University of Florida College of Medicine, USA
Keynote: Surgery Curr Res
During the last several years, increased public awareness, advances in breast imaging and enhanced screening programs have led to early breast cancer detection and attention to cancer prevention. The numbers of image-detected biopsies have increased and pathologists are expected to provide more information with smaller tissue samples. These biopsies have resulted in detection of increasing numbers of high-risk proliferative breast diseases and in situ cancers. The general hypothesis is that some forms of breast cancers may arise from established forms of ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) and possibly from more common forms of ductal hyperplasia. However, this is an oversimplification of a very complex process, given the fact that the majority of breast cancers appears to arise de-novo or from a yet unknown precursor lesion. Currently, ADH and DCIS are considered as morphologic risk factors and precursor lesions for breast cancer. However, morphologic distinction between these two entities has remained a real issue that continues to lead to over diagnosis and over treatment. Aside from morphologic similarities between ADH and low grade DCIS, biomarker studies and molecular genetic testing‚??s have shown that morphologic overlaps are reflected at the molecular levels and raise questions about the validity of separating these two entities. It is hoped that as we better understand the genetic basis of these entities in relation to ultimate patient outcome, the suggested use of the term of ‚??Borderline Breast Disease‚?Ě can minimize the number of patients who are subject to overtreatment.
Shahla Masood is currently a Professor and Chair of the Department of Pathology at University of Florida College of Medicine, Jacksonville and Chief of Pathology and Laboratory Medicine at Shands Jacksonville. She is also the Director of the Pathology Residency Training Program, as well as Cytopathology and Breast Pathology Fellowship Training Program. In addition, she is the Medical Director of Shands Jacksonville Breast Health Center. As an internationally recognized expert in breast cancer diagnosis and prognosis, she has fostered the concept of an integrated multidisciplinary approach in breast cancer care, research and education. She has recently been appointed to chair a committee of the National Accreditation Program for Breast Centers (NAPBC) with a new initiative to explore the possibility of expansion of this program to an international level.
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