Scientific Program

Day 1

Day 1

  • Case Review as an Anatomic Pathology Quality Assurance Tool to Reduce Diagnostic Discordance in Breast Cancer

    QualityStar LLC

    Mark Priebe is a subject matter expert in the utilization of whole slide digital imaging for quality assurance of surgical pathology for cancer. Mark has presented on quality in surgical pathology via podium and posters at multiple scientific meetings and was the Co-Chair for Pathology 16 (Chicago). Mark received his undergraduate degree in Medical Technology from Marquette University, Milwaukee, and advance certification by the ASCP in Immunohematology from the Medical College of Wisconsin, Mark is the co-developer of QualityStar quality consortium of Omaha Nebraska. QualityStar is an external peer review quality assurance program for Surgical Pathology, approved by the American Board of Pathology for Part II (SAM) and IV (QA) MOC, the Agency for HealthCare Research and Quality (AHRQ) as a Patient Safety Organization (PSO), Indiana State Medical Association certified for AMA PRA Category 1 Credits, and Qualified Clinical Data Registry (QCDR) for Anatomic Pathology approved by CMS. The Mission of QualityStar is to support the reduction of major diagnostic discordance in surgical pathology by 5% (7 to 2%) impacting the lifes of over 80,000 patients annually in North America.


    Objective: To review Quality Assurance Case Review programs that focus on reducing cancer diagnostic discordance in anatomic pathology and validating their ability to detect case based interpretive error. Design: From an extensive number of published studies, the rate of major discrepancies identified for cancer patients referred to another institution occur from 4.6% to 14.7%, depending on type of tissue. However, published data indicates the current intra-lab QA programs ability to detect these discrepancies is only 0.8% to 1.7%. Implementing GAP analysis, four formal anatomic pathology quality assurance case review programs, both inter and intra-lab, were reviewed for their ability to satisfy a set of selected design attributes known to help identify interpretive error. Peer reviewed literature was researched to support claims for each program’s percent compliance to the attributes, strengths, drawbacks, and best demonstrated practices were identified. Results: No program met the selected attribute listing 100%, and compliance ranged from 29% (met 2 of 7) to 86% (met 6 of 7) for each program. Conclusion: Pathology laboratories and radiology departments should be aware of the limitations of each QA program and take into consideration their case and medical specialist mix and current on-site concerns in order to select a program with attributes that best match their QA goals. In general, programs that are standardized, include external review by subspecialist and are performed close to the final sign-out date may offer the greatest amount of error discovery and potential to positively influence patient outcomes and continuous improvement. Although this study focused on discordance in cancer related surgical pathology, case review can also be an effective tool in discovery of all histology/cytology and medical imaging diagnostic and clerical discrepancies.

  • Comparison of aspirin and ibuprofen bulk and nano forms in peripheral lymphocytes from breast cancer patients and healthy individuals

    University of Bradford

    Diana Anderson holds the established Chair in Biomedical Sciences at the University of Bradford. She obtained her first degree in the University of Wales and second degrees in the Faculty of Medicine, University of Manchester. She has 450+ peer-reviewed papers, 9 books, has successfully supervised 29 PhDs, and been a Member of Editorial Boards of 10 international journals. She has been or is Editor in Chief of a book Series on toxicology for J. Wiley and sons and the Royal Society of Chemistry respectively. She gives key note addresses at various international meetings. She is a consultant for many international organizations, such as the WHO, NATO, TWAS, UNIDO and the OECD.


    Recent studies have suggested that regular intake of some non-steroidal anti-inflammatory drugs (NSAIDs) have a preventative effect against several types of tumours including breast cancer in humans. This work aims to study the effect of both ibuprofen and aspirin on DNA damage using lymphocytes obtained from breast cancer patients and comparing the result with lymphocytes from healthy females as a control. Lymphocytes are useful surrogates for cancer cells. Nanoparticles (NPs) and bulk sizes were used in the Comet and micronucleus assays. Two hundred and fifty ng/ml of ibuprofen (NPs and bulk) and 500 ng/ml of aspirin were used as non-toxic doses to treat the lymphocytes. Aspirin, both bulk and nano sizes, showed a significant reduction in DNA damage in the Comet and micronucleus assays. However, the effect of aspirin nano (P?0.01) was more significant compared to aspirin bulk (P?0.05). Ibuprofen, in contrast, showed a significant reduction in micronucleus (MNi) frequency in the micronucleus assay with the nano form (P?0.001) being more significant than the bulk form (P?0.01), whilst its preventative effect with the Comet assay was insignificant. These observations suggest that NPs have better penetration through the nuclear membrane due to their smaller sizes compared to their bulk size. Aspirin was more effective than ibuprofen in the reduction of DNA damage and MNi formation in the Comet and micronucleus assays. NPs were more effective than bulk sizes. The results are consistent with the view that NSAIDs, particularly aspirin and ibuprofen, could have a promising role in cancer treatment including breast cancer.

  • Novel herbal drugs enhanced radiotoxicity of breast cancer lines with relevance to improving cancer radiotherapy

    University of Mumbai

    Dr K. P. MISHRA - DIRECTOR - Dr Mishra was President of Indian Biophysical Society, 2005-2008. Prior to this honour, he served on the Executive Council of IBS. He served as Member of National Committee of Biophysics of INSA for IUPAB .He was a Member of INSA delegation to IUPAB Congress in Hungary and a Member of Asian Biophysics Committee during his Presidency of IBS. Dr Mishra obtained his M.Sc. from Allahabad University and Ph.D. from Gujarat University. He has a bright educational career throughout and is a recipient of National Scholarship of Govt of India.


    Cancer incidence and mortality have been rapidly increasing in the industrialized world. Breast cancer in women is one of the major diseases in both developed and developing countries. Apart from surgery and chemotherapy, radiotherapy is a most prevalent treatment modality but frequently observed problems of general toxicity, exorbitant cost and non-specific action pose profound limitations in treatment of cancer patients. While considerable technical improvement has been made in delivering the radiation to the target tissue but technical limitations yet pose many daunting challenges. The search for new drugs for cancer treatment has been a challenging task for pharmaceutical companies. A predicament is faced in the clinic because anticancer drug as well as radiation kill equally both cancer and normal cells of the patients producing undesirable side effects compelling discontinuation of the treatment. Research is, therefore, warranted to develop non-toxic and affordable drugs for effective treatment of cancer patients. To meet these objectives, our laboratory has actively been investigating to develop novel drugs from plant kingdom and targeted approaches to selectively kill the cancer cells while sparing the normal cells. The results of our studies on MCF 7 and T40D breast cancer lines have shown great promise of enhancing radiosensitivity of these cell lines to gamma radiation in vitro. A developing strategy that holds promise in treatment of cancer patients consists in searching for natural compounds which can selectively enhance tumor cell toxicity to radiation but spare normal cells as desired in clinical settings. Recent research from screening studies have found some potent phytodrugs from plant kingdom which display unique ability to cause no or minimal toxicity to normal cells but remarkably sensitize tumor cells to ionizing radiation (1-3). The mechanism involves the radiation generated reactive oxygen species (ROS) which trigger induction of apoptosis (cellular suicide) in tumor cells because of the high oxidative stress status in these cells. This talk is designed to present a brief highlight of developing plant based herbal drugs for improving chemo and radiotherapy of cancer patients. This talk is based on the recent research results from our laboratory (1-5). A few examples of notable herbals such as triphala, ellagic acid and silibinin will be given for the observed increased tumor cytotoxicity in tumor cells by compounds from plant sources which hold promise of improving cancer radiotherapy.

Breast Cancer
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