Histopathology

The histopathologists from Davies Campbell de Lambert Pathology, led by Dr Julie Burn, have provided diagnostic services to The Strathfield Breast Centre since 1989. The pathology service is closely integrated with the clinical services and provides an important consultative role in the management of breast cancer patients. Dr Burn participates in Breastscreen NSW (Western).

Role

The histopathologists have developed expertise in the interpretation of breast cytology, and biopsy and mastectomy specimens.

In addition to determining if cancer is present in breast biopsy specimens, the pathologist evaluates a number of prognostic factors that will be used to guide therapy. These factors include size and special characteristics of the tumor, extension into surrounding breast tissue, and spread to the lymph nodes.

Ancillary studies that are important in predicting which therapies will be most successful for treating each individual tumor are also performed for invasive cancers. These include:

• Expression of oestrogen and progesterone receptors, studied by Immunohistochemistry to predict the tumor’s likely response to antihormonal therapies.
• HER2/neu status can be assessed. The HER2/neu gene is amplified in 15-30% of breast cancers. The status of HER2/neu is assessed by immunohistochemistry and equivocal (2+) results are further tested by FISH.

Activities

Pathology Concensus Meetings: All pathologists review diagnostically difficult cases on a daily basis.

Breast Clinic Multidisciplinary Meetings: The pathologists review the breast pathology for all patients seen at the clinic and update clinicians on pertinent breast pathology–related issues.

We attend for intraoperative frozen section diagnosis, to assist surgeons determine the best treatment options at the time of surgery.

We collaborate closely with the clinical service in research projects.