Program Goals

The goal of the breast pathology fellowship program is to provide in depth clinical, research and teaching experience in the field of breast and gynecologic pathology so that at the end of the year, the fellow has achieved expertise in the field and is prepared to practice independently in either an academic or community hospital setting. This goal will be accomplished by offering a well-structured curriculum with responsibilities for trainees as follows:

1. Review and signout of breast and gynecologic cases: The fellow will be assigned to either the breast or gynecologic service on alternating weeks, and will be responsible for reviewing and dictating the breast or gynecologic cases (including consults and referrals from outside institutions) and signing out those cases with an attending breast or gynecologic pathologist on a daily basis.  This includes those breast and gynecologic cases which are not handled by the daily resident assigned to biopsy/gross signout.
2. Intraoperative gross consultations: The fellow will participate in the evaluation of all breast and gynecologic surgical specimens submitted for intraoperative gross assessment under the supervision of an attending breast or gynecologic pathologist.
3. Reporting of biomarkers: The fellow will gradually develop expertise in interpreting and scoring the immunohistochemistry (IHC) results of estrogen and progesterone receptors and HER-2/neu overexpression by reviewing the IHC slides independently and signing out with the attending breast pathologist. He/she will also be trained in interpreting FISH results for HER-2/neu gene amplification.The fellow will gradually develop expertise in interpreting IHC results of mismatch repair proteins and PD-L1 testing by reviewing the IHC slides independently and signing out with the attending gynecologic pathologist.
4. Teach and supervise residents: The fellow will have an active role in teaching and supervising residents in the grossing room and will assist them in formulating gross and microscopic diagnoses when needed. He/she will prepare and give didactic lectures and unknown slide conferences for house staff and medical students when needed.
5. Multidisciplinary rotations: The fellow will have opportunities for one week rotations in breast imaging, breast surgery, medical oncology and radiation oncology at the Comprehensive Breast Care Center at our Wilmot Cancer Institute. This will give the fellow insight into the significant role of the integrated multidisciplinary approach in treating breast cancer and will provide him/her with a better understanding of the clinical and management implications of pathologic diagnoses. Rotations with gynecologic oncologic surgeons are also an option, in order to gain a better understanding of the clinical and management implications of gynecologic pathologic diagnoses.
6. Multidisciplinary case conferences: The fellow will present the pathology findings at the weekly multidisciplinary case management conferences. This is an excellent opportunity to interact with clinical colleagues and strengthen interpersonal communication skills.
7. Elective rotation: The fellow will be given an opportunity to rotate in a second subspecialty of his/her choice within the department, if requested.