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Pathologists Have Difficult Task of Properly Diagnosing Breast Cancer


SPRINGFIELD, Mass. (WGGB) — More than 200,000 women are diagnosed with breast cancer every year, but few come face-to-face with the person who actually makes the diagnosis.

When you’re the doctor analyzing tissue samples from biopsies and advising other doctors how to proceed, guesswork is pretty much out of the question.

“In baseball, if you’re hitting .400, that means you’re getting on base four out of ten times. We have to get on base 100 percent of the time. We have to be right because so much weighs upon the diagnosis we render,” says Dr. Christopher Otis, director of surgical pathology at Baystate Medical Center.

But a pathologist’s job goes well beyond determining whether or not a patient has a tumor, because there are hundreds of types, including many specific to breast cancer.

Dr. Giovanna Crisi, a pathologist at Baystate Medical Center, adds “We call them Luminal A, Luminal B, HER-2 positive and triple negative tumors and then the basil-like tumors, so we have five different types of tumors that we can identify, based on the genetic and molecular changes they have.”

Once pathologists make a diagnosis, they then help surgeons, radiologists, clinicians and patients determine personalized treatment plans based on their tumor’s characteristics.

For the most part, doctors and patients lean toward less-invasive surgery.

“The surgery now is very conservative. The big thing is conservative surgery these days and it depends a lot on the type of tumor, also the age of the patient, and the other risk factors of the patient, family history,” Crisi notes.

Otis says, “The cancer treatment is found in multiple different places and it’s different in another person who has the same breast cancer as it appears under a microscope.”

Dr. Otis says he rarely comes face-to-face with his patients, but he hopes the role of the pathologist will some day evolve and extend his responsibilities further.

“One of the things we rely on is our clinical colleagues to explain the diagnosis to the patient, and, quite frankly, some of us in pathology are probably better equip to know about the intricacies of that diagnosis. So I think that in the future, pathologists are going to become more visible to the general public,” Otis explains.

Baystate and the Rays of Hope Foundation are holding their 20th annual breast cancer awareness walk this Sunday, October 20, in Springfield and Greenfield.

You can CLICK HERE for more information on this weekend’s events.

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