Day 1 :
University of Florida College of Medicine – Jacksonville, USA
Time : 10.00AM
Shahla Masood is currently a Professor and Chair of the Department of Pathology at University of Florida College of Medicine, Jacksonville and Chief of Pathology and Laboratory Medicine at Shands Jacksonville. She is also the Director of the Pathology Residency Training Program, as well as Cytopathology and Breast Pathology Fellowship Training Program. In addition, she is the Medical Director of Shands Jacksonville Breast Health Center. An internationally recognized expert in breast cancer diagnosis and prognosis, she has fostered the concept of an integrated multidisciplinary approach in breast cancer care, research and education. She has recently been appointed to chair a committee of the National Accreditation Program for Breast Centers (NAPBC) with a new initiative to explore the possibility of expansion of this program to an international level.
During the last several years, the discipline of cytopathology has played a major role in responding to the changing trends in breast health care. Pathologists have been engaged not only in interpreting but also in performing minimally invasive procedures. These procedures have proved efficient in the diagnoses of benign and malignant breast disease and are reliable in providing prognostic/predictive information. Fine needle aspiration biopsy is a time challenged, convenient, cost effective and rapid procedure, which is designed to remove the anxiety of a patient with a benign breast disease. With the availability of the bedside interpretation, the diagnosis of malignancy can accelerate plans for an optimal therapy. Core needle biopsy is more time consuming, more invasive and more expensive. It also shares similar limitations with FNAB. Sampling errors associated with inherent heterogeneity of breast lesions are serious concerns. In CNB, the rate of discovering carcinoma in situ in the follow up surgical excision of a lesion previously diagnosed as atypical ductal hyperplasia is significant. In addition, it is not unusual to discover invasive lesions in lumpectomy or mastectomy specimens diagnosed as in situ lesions by CNB. Despite the credibility of breast FNAB and CNB, the choice of the procedure will ultimately depend on local practice considerations and the availability of an experienced pathologist interested in breast cytopathology. The National Cancer Institute guidelines recommending appropriate FNAB sampling technique, training requirements, uniform criteria for specimen adequacy and radiologic pathologic correlation may assist in further acceptance of FNAB as a preferred diagnostic procedure particularly in palpable breast lesions. Aside from FNAB, breast cytomorphology has become an integral part of practice of breast pathology. The use of imprint cytology for assessment of metastatic disease in sentinel lymph node biopsy is now a common practice. Lymphatic mapping with sentinel lymph node biopsy allows a detailed pathologic examination of the nodes most likely to contain metastatic tumor. Intraoperative detection of metastasis will lead to complete axillary lymph node detection in one surgical setting. Imprint cytology has shown superiority to frozen section and is the recommended procedure by the College of American Pathologists and the panelist of the “Philadelphia Consensus Meeting for Sentinel Node Biopsy.” Imprint cytology has also been effectively utilized for assessment of breast lumpectomy margins as a complement to frozen section. In addition, recent focus on early breast cancer detection and prevention has opened a new way to use minimally invasive procedures, such as FNAB, nipple fluid aspiration and ductal lavage for identification of high risk individuals. Chemopreventive studies have already confirmed the value of cytomorphology as a risk predictor. Recognition of cytomorphology of high risk proliferative breast disease and premalignant lesions is an intriguing concept to identify patients who may benefit from various risks reduction modalities. Coupled with molecular biologic testing and the new innovative imaging and surgical procedure such as ductoscopy, soon there will be an exciting opportunity for breast cytopathology to become an integral part of breast cancer research and preventions.
University of Mississippi Medical Center, USA
Keynote: The Effects of Sustained Delivery of Estrogen on the Structural and Functional Activity of Renal Pathology
Time : 10:30-11:00
Ham Benghuzzi received his Master in Chemistry and PhD in biological Sciences with concentration in physiology from University of Dayton in Ohio. In 1993, he completed postdoctoral training in pathology department at the University of Michigan Medical center. Thereafter, he joined the university of Mississippi Medical Center and currently he is professor in the department of diagnostic and clinical health sciences. He is a fellow of the American Institute of Medical and Biological Engineering, as well as, International Fellow of the World Congress of Biomaterials Societies (Japanese, American, Asian, and European). He is a pioneer scientist in ceramic drug delivery systems. His area of research is the development and applications of novel ceramic drug delivery systems (over 26 years/over 300 publications and 600 abstracts at various meetings). He served and serving as a major advisor for over 35 PhD students as well as a mentor for students at various levels (High school, undergraduate, MS, residents and postdoctoral). He received Nemours awards and honors from very prestigious societies and organizations. He was invited as a keynote speaker at state, national and international levels. His recent research was the first, worldwide, to histopathologicaly identify the role of sustained delivery of reproductive hormones in the induction of azoospermia.
It was reported in numerous studies that estrogen replacement therapy in post-menopausal women may interfere with the functional capacity of the renal system. Strong scientific evidence about the level of alternation at the glomerular level has to be elucidated. Several experiments conducted in our laboratories hypothesized that sustained delivery of estrogen will alter the glomerular structure and function. The specific objective of this research was to evaluate the effect of physiological dose (10-20 pg./ml) of sustained delivery of estrogen on the glomerular histopathology using adult ovariectomized adult rats as a model. A total of 120 rats were divided into four equal groups and served as intact, control, sham (OVX), exposed to sustained delivery of E, respectively. At the end of 2, 4 and 8 weeks post treatment ten animals from each group were sacrificed and the kidney were removed, fixed and processed for histopathological evaluation following standard laboratory protocols. Blood samples were collected daily for eight weeks and subjected to differential hematology. The results of this study demonstrated that the wet weights of the kidneys collected from estrogen treated animals has shown a slight increase in weight compared to intact animals (p< 0.05). Histopathological evaluation revealed that the glomeruli appeared slightly larger in the E treated animals compared OVX, Sham and intact animals. Occasional tubular damage was observed at the end of 8 week phase in estrogen exposed animals. Major shift in essential biomarkers were noted upon sustained delivery of estrogen at the end of two weeks. Gonadotropins levels were suppressed in all estrogen treated animals compared to OVX group. This observation may contribute to a functional change in the filtration rate and has to be taken in consideration in the renal function assessment.