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Breast Pathology

A Subspecialty Of  Anatomic Pathology

About Breast Pathology

Stanford’s Breast Pathology offers a full range of evaluation and diagnosis for breast pathology. Our team of experts provide state-of-the-art diagnostic services focused on precise diagnoses of benign, atypical and malignant breast lesions.

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Our Services

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Our Faculty

Ancillary Testing

 

Stanford’s Breast Pathology Service specializes in interpreting and evaluating core needle breast biopsies, incisional and excisional biopsies, lumpectomy and mastectomy specimens, sentinel lymph nodes, axillary dissections, prophylactic and oncoplastic reduction mammoplasty, and neoadjuvant breast cases. Our services include:

 

Primary Pathology Diagnosis

All breast biopsies and surgeries taking place at Stanford Hospital undergo gross and microscopic pathology examination and reporting by the breast pathology service. We also accept wet tissue consult cases from clients outside of the Stanford system.

 

Consultative Opinions & Case Reviews

When a pathologist, clinician or patient not being treated at Stanford has a challenging breast pathology case, a specific question or just wants confirmation of the diagnosis, their pathology material can be sent for review to the Consult Service at Stanford Pathology and one of our breast pathologists will provide their consultative opinion on the case. This service includes assignment of a specialty pathology fellow to each case for individualized service, including call-backs with updates and final results.

The Stanford Breast Pathology Service sets high standards to ensure the most accurate diagnosis. Our faculty are involved in setting national and international standards in breast pathology including for the WHO, CAP, ASCO/CAP Testing Guidelines, International Collaboration on Cancer Reporting and AJCC Staging. In addition to having faculty with specialty expertise in breast pathology, some additional ways we ensure high quality, accurate breast pathology diagnoses including the following:

  • Careful correlation of the pathology findings with the available clinical and imaging findings, including digital X-ray evaluation of most surgical cases grossed at Stanford to ensure that all lesions are appropriately sampled.
  • Synoptic reporting for all primary diagnoses and breast cancer prognostic/predictive markers according to CAP/ASCO and Stanford guidelines.
  • Correlation of all ancillary tests with primary histology to ensure that the results are concordant and accurate. 
  • A policy requiring that two breast pathologists review all breast biopsies in which a diagnosis of atypical ductal hyperplasia or low grade ductal carcinoma in situ is being considered as the primary diagnosis in order to ensure diagnostic agreement on these challenging diagnoses.
  • Quality assurance policies on diagnostic agreement for breast cancers  and for ancillary testing (including for unusual HER2 FISH testing results and Low Positive ER results).
  • Turn-around time standards adhered to for the fastest, most accurate reporting consistent with optimal patient care.
  • In addition to many cases being reviewed by multiple members of the faculty, cases get multiple reviews by pathologists-in-training including resident and fellow-level trainees, with preliminary fellow-level “hot-seat” diagnoses available before final reporting.
  • Adherence to CAP guidelines for hormone receptor and HER2 testing, including proficiency testing by all faculty on the breast service.

Consult Cases

To submit slides for case review, please fill out a Stanford requisition and include all slides, relevant reports, and ancillary testing materials and reports. If possible, please include a block, as it will greatly speed the finalization of the case should additional testing be necessary. Package all materials securely and send via a padded envelope.

 

Wet Tissue Specimens

Please submit materials in proper transport media. All samples should be labeled with the patient information (name, DOB and one other unique identifier) and sealed in a biohazard bag. 

 

Samples and consult materials should be shipped or delivered via courier to:

 

Stanford Surgical Pathology – Consults:
Attn: Breast Pathology

300 Pasteur Drive, Room H2110
Stanford, CA 94305
Telephone: 650-723-7211
Fax: 650-725-7409

Stanford Surgical Pathology – Wet Tissue:
Attn: Breast Pathology

3375 Hillview Avenue
Palo Alto, CA 94304
Telephone: 650-723-7211
Fax: 650-725-7409

Breast Pathology Requisition

 

New Client Inquiries

To arrange to be set up as a new client, please contact:
ClinOpsContracts@stanfordhealthcare.org.

 

Contact Us

To submit a specimen to Stanford Breast Pathology, please complete a requisition and send with sample to:

 

Stanford Breast Pathology

300 Pasteur Drive, Room H2110
Stanford, CA 94305

Phone: 650-723-7211
Fax: (650) 725-7409

breastpathology@
stanfordhealthcare.org

Do not send patient info to this email.

