—  SPECIALTY CONFERENCE  — Breast Pathology Tuesday, March 23, 7:30 PM Salon 1 and Balconies Uses and Limitations of Adjunctive Studies for Solving Problems In Breast Pathology Moderator: STUART J. SCHNITT Beth Israel Deaconess Medical Center Boston, MA Disclosure: In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Symposium) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. The speakers listed below have indicated they have nothing to disclose. Panelists: CAROL A. REYNOLDS, Mayo Clinic, Rochester, MN TIMOTHY W. JACOBS, Virginia Mason Medical Center, Seattle, WA SANDRA J. SHIN, Weill Cornell, Medical Center, New York, NY IAN O. ELLIS, City Hospital, NHS Trust, Nottingham, UK GELAREH FARSHID, BreastScreen South Australia & South Australian Pathology, Adelaide, South Australia Clinical histories are displayed below. For the fastest viewing of virtual slides, click: under each thumbnail image below. You must have Aperio ImageScope installed on your PC. If you do not already have Aperio ImageScope, Windows users with administrator privileges may download and install a free version in order to view USCAP Virtual Slides. Click the icon on the right to get your free copy:   Or, click on slide thumbnail images to view each slide in a Web-based slide viewer, which is somewhat slower. If you have any difficulties viewing these slides, email or call George Clay at +1.724.449.1137. Case 1 Submitted by: Carol A. Reynolds - Mayo Clinic, Rochester, MN Clinical Summary: 55 year old woman with a small nodule noted by ultrasound in the left breast. Ultrasound-guided core needle biopsy performed. Case 1 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 1 - Figure 1 Case 1 - Figure 2 Case 1 - Figure 3 Case 1 - Figure 4 Case 2 Submitted by: Timothy W. Jacobs - Virginia Mason Medical Center, Seattle, WA Clinical Summary: A 39 year old woman underwent prophylactic mastectomy. The nipple was unremarkable clinically, as well as on gross pathologic examination. Images are from a routine section of the nipple. Case 2 - Figure 1 Case 2 - Figure 2 Case 2 - Figure 3 Case 2 - Figure 4 Case 2 - Figure 5 Case 2 - Figure 6 Case 2 - Figure 7 Case 2 - Figure 8 Cytokeratin 7 Case 3 Submitted by: Sandra J. Shin - Weill Cornell Medical Center, New York, NY Clinical History: 51 year-old female with new onset 2.5 cm retroareolar mass. Needle core biopsy is performed. Case 3 - Figure 1 Case 3 - Figure 2 Case 3 - Figure 3 Case 3 - Figure 4 Case 3 - Figure 5 Case 4 Submitted by: Ian O. Ellis - City Hospital, NHS Trust, Nottingham, UK Clinical Summary: An 83 year old woman who presented symptomatically with a lump in her left breast. Clinical examination showed a small illdefined lump in the upper outer quadrant. Imaging with ultrasound and mammography showed an partly circumscrbed mass lesion. An ultrsound guided needle core biopsy was taken. Case 4 - Figure 1 Case 4 - Figure 2 Case 4 - Figure 3 Case 4 - Figure 4 Case 4 - Figure 5 Case 4 - Figure 6 Case 4 - Figure 7 Case 5 Submitted by: Gelareh Farshid - BreastScreen South Australia & South Australian Pathology, Adelaide, South Australia Clinical Summary: A 54 year old women presented with an inoperable 10.5cm mass in the left breast. Core biopsy showed an infiltrating ductal carcinoma, ER+ve, PR +ve, HER2 not amplified. Staging investigations were clear. She was treated with neoadjuvant chemotherapy, an aromatase inhibitor and radiation therapy. Proceeded to mastectomy, axillary clearance and a TRAM reconstruction. She made an uneventful recovery with a good cosmetic result. Pertinent Laboratory Data: No discrete mass found on gross inspection. An ill defined, diffusely edematous region with prominent ducts,140x70x25mm, merges with the central breast disc. The axillary clearance specimen showed very small lymph nodes, largest 5mm. Case 5 - Figure 1 Case 5 - Figure 2 Case 5 - Figure 3 Case 5 - Figure 4 Case 5 - Figure 5 Case 5 - Figure 6 Handouts for all Specialty Conferences will be accessible via the "Educational Materials" section on the homepage the morning after each respective conference. Printed copies of the handout will not be available at the meeting.