Disease Detectives
Pathologists work behind the scenes to ensure accurate diagnoses. BIDMC's Stuart Schnitt, MD, recently became president of the U.S. & Canadian Academy of Pathology. Here, he answers our questions about this vitally important field.
Q: What is the role of the pathologist?
A: Pathologists are physicians who have special training and expertise in diagnosing disease from tissue samples, blood samples and other body fluids. Here at BIDMC, pathologists examine approximately 50,000 tissue specimens, 50,000 cytology (cell) specimens and perform nearly 7 million laboratory tests each year.
Q: How does the pathologist fit in with the overall health care team?
A: Before a physician can begin to treat a patient, he or she must have as much information as possible about the specific disease the patient has, and how the disease might respond to various treatments. It is the responsibility of the pathologist to examine and interpret tissue samples and, when necessary, to conduct specialized tests to correctly identify the type of disease in order to help the physician develop the right treatment plan to ensure the best possible outcome. The experience and knowledge of the pathologist is critically important in this team effort. Clearly, if the pathologist does not correctly diagnose the disease, then the treatment may be incorrect and the patient outcome may be compromised.
Q: What lies ahead for pathology?
A: Pathologists are actively engaged in research efforts to enhance the accuracy and the thoroughness of tissue and laboratory diagnosis. The very concept of personalized medicine -- in which a treatment plan is tailored to meet the individual needs of each patient -- depends in large part upon the pathologist to analyze each patient sample and extract the maximum amount of information to help the treating physician select the most appropriate treatment plan for that one patient. We are now at the beginning of a revolution in individualized tissue diagnostics and pathologists are helping to lead the way in developing new, more comprehensive tests to produce the best possible clinical outcome.
Q: Your own research focuses on breast cancer. Can you summarize your work and where things stand today?
A: My own research has focused primarily on risk factors for local recurrence in patients with invasive breast cancer and ductal carcinoma in situ treated with breast-conserving therapy. I've also focused on the relationship between benign breast disease and breast cancer risk, and the role of the tumor microenvironment in breast tumor progression.
It is, however, important to understand that breast cancer is not a single disease. Rather the term "breast cancer" encompasses a group of diseases that differ from each other in several key aspects including their prognosis and their response to various treatments. The complexity and diversity of breast cancer is increasingly being recognized through the use of newer molecular and genetic techniques to analyze tumors. It is likely that through further molecular and genetic studies we will be able to identify new targets for both the treatment and prevention of breast cancers, and, in turn, provide a better and more individualized approach to patient management.
About Stuart Schnitt, MDDr. Stuart Schnitt, Director of Anatomic Pathology at Beth Israel Deaconess Medical Center (BIDMC) and an internationally recognized expert in breast cancer pathology, was inducted as president of the United States & Canadian Academy of Pathology (USCAP) on April 1. Learn more >> |
Posted April 2010
