Common Errors in Breast Pathology and How to Avoid Them

The purpose of this presentation is to highlight, in a case-based format, four important scenarios all pathologists who routinely examine breast specimens should be aware of to avoid common pitfalls in the histopathologic diagnosis and biomarker interpretation of suspected breast cancers and their mimics.

Lecture Presenter
Susan C. Lester, MD, PhD
Susan C. Lester, MD, PhD
Senior Consultant, Brigham and Women's Hospital, Department of Pathology and Dana Farber Cancer Institute
Assistant Professor of Pathology, Harvard Medical School

Dr. Lester received her PhD in genetics at the University of Wisconsin and her MD from Harvard Medical School. She trained in pathology at Brigham and Women’s Hospital in Boston and was the Chief of Breast Pathology Services for over 20 years. She has served on committees for the College of American Pathology, the American Joint Committee on Cancer, and the World Health Organization. She was the chairperson of the CAP breast cancer review panel during the development of the first standardized reporting protocol for DCIS as well as a major revision of the invasive cancer protocol. Dr. Lester is well known for writing the Manual of Surgical Pathology, as well as co-writing Diagnostic Pathology: Breast with Dr. David Hicks, and being the lead writer of Diagnostic Pathology: Intraoperative Consultation (both included in ExpertPath and PathPrimer). She has also written numerous chapters including the Breast Chapter for Robbins and Cotran Pathologic Basis of Disease and Robbins Basic Pathology. She has a major interest in pathologic/radiologic correlation and has published widely in this area. A current area of interest is developing open access internet pathology teaching education tailored for pathologists in countries with limited resources.

Objectives

After this presentation, participants will be able to:

Recognize the most common benign histologic mimics of invasive breast carcinoma and apply appropriate immunohistochemical stains to distinguish between these lesions
Identify the scenarios and factors most commonly associated with the rendering of false negative ER and false positive HER2 results in breast cancers
Devise practices to avoid misdiagnosis of breast cancers as neuroendocrine carcinomas