The main focus of TissuPath's Division of Breast Pathology is the accurate diagnosis of breast cancers. TissuPath pathology reports indicate the type of tumour and the features of it which are important in determining how the tumour is likely to behave and to respond to different therapies.

There are many varieties of breast cancer, and the prognosis to a considerable extent depends on the variety – hence the need for accurate diagnosis by a breast pathologist.

Perhaps more importantly, the response of each individual breast cancer to certain types of chemotherapy depends on whether the tumour cells express particular proteins (oestrogen and progesterone receptors) or whether the cells show "amplification" (an increase in number) of the Her-2/neu gene.

Pathologists in TissuPath's Division of Breast Pathology work closely with breast surgeons, radiologists and ultrasonographers to accurately diagnose and categorize breast biopsies or surgically-removed breast cancers, to ensure that you as a patient receive the best care.

Some breast masses will first undergo Fine Needle Aspiration (FNA) and the material obtained will be examined with a microscope (cytopathological examination. If this examination is indeterminate, a biopsy will usually be performed and referred for histopathological review (see What is Histopathology.

With routine staining procedures TissuPath pathologists can determine whether or not breast cancer is present, and the variety of cancer.

Critical to prognosis and therapy is whether the breast cancer expresses proteins which bind certain female hormones, estrogen or progesterone receptors to determine whether the cancer expresses these receptors TissuPath pathologists "stain" the specimen with antibodies to these receptors using Immunohistochemistry.

The other factor critical to prognosis and response to a specific treatment is whether or not the tumor shows amplification of the Her-2/neu gene. Although amplification of this gene is an adverse prognostic factor by itself, it also confers responsiveness to a group of very effective and unique "targeted" therapeutics, including trastuzumab (Herceptin®). In collaboration with our cytogeneticists, TissuPath pathologists use primarily Chromogenic in situ Hybridization (CISH). to determine whether or not the breast cancer shows Her-2/neu amplification, although some cases also require FISH testing.