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Non-Invasive Nightmares in Breast Pathology

Evaluated by: David B. Kaminsky, M.D., FIAC, October 21, 2017
Original release date: January 5, 2018
Access to this course expires on: October 21, 2020, at 11:59 PM Pacific Time

Course Description
Non-invasive lesions of the breast frequently present diagnostic difficulties for pathologists in their daily practice. Intraductal lesions per se are often challenging to distinguish amongst those which are benign, atypical or carcinoma in situ. Furthermore, non-invasive lesions (either benign or in situ carcinomas) may mimic invasive carcinomas, and vice versa. This course will include both common as well as less frequently seen non-invasive breast lesions which pathologists and pathologists in training would encounter in their breast pathology practice, and will provide diagnostic strategies useful in recognizing and distinguishing these potentially hazardous cases.

Target Audience
Practicing academic and community pathologists, and pathologists-in-training

Learning Objectives
Upon completion of this educational activity, learners will be able to:  
  • Discuss immunophenotype and molecular alterations of papillary carcinoma
  • Understand the clinical implications of a diagnosis of encapsulated papillary carcinoma
  • Recognize lobular immunophenotype and the diagnostic pitfalls in E-cadherin immunohistochemistry 
  • Discuss the clinical significance and management of LCIS
  • Discuss the clinical significance and management of cribriform breast lesions
  • Understand the characteristic histologic and immunophenotypic features of cribriform breast lesions
  • Understand the uses and limitations of CK 5/6 immunohistochemistry for proliferative ductal lesions
  • Discuss the clinicopathologic features of solid papillary carcinoma
  • Recognize the morphologic features of flat epithelial atypia
  • Understand the pathologic features and genetics of columnar cell lesions
  • Understand the morphologic spectrum of sclerosing lesions of the breast and how they may mimic carcinoma
  • Discuss the use of immunohistochemistry in the diagnosis of microglandular adenosis

Continuing Medical Education and Maintenance of Certification
The United States and Canadian Academy of Pathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The United States and Canadian Academy of Pathology designates this enduring material for a maximum of 3  AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

USCAP is approved by the American Board of Pathology (ABPath) to offer Self-Assessment credits (SAMs) and Lifelong Learning (Part II) credit for the purpose of meeting the ABPath requirements for Continuing Certification (CC). Registrants must take and pass the post-test in order to claim SAMs credit.

Physicians can earn a maximum of 3 SAM/Part II credit hours.

The faculty, committee members, and staff who are in position to control the content of this activity are required to disclose to USCAP and to learners any relevant financial relationship(s) of the individual or spouse/partner that have occurred within the last 12 months with any commercial interest(s) whose products or services are related to the CME content. USCAP has reviewed all disclosures and resolved or managed all identified conflicts of interest, as applicable.

The following faculty reported no relevant financial relationships: Timothy W. Jacobs, MD, Yunn-Yi Chen, MD, PhD.  

USCAP staff associated with the development of content for this activity reported no relevant financial relationships.

To earn CME and SAM credit, all learners must take a content-based exam and achieve a minimum score of 80%. If learners do not achieve a passing score of 80%, they have the option to retake the exam. After you pass the test and complete the evaluation, your certificate of completion will be available to view and print by clicking here.

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