Dr Imrana TanvirAsst Prof FMH

What does a pathologist do?

Why should women be aware of the pathologist?

FNA services

Reporting of surgical specimens core biopsy WLE Mastectomy

Therapeutic marker

Pathological examination is the gold standard for diagnosis in cancer

Its role has also included the elucidation of etiology, pathogenesis, clinicopathological correlation, and prognostication.

It has shifted the focus to prognostication, with increased attention being paid to the identification of morphological features and immunohistochemical markers of prognostic relevance.

Fine needle aspiration cytology (FNAC) of breast lumps is an important part of the triple assessment of the palpable breast lump - clinical

- radiological - pathological

It has reduced the number of open breast biopsies.

Very rarePainBleeding/hematoma: PressureInfection: Proper cleaningPneumothorax: Vasovagal reaction: Needle tract seeding? No

Is another method of 'tissue diagnosis‘ A more invasive procedure than FNA - involves making a small incision. -A large needle is passed through this

incision -several narrow samples of the tissue are

taken.

Ultrasound or mammographic guidance may be needed.

Is faster, less expensive than surgical biopsy.

Less tissue is removed resulting in no deformity or scaring.

CRITERIA Primary Tumor

–size–Cellularity–Invasive vs in situ–Margins

Axillary Lymph Nodes–Number of positive nodes–Size of metastases–Extranodal extension

Sup

MedLat

Inf

Ant

ant

sup

inf

Lymph Nodes

Sentinel lymph node

Axillary dissection

Therapeutic and Prognostic Markers

ESTROGEN RECEPTORS

PROGESTERON RECEPTORS

HER 2/Neu

Pathologists continue to play their traditional role in diagnosis.

Pathologists now have the additional role of identifying biomarkers responsive to therapeutic manipulation.

Playing an inextricable role as diagnostic oncologists in the management of breast cancer.