MD, PhD
Associate Professor, Pathology and Laboratory Medicine
Director, Breast Pathology
Director, Anatomic and Surgical Pathology
UNC-Chapel Hill
Breast Cancer
Area of Interest
The broad category of benign breast disease or benign breast disorders (BBD) contains a variety of proliferative and non-proliferative lesions with different clinical and breast cancer risk implications. The best risk estimates for histologically defined risk-associated lesions come from case-control studies that are primarily based primarily open biopsies from the pre-mammographic era. Approximately 1.7 million women undergo breast biopsy annually in the United States and approximately 25-30% of breast cancers diagnosed in the Unites States develop in women with a history of a breast biopsy or BBD. Many of my projects and publications focus on BBD detected by breast cancer screening and diagnosed in core needle biopsy specimens. The risk-associated lesions we have studied include atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS) and radial scars. The studies are multidisciplinary in design, emphasizing central pathology review, correlation with radiologic findings and determining outcomes for patients who do or do not undergo immediate surgical excision. For various histologically defined entities, we have examined two aspects of breast cancer risk: 1) the risk of an immediate upgrade to carcinoma in an initial diagnostic excisional biopsy, and 2) the subsequent risk of developing carcinoma in either breast for patients who are not upgraded on excision. In our initial results, the breast cancer risk associated with ADH, ALH and LCIS and the clinicopathologic features of subsequent breast cancers appear to be similar to what has been reported in the larger case-control studies. To extend these findings we would like to do larger studies with comparison to a control population and begin to develop tissue-based biomarkers for individualized risk assessment.
Awards and Honors
- Chief Resident, Clinical Pathology, Yale-New Haven Hospital, 2003
- Chief Resident, Anatomic Pathology, Yale-New Haven Hospital, 2002
- Dr. Halina Goldstein Award for Excellence in Autopsy Pathology, Department of Pathology, Yale School of Medicine, 2000
- Ph.D., with Distinction, Medical College of Georgia, 1999
- Graduation with High Honors, University of Georgia Honors Program, 1992
- Phi Beta Kappa, University of Georgia, 1992
- Magna cum laude, University of Georgia, 1992
- Alumni Foundation Scholarship, University of Georgia, 1988
