostic tests, for the assessment of breast disease. Approximately 350 new cases of infiltrating and/or in-situ breast cancers (19% of total cancer patients) are diagnosed yearly, and about 80 new cases of atypical ductal hyperplasia and/or lobular neoplasia are also diagnosed each year.
Among the techniques available in the department are:
Breast Fine Needle Aspiration (FNA), an active service of the cytology division of pathology with highly qualified cytotechnologists and board certified cytopathologists.
Histopathology of the breast including core needle biopsy and mammotome biopsy histologic evaluation, with double read of each tissue specimen by two pathologists.
Excisional biopsy and needle localization excisional biopsy histological evaluation with mapping of targeted lesions.
Sentinel lymph node assessment by standardized protocol.
Intraoperative sentinel lymph node cytologic evaluation.
Ancillary studies performed on a routine basis are immunohistochemical evaluation of hormone receptor status and evaluation of HER-2/neu overexpression. Chromogen in-situ hybridization (CISH) for evaluation of HER-2/neu amplification will be available in the near future. Flouescent in-situ hybridization (FISH) for evaluation of HER-2/neu amplification is done off site (Mayo Clinic).
Additional immunohistochemical studies that are available, but not routinely performed, include:
evaluation of other prognostic/predictive factors, such as Ki-67 (Mib-1) for proliferative index
epidermal growth factor receptor (EGFR) and p53.
In conjunction and in close collaboration with the Baystate Regional Cancer Program / Comprehensive Breast Center, a Multidisciplinary Breast Conference is held on a weekly basis, with participation from pathologists, surgeons, radiologists, radiotherapists, oncologists and plastic surgeons, to assess the therapeutic options available for each individual patient.
Breast Cancer Research is an active field of research in the Department of Pathology and part of the educational program. Staff research interests vary greatly from basic science research to translational research and clinical research with participation in local and national studies. The pathologists with breast research interests have received several grants including the Rays of Hope grant funding and Susan Komen grant funding.
The research is both Baystate Health based as Primary Investigator and/or performed in collaboration with other institutions, including University of Massachusetts at Amherst, Pioneer Valley Life Sciences Institute, University of Massachusetts at Worcester, Harvard University and Albert Einstein University School of Medicine.