Stuart J. Schnitt MD, Beth Israel Deaconess Medical Center, Boston, MA
Jennifer L. Hunt MD, University of Arkansas for Medical Sciences, Little Rock, AK
Molecular assays using a variety of techniques are currently being utilized to refine the classification of breast cancer, to assess prognosis in patients with breast cancer, and to obtain a better understanding of breast tumorigenesis and breast cancer progression. Integrating information obtained from these molecular assays with traditional pathologic assessment of breast lesions is becoming increasingly important. However, making this integration clinically relevant and useful requires that pathologists have an appreciation for the uses, techniques, and limitations of the molecular assays. A better understanding of the basics of these molecular techniques will be of value for any pathologist in current clinical practice since these assays are being used increasingly.
The goal of this course is to provide practicing pathologists and pathologists in training with 1) an understanding of the increasingly important role of various molecular assay methods in the analysis of breast lesions and 2) an appreciation of the key technical and interpretive uses and limitations of these molecular assays. Using a case-based presentation format, a clinical issue or problem in breast pathology will be presented and the corresponding molecular assay will be discussed. The molecular component will include a discussion of the basics of the technique and its application to the particular problem illustrated by the case. The cases, clinical issues, and corresponding molecular techniques to be presented are shown below:
|Case|| Clinical Issue/Morphologic Discussion|| Corresponding Molecular Technique/Discussion|
|1|| Specimen mix-up|| DNA fingerprinting/specimen identity|
|2|| Molecular classification of breast cancer|| Gene expression profiling|
|3|| BRCA1-associated breast cancer|| Mutation analysis/sequencing|
|4|| Pleomorphic LCIS and other non-classical variants of LCIS|| Array based comparative genomic hybridization (aCGH)|
|5|| Low and high grade breast neoplasia pathways|| Loss of heterozygosity (LOH)|
|6|| Molecular prognostic factors/Oncotype DX|| Reverse transcriptase polymerase chain reaction (RT-PCR)|
Case histories and images will be available on the USCAP website for review by registrants prior to the course. A syllabus will be distributed to registrants at the meeting. After the meeting, all participants will receive web access to the PowerPoint presentation given at the USCAP Annual Meeting along with the text portion of the syllabus. Upon completion of this educational activity, participants should be able to: 1) Identify cases in routine clinical surgical pathology practice where there is an increasingly important role for molecular assays in the evaluation of breast lesions; 2) Integrate results obtained from molecular assays with those derived from traditional methods for diagnosis of breast lesions; and 3) Identify technical limitations of commonly used molecular assay methods.
(LAST SCHEDULED PRESENTATION)