Medical Director:
Kimberly Allison, MD

 

To arrange to be set up as a new client, please contact:
ClinOpsContracts@
stanfordhealthcare.org

 

Download Breast Pathology Requisition

SAMPLE SUBMISSION LOGISTICS
For more information on submitting cases, see the links below:

All Requisitions
Download Stanford Requisitions for specimen submission.

Account Set-up
Information on personalized requisitions, supplies, shipping and courier pick-up.

Pricing Inquiries
Pricing inquiries and contract information.

Billing
Billing policies, information and questions.

Results Web Portal
Request access or log-in to our client results portal.

Specimen Collection and Handling
Specifications for Specimen Collection and Handling.

Consult Service FAQ's
Get answers to Frequently Asked Questions.

Kimberly Allison, MD

Kimberly Allison, MD

APPOINTMENTS

  • Vice Chair of Education, Department of Pathology
  • Director of Breast Pathology Service and Breast Pathology Fellowship Program
  • Professor of Pathology

PRACTICE AREAS

  • Breast Pathology
  • Anatomic and Clinical Pathology

CONTACT

Email: allisonk@stanford.edu
Phone: (650) 723-7211

More information about Kimberly Allison:
https://med.stanford.edu/profiles/kimberly-allison
https://profiles.stanford.edu/kimberly-allison

Gregory Bean, MD, PhD

Gregory Bean, MD, PhD

APPOINTMENTS

  • Associate Professor of Pathology

PRACTICE AREAS

  • Anatomic Pathology
  • Breast Pathology

CONTACT

Email: beang@stanford.edu
Phone: (650) 723-7211

More information about Gregory Bean:
https://med.stanford.edu/profiles/gregory-bean
https://profiles.stanford.edu/gregory-bean

Richard K. Sibley, MD

Richard K. Sibley, MD

APPOINTMENTS

  • Emeritus Professor of Pathology

PRACTICE AREAS

  • Anatomic Pathology
  • Pathology

CONTACT

Email: Richard.Sibley@stanford.edu
Phone: (650) 723-8002

More information about Richard Sibley:
https://med.stanford.edu/profiles/richard-sibley
https://profiles.stanford.edu/richard-sibley

Megan Troxell, MD, PhD

Megan Troxell, MD, PhD

APPOINTMENTS

  • Professor of Pathology
  • Co-Director, Surgical Pathology 

PRACTICE AREAS

  • Anatomic Pathology
  • Breast Pathology
  • Renal Pathology
  • Genitourinary Pathology
  • Transplant Pathology

CONTACT

Phone: (650) 723-1410

More information about Megan Troxell:
https://med.stanford.edu/profiles/megan-troxell
https://profiles.stanford.edu/megan-troxell

Robert West, MD, PhD

Robert West, MD, PhD

APPOINTMENTS

  • Professor of Pathology
  • Co-Director, Immunopathology Laboratory

PRACTICE AREAS

  • Breast Cancer
  • Breast pathology
  • Anatomic Pathology
  • Pathology and Laboratory Medicine

CONTACT

Email: rbwest@stanford.edu
Phone: (650) 736-2664

More information about Robert West:
https://med.stanford.edu/profiles/robert-west
https://profiles.stanford.edu/robert-west

Ancillary Testing

Stanford Pathology relies on a suite of ancillary testing offerings to support our expert diagnosis. Learn more about these offerings:

 

Molecular Pathology

  • Selection by a breast pathologist of the most appropriate tissue block for requested send-out tests such as OncotypeDX.
  • The Stanford Molecular Diagnostic Laboratory also offers additional assays for the detection of potentially actionable mutations in cancer.
 

Cytogenetics/FISH

  • HER2 testing: HER2 testing performed by both immunohistochemistry and fluorescence in situ hybridization (FISH) on invasive breast cancers to assess the likelihood of benefit from HER2 targeted therapies.
 

Immunohistochemistry

Immunohistochemistry stains aid in diagnosis including: myoepithelial markers (invasion vs non-invasive lesions), histologic subtype markers, metastatic carcinoma markers, etc.

  • Hormone receptor testing: Estrogen and progesterone receptor testing on both ductal carcinoma in situ and invasive breast cancers to assess the phenotype, provide prognostic information and to provide advice on the likelihood of response to hormone-based drug therapies. Androgen receptor testing is also available on request.
  • HER2 testing: HER2 testing performed by both immunohistochemistry and brightfield dual in situ hybridization (DISH) or fluorescence in situ hybridization (FISH) on invasive breast cancers to assess the likelihood of benefit from HER2 targeted therapies.
  • Ki67: Provides an estimate of the proliferation index of invasive cancers.
Our Services

Stanford’s Breast Pathology Service specializes in interpreting and evaluating core needle breast biopsies, incisional and excisional biopsies, lumpectomy and mastectomy specimens, sentinel lymph nodes, axillary dissections, prophylactic and oncoplastic reduction mammoplasty, and neoadjuvant breast cases. Our services include:

 

Primary Pathology Diagnosis

All breast biopsies and surgeries taking place at Stanford Hospital undergo gross and microscopic pathology examination and reporting by the breast pathology service. We also accept wet tissue consult cases from clients outside of the Stanford system.

