Breast Pathology Fellowship
Introduction: This one-year fellowship is structured to provide comprehensive training in breast pathology with special emphasis on a multidisciplinary approach to diagnosis and management of breast diseases. The fellowship was initiated in 2011 along with the establishment of the Dubin Breast Center, a specialized breast cancer care center at The Mount Sinai Health System campus. Patients here receive personalized treatment by a well-integrated team of dedicated breast surgeons, plastic and reconstructive surgeons, breast imagers, medical oncologists, radiation oncologists, and breast pathologists.
The Division of Breast Pathology is comprised of 4 full time pathologists specializing in breast pathology. Under the leadership of Dr. Ira J. Bleiweiss, an internationally recognized breast pathologist, the division is committed to providing outstanding diagnostic services for excellent better patient care and to preparing the next generation of pathologists as experts in the challenging field of breast pathology. The Division receives approximately 9000 breast cases every year including 1000 new cancer cases, 5300 core biopsies, and approximately 700 cases from outside institutions for second opinions.
Requirements: Fellows must have completed at least three years of Anatomic Pathology residency or four years of combined Anatomic and Clinical Pathology residency (AP/CP) in an accredited program.
Number of appointments: One position is available each academic year.
Responsibilities: The goal of the breast pathology fellowship program is to provide in depth clinical, research and teaching experience in the field of breast pathology so that at the end of the year, the fellow has achieved expertise in this 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 and responsibilities to trainees as follows:
1) Review and signout of cases: The fellow will be responsible for reviewing and dictating the breast cases (including consults and referrals from outside institutions) and signing those cases out with the attending on a daily basis. This includes those breast cases which are not handled by the daily resident assigned to biopsy/gross signout.
2) Grossing: Depending on departmental service needs, the fellow will be on clinical service for up to 3 months and will be expected to gross breast cases during this period. The spectrum of cases is wide and includes lumpectomies, total mastectomies, needle-localized excisions, radiolabeled seed localized excisions, status post neoadjuvant therapy cases, nipple sparing mastectomies, and cases with multifocal and multicentric tumors.
3) Intraoperative consultations: During the entire year, the fellow will gain experience in intraoperative evaluation of sentinel lymph nodes (touch preps and frozen sections) and breast surgical specimens under close supervision of an attending.
4) Reporting of biomarkers: The fellow will gradually develop expertise in interpreting and scoring the IHC results of estrogen and progesterone receptors and HER-2/neu overexpression by signing out with the attending every day. He/she will also be trained in interpreting FISH results for HER-2/neu gene amplification and newer techniques including silver and chromogenic in-situ hybridization.
5) 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 the microscopic diagnosis whenever needed. He/she will get opportunity to render didactic lectures and moderate unknown slide conferences for house staff and medical students.
6) Multidisciplinary rotations: The fellow will have one week rotations in breast imaging, breast surgery, medical oncology and radiation oncology at Dubin Breast Center. This will give him/her an insight into the significant role of the integrated multidisciplinary approach in treating breast cancer and will provide him/her better understanding of clinical and management implications of pathologic diagnosis.
7) Multidisciplinary case conferences: The fellow will present the pathology findings at weekly multidisciplinary case management conference. This is an excellent opportunity to interact with clinical colleagues and strengthen their interpersonal communication skills.
8) Elective rotation: The fellow will be given an opportunity to rotate at his subspecialty of choice other than breast, within the department, if requested.
Research: Division of Breast Pathology is active in clinical, translational and collaborative research focused at understanding the biology and behavior of various types of breast cancers and associated high-risk lesions. Fellow is expected to participate in at least one clinico-pathological or translational research project during the year. He/she will be encouraged to present his/her work at any major breast pathology meeting and/or USCAP meeting.
Community: The Mount Sinai Health System is located in a beautiful residential neighborhood along the Upper East Side in Manhattan within one block walking distance of Central Park and many restaurants and attractions including the famous museum mile. Upper East
Stipends: Commensurate with the level of training.
Application: Application should be submitted before December 31st of the previous year and must include the curriculum vitae, personal statement, three letters of recommendation and copies of USMLE scores.
Dr. Anupma Nayak, MBBS, MD
Program Director, Breast Pathology Fellowship
Dr. Ira J. Bleiweiss, MD
Chief, Division of Breast Pathology
Director, Anatomic Pathology
Icahn School of Medicine
Department of Pathology Box 1194
One Gustave L. Levy Place
New York, NY 10029