USCAP Perplexing Problems in Breast Pathology (and How to Solve them) 2020

This course is designed to eliminate a variety of practice gaps in diagnostic breast pathology. In general, there is a misdiagnosis rate of ~10% in breast biopsies. For some lesions which are notoriously problematic, the misdiagnosis rate is even higher.

Review of the literature and the faculty’s clinical experience as consultant breast pathologists have clearly documented areas in breast pathology that remain diagnostic problems even for experienced pathologists. These include the categorization of proliferative breast lesions, the classification of in situ lesions, papillary lesions, fibroepithelial lesions, spindle cell lesions, vascular lesions, the distinction between invasive and in situ lesions, and the proper classification of a variety of uncommon benign and malignant lesions. In addition, with the frequent use of core needle biopsy of non-palpable breast lesions, pathologists are often faced with the challenge of distinguishing these entities on small specimen samples.

This interactive microscopy course attempts to eliminate diagnostic error by highlighting pitfalls and the approaches to resolving them by using routine microscopic examination of H and E-stained sections and immunostains. The role of newer adjunctive molecular tests will also be discussed where appropriate.

Learning Objectives
– Upon completion of this educational activity, learners will be able to:
– Evaluate diagnostic criteria and clinical significance of various common and uncommon benign, in situ and malignant lesions of the breast in both core needle biopsy specimens and surgical specimens
– Describe the differential diagnostic problems encountered in breast pathology and develop strategies to resolve them in your practice environment
– Utilize the latest information on the uses and limitations of immunohistochemistry in resolving diagnostic problems in breast pathology