 

Consultative Opinions & Case Reviews

When a pathologist, clinician or patient not being treated at Stanford has a challenging breast pathology case, a specific question or just wants confirmation of the diagnosis, their pathology material can be sent for review to the Consult Service at Stanford Pathology and one of our breast pathologists will provide their consultative opinion on the case. This service includes assignment of a specialty pathology fellow to each case for individualized service, including call-backs with updates and final results.

The Stanford Breast Pathology Service sets high standards to ensure the most accurate diagnosis. Our faculty are involved in setting national and international standards in breast pathology including for the WHO, CAP, ASCO/CAP Testing Guidelines, International Collaboration on Cancer Reporting and AJCC Staging. In addition to having faculty with specialty expertise in breast pathology, some additional ways we ensure high quality, accurate breast pathology diagnoses including the following:

  • Careful correlation of the pathology findings with the available clinical and imaging findings, including digital X-ray evaluation of most surgical cases grossed at Stanford to ensure that all lesions are appropriately sampled.
  • Synoptic reporting for all primary diagnoses and breast cancer prognostic/predictive markers according to CAP/ASCO and Stanford guidelines.
  • Correlation of all ancillary tests with primary histology to ensure that the results are concordant and accurate. 
  • A policy requiring that two breast pathologists review all breast biopsies in which a diagnosis of atypical ductal hyperplasia or low grade ductal carcinoma in situ is being considered as the primary diagnosis in order to ensure diagnostic agreement on these challenging diagnoses.
  • Quality assurance policies on diagnostic agreement for breast cancers  and for ancillary testing (including for unusual HER2 FISH testing results and Low Positive ER results).
  • Turn-around time standards adhered to for the fastest, most accurate reporting consistent with optimal patient care.
  • In addition to many cases being reviewed by multiple members of the faculty, cases get multiple reviews by pathologists-in-training including resident and fellow-level trainees, with preliminary fellow-level “hot-seat” diagnoses available before final reporting.
  • Adherence to CAP guidelines for hormone receptor and HER2 testing, including proficiency testing by all faculty on the breast service.

close Our Services
Submit a Specimen

Consult Cases

To submit slides for case review, please fill out a Stanford requisition and include all slides, relevant reports, and ancillary testing materials and reports. If possible, please include a block, as it will greatly speed the finalization of the case should additional testing be necessary. Package all materials securely and send via a padded envelope.

 

Wet Tissue Specimens

Please submit materials in proper transport media. All samples should be labeled with the patient information (name, DOB and one other unique identifier) and sealed in a biohazard bag. 

 

Samples and consult materials should be shipped or delivered via courier to:

 

Stanford Surgical Pathology – Consults:
Attn: Breast Pathology

300 Pasteur Drive, Room H2110
Stanford, CA 94305
Telephone: 650-723-7211
Fax: 650-725-7409

Stanford Surgical Pathology – Wet Tissue:
Attn: Breast Pathology

3375 Hillview Avenue
Palo Alto, CA 94304
Telephone: 650-723-7211
Fax: 650-725-7409

Breast Pathology Requisition

 

New Client Inquiries

To arrange to be set up as a new client, please contact:
ClinOpsContracts@stanfordhealthcare.org.

 

Contact Us

To submit a specimen to Stanford Breast Pathology, please complete a requisition and send with sample to:

 

Stanford Breast Pathology

300 Pasteur Drive, Room H2110
Stanford, CA 94305

Phone: 650-723-7211
Fax: (650) 725-7409

breastpathology@
stanfordhealthcare.org

Do not send patient info to this email.

Medical Director:
Kimberly Allison, MD

 

To arrange to be set up as a new client, please contact:
ClinOpsContracts@
stanfordhealthcare.org

 

Download Breast Pathology Requisition

SAMPLE SUBMISSION LOGISTICS
For more information on submitting cases, see the links below:

All Requisitions
Download Stanford Requisitions for specimen submission.

Account Set-up
Information on personalized requisitions, supplies, shipping and courier pick-up.

Pricing Inquiries
Pricing inquiries and contract information.

Billing
Billing policies, information and questions.

