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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.