This week was a bit busier than the last. I attended two Anatomic Pathology Resident Teaching conferences: Small Glandular Proliferations of the Breast and Papillary Lesions, both of which were presented by my clinician. Dr. Shin discussed why and how it was beneficial to learn from pattern specific instruction and how to correctly use immunohistochemistry if one was stuck on a particular case. She also discussed the difficulties in diagnosing or even identifying papillary lesions as they are complex and heterogenous, and do not follow stepwise progression of increasing change and "atypia."
Dr. Shin was on service this week, which mean that she sat the with the breast pathologist resident on call to go through cases. During my first session with them I almost had motion sickness looking through a multiple-ocular lens microscope that someone else was controlling and sliding numerous histological slides under; thank goodness I quickly got used to it, else I would not have been able to sit in any of the other sessions! I also observed the breast pathologist resident on call gross a few breast tissue samples. One sample was a mastectomy specimen with invasive carcinoma and numerous calcification nodules - I was able to palpate the both to understand their different textures (sites of calcification are more granular/gritty). After cutting samples from the cancer and calcification sites, the resident also took representative cuts from the four quadrants of the breast (upper outer quadrant (UOQ), lower outer quadrant (LOQ), lower inner quadrant (LIQ), and upper inner quadrant (UIQ)). After obtaining all her samples, she would let them fix before sending them to the next point in the assembly (embed in paraffin, slice, stain, etc) for immunohistochemistry.
Other than working on the Breast Tumor database, I've also been working on one of my research projects to extract cases in which patients have had needle core biopsy (NCB) samples test positive for lobular carcinoma in-situ (LCIS). I would also take note if they had a subsequent excision and if that excision remained positive for LCIS or had upgraded to an invasive carcinoma. I've been going through the cases year by year so its been slow going, but its been moving along smoothly - just finished 2011 today! This study would aid clinicians in understanding whether LCIS is a precursor to invasive carcinoma and how to proceed with treating their patients (excising the tissue containing the LCIS).
Happy independence week all! :)
Dr. Shin was on service this week, which mean that she sat the with the breast pathologist resident on call to go through cases. During my first session with them I almost had motion sickness looking through a multiple-ocular lens microscope that someone else was controlling and sliding numerous histological slides under; thank goodness I quickly got used to it, else I would not have been able to sit in any of the other sessions! I also observed the breast pathologist resident on call gross a few breast tissue samples. One sample was a mastectomy specimen with invasive carcinoma and numerous calcification nodules - I was able to palpate the both to understand their different textures (sites of calcification are more granular/gritty). After cutting samples from the cancer and calcification sites, the resident also took representative cuts from the four quadrants of the breast (upper outer quadrant (UOQ), lower outer quadrant (LOQ), lower inner quadrant (LIQ), and upper inner quadrant (UIQ)). After obtaining all her samples, she would let them fix before sending them to the next point in the assembly (embed in paraffin, slice, stain, etc) for immunohistochemistry.
Other than working on the Breast Tumor database, I've also been working on one of my research projects to extract cases in which patients have had needle core biopsy (NCB) samples test positive for lobular carcinoma in-situ (LCIS). I would also take note if they had a subsequent excision and if that excision remained positive for LCIS or had upgraded to an invasive carcinoma. I've been going through the cases year by year so its been slow going, but its been moving along smoothly - just finished 2011 today! This study would aid clinicians in understanding whether LCIS is a precursor to invasive carcinoma and how to proceed with treating their patients (excising the tissue containing the LCIS).
Happy independence week all! :)
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