Results Web Portal
Request access or log-in to our client results portal.

Specimen Collection and Handling
Specifications for Specimen Collection and Handling.

Consult Service FAQ's
Get answers to Frequently Asked Questions.


close Submit a Specimen
Our Faculty

Kimberly Allison, MD

Kimberly Allison, MD

APPOINTMENTS

  • Vice Chair of Education, Department of Pathology
  • Director of Breast Pathology Service and Breast Pathology Fellowship Program
  • Professor of Pathology

PRACTICE AREAS

  • Breast Pathology
  • Anatomic and Clinical Pathology

CONTACT

Email: allisonk@stanford.edu
Phone: (650) 723-7211

More information about Kimberly Allison:
https://med.stanford.edu/profiles/kimberly-allison
https://profiles.stanford.edu/kimberly-allison

Gregory Bean, MD, PhD

Gregory Bean, MD, PhD

APPOINTMENTS

  • Associate Professor of Pathology

PRACTICE AREAS

  • Anatomic Pathology
  • Breast Pathology

CONTACT

Email: beang@stanford.edu
Phone: (650) 723-7211

More information about Gregory Bean:
https://med.stanford.edu/profiles/gregory-bean
https://profiles.stanford.edu/gregory-bean

Richard K. Sibley, MD

Richard K. Sibley, MD

APPOINTMENTS

  • Emeritus Professor of Pathology

PRACTICE AREAS

  • Anatomic Pathology
  • Pathology

CONTACT

Email: Richard.Sibley@stanford.edu
Phone: (650) 723-8002

More information about Richard Sibley:
https://med.stanford.edu/profiles/richard-sibley
https://profiles.stanford.edu/richard-sibley

Megan Troxell, MD, PhD

Megan Troxell, MD, PhD

APPOINTMENTS

  • Professor of Pathology
  • Co-Director, Surgical Pathology 

PRACTICE AREAS

  • Anatomic Pathology
  • Breast Pathology
  • Renal Pathology
  • Genitourinary Pathology
  • Transplant Pathology

CONTACT

Phone: (650) 723-1410

More information about Megan Troxell:
https://med.stanford.edu/profiles/megan-troxell
https://profiles.stanford.edu/megan-troxell

Robert West, MD, PhD

Robert West, MD, PhD

APPOINTMENTS

  • Professor of Pathology
  • Co-Director, Immunopathology Laboratory

PRACTICE AREAS

  • Breast Cancer
  • Breast pathology
  • Anatomic Pathology
  • Pathology and Laboratory Medicine

CONTACT

Email: rbwest@stanford.edu
Phone: (650) 736-2664

More information about Robert West:
https://med.stanford.edu/profiles/robert-west
https://profiles.stanford.edu/robert-west


close Our Faculty
Ancillary Testing

Ancillary Testing

Stanford Pathology relies on a suite of ancillary testing offerings to support our expert diagnosis. Learn more about these offerings:

 

Molecular Pathology

  • Selection by a breast pathologist of the most appropriate tissue block for requested send-out tests such as OncotypeDX.
  • The Stanford Molecular Diagnostic Laboratory also offers additional assays for the detection of potentially actionable mutations in cancer.
 

Cytogenetics/FISH

  • HER2 testing: HER2 testing performed by both immunohistochemistry and fluorescence in situ hybridization (FISH) on invasive breast cancers to assess the likelihood of benefit from HER2 targeted therapies.
 

Immunohistochemistry

Immunohistochemistry stains aid in diagnosis including: myoepithelial markers (invasion vs non-invasive lesions), histologic subtype markers, metastatic carcinoma markers, etc.

  • Hormone receptor testing: Estrogen and progesterone receptor testing on both ductal carcinoma in situ and invasive breast cancers to assess the phenotype, provide prognostic information and to provide advice on the likelihood of response to hormone-based drug therapies. Androgen receptor testing is also available on request.
  • HER2 testing: HER2 testing performed by both immunohistochemistry and brightfield dual in situ hybridization (DISH) or fluorescence in situ hybridization (FISH) on invasive breast cancers to assess the likelihood of benefit from HER2 targeted therapies.
  • Ki67: Provides an estimate of the proliferation index of invasive cancers.

close Ancillary Testing

Residencies and Fellowships

Anatomic Pathology Residency Programs

Stanford Pathology offers a 3-year Anatomic Pathology residency and 4 year combination residencies in Anatomic Pathology/Clinical Pathology and Anatomic Pathology/Neuropathology.

 

Breast Pathology Fellowships

Stanford offers an ACGME-accredited Fellowship in Breast Pathology.

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