The Breast Pathology program specializes in interpreting and evaluating core needle breast biopsies, incisional and excisional biopsies, lumpectomy or partial and total mastectomy specimens, sentinel lymph nodes, axillary dissections, prophylactic and oncoplastic reduction mammoplasty, and neoadjuvant breast cases. The faculty is board-certified in anatomic pathology and many of the pathologists also have subspecialty expertise in breast pathology. We provide state-of-the-art diagnostic services focused on precise diagnoses of both benign and malignant breast diseases. In cases with malignant diagnosis, additional ancillary studies for receptors are reported with two- to three-day turnaround times. We work closely with our clinical team to ensure that our patients get accurate and reliable results that are critical to patient care. The first question a breast pathologist seeks to answer when reading a breast biopsy is whether cancer is present. But the information included in the pathology report goes far beyond the “yes” or “no” diagnosis. Even if the biopsy is benign, we need to ensure that the calcifications seen on imaging correlate with calcifications seen on the core biopsy pathology specimen. The earliest stage of breast cancer, called ductal carcinoma in situ (DCIS), is usually detected in this manner. Discordance between pathology and imaging is addressed by means of communication between the radiologist and pathologist in a radiology-pathology conference or by individual communication. A pathology report always has a detailed visual morphologic description of the tumor. The initial biopsy report includes information on whether the cancer is confined within the ducts (in situ carcinoma) or has breached the duct wall and invaded into the adjacent stroma (invasive carcinoma). We provide intraoperative consultation on sentinel lymph nodes in the frozen section suite to detect metastases, which will then help the surgeon in planning patient management. Additional details will be studied and added to the pathological report after mastectomy and sentinel node biopsy to determine whether the cancer has metastasized or spread to any lymph nodes. Tumor size, histologic grade, and lymph node status are prognostic indicators that provide valuable information about the likely clinical outcome. For example, a patient whose tumor is well-differentiated and has negative margins, i.e., has clear margins, has a better prognosis than a patient whose tumor is one that is poorly differentiated and is present at the margin.

The Center for Breast Cancer at Smilow Cancer Hospital and Yale Cancer Center provides coordinated, state-of-the-art care for patients with benign and malignant diseases of the breast. For patients diagnosed with breast cancer , we offer dedicated care, innovative treatment options, and cutting-edge research. A great deal of progress in the detection and treatment of breast cancer has been made in recent years, and our physicians are on the leading edge of finding even better solutions. Women with a diagnosis of breast cancer are cared for by a multidisciplinary team of physician specialists, including radiologists, breast surgeons, medical oncologists, radiation oncologists, pathologists, and plastic surgeons. From the tranquility of the building, to our complementary therapy services, to the most sophisticated personalized therapies and equipment available, Yale is committed to tailoring treatment to our patients to ensure they have the best experiences possible during their time in our care. Breast Surgery Although many general surgeons perform breast surgery, dedicated breast surgeons have the experience and knowledge to handle difficult or unusual cases, and are generally more likely to understand the complexities of breast diagnosis and treatment. The surgeons at the Center for Breast Cancer at Smilow Cancer Hospital and Yale Cancer Center perform breast surgery exclusively, and are nationally known as leaders in their field. Yale surgeons were among the first to perform a lumpectomy instead of a mastectomy, and were instrumental in the development of noninvasive procedures like sentinel lymph node biopsy, intraoperative guidance by ultrasound, and advanced oncoplastic procedures. Our surgeons are experienced in cutting-edge techniques, such as skin-sparing and nipple-sparing mastectomy, and often work hand-in-hand with our plastic surgeons to offer women a variety of options for breast reconstruction. Medical Oncology Many patients with breast cancer also need medical therapy, such as chemotherapy and/or endocrine therapy. Our team of experts utilizes both standard chemotherapies and novel targeted therapies to attack the cancer precisely while minimizing harm to normal tissues. Our medical oncologists are nationally recognized for their contributions to breast cancer research. For example, investigators at Yale helped to elucidate the biology of a cellular receptor called HER2. As a result, our medical oncologists have been successful in developing treatment strategies for HER2-positive breast cancer, and have extended this expertise to provide effective therapies for triple-negative/basal-like and hormone receptor-positive breast cancer. They continue to study new treatments, and patients at Smilow Cancer Hospital have the opportunity to receive such novel therapies through clinical trials, many of which are not available elsewhere in Connecticut. New and complicated patient cases are discussed weekly by the entire team so that