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Liza Quintana, MD

Mar 19, 2020 • 6 tweets • 5 min read • Read on X

@BIDMCpath

Breast biopsy for calcs. What is your diagnosis? Would you do stains? Since I’m asking that means I did 😉🔬 #breastpath @BIDMCpath @CollinsLauraC @jennpincus @RanaAldreesMD @tlabiano @lara_pijuan @ADamronMD @ariella8 @kis_lorand @TheISBP

Thanks for all the comments! Here are the stain. All (including p120, not pictured) were consistent with a lobular phenotype.

There were some hints in the background with areas of classical LCIS.

This is a nice example of florid LCIS with comedo necrosis and associated calcifications. The nuclei aren't pleomorphic enough for me to call PLCIS; I would classify these are type B cells. Exc was recommended and showed more florid and classical LCIS with no invasive component.

We have limited info on the natural history of PLCIS and FLCIS. Per the who 25-60% of cases on core are upgraded to carcinoma on exc therefore exc is recommended.

https://twitter.com/LizaMQuintana/status/959528557331582976

Here is an example of PLCIS with associated invasive lobular I had a couple years ago.

https://twitter.com/LizaMQuintana/status/959528557331582976

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More from @LizaMQuintana

Liza Quintana, MD

@LizaMQuintana

Nov 20, 2020

@DrJordanaP

1/ #BreastRadPath with @DrJordanaP

For this tweetorial we are going to talk about how we evaluate the biomarkers ER, PR, and HER2.

@BIDMCpath @BIDMC_BreastImg @CollinsLauraC @ADamronMD @GuzmanArocho @XeniaParisi @MarcosLepeMD @DrGeeONE @smlungpathguy

2/ The biomarkers provide predictive information (how a patient may respond to targeted therapy) as well as prognostic information. It helps to organize patients into treatment groups that follow different algorithms and guidelines.

3/ Biomarkers are evaluated in routine clinical mgmt of patients with breast cancer. The 3 routinely tested:

Hormone receptors (HR): Estrogen receptor (ER) and Progesterone receptor (PR)
&
Human epidermal growth factor receptor 2 (HER2)

(chart from: bit.ly/3lPbqoY)

Read 18 tweets

Liza Quintana, MD

@LizaMQuintana

Oct 14, 2020

@DrJordanaP

#breastradpath with @DrJordanaP

For #BreastCancerAwarenessMonth month we want to review the process from imaging to diagnosis of breast cancer. 1/

@DrJordanaP

It starts when a patient comes in for a screening or diagnostic mammogram. Here is @DrJordanaP reviewing #mammograms in the reading room. 2/

@DrJordanaP

Please review screening modalities in this amazing tweetorial from last week from @DrJordanaP! 3/

https://twitter.com/DrJordanaP/status/1313207983405510657?s=20

Read 24 tweets

Liza Quintana, MD

@LizaMQuintana

Sep 28, 2020

@DrJordanaP

Case 3 #breastradpath with @DrJordanaP

44 yo woman. On req: "faint grouped microcalcs." #breastimagers separate calcs and no calcs cores into separate containers (so helpful!). There was only one block of cores with calcs. Here are the #breastpath images. Thoughts? Next steps?

@DrJordanaP

You are all thinking the way I did! For cases with calcs, I always review the imaging, and in particular the specimen radiograph, to see the morphology of the calcs I should look for. Check out the imaging from @DrJordanaP 👇

https://twitter.com/DrJordanaP/status/1311274647619428352?s=20

The tiny calc in the initial levels of the CNB are not the same as the calcs seen on imaging. We need to find those calcs --> LEVELS! (I haven't heard it called steps before! I like!) #breastradpath correlation is so important here!

Read 11 tweets

Liza Quintana, MD

@LizaMQuintana

Sep 17, 2020

@BIDMCpath

Hi #pathology tweeples! I just realized that the callus I have on my pinky is from using it to steady my hand as I dot 😂(with my green pen of course 😉). I must dot A LOT! 💪🔬

I have some #path (mostly) dotting related questions out of curiosity.

@BIDMCpath

@Chucktowndoc

The #pathology tweeples have very strong opinions about dotting pen color! My tweet is inspired by this from @Chucktowndoc

https://twitter.com/Chucktowndoc/status/1299485866566529024?s=20

Does anyone else have a dotting pen-induced callus? (Just me? I hope I'm not alone. 🤞😊)

Read 11 tweets

Liza Quintana, MD

@LizaMQuintana

Sep 15, 2020

@DrJordanaP

#breastradpath with @DrJordanaP

We are excited to share the first case in our #breastimaging and #breastpath correlation series! This case highlights challenges of imaging/management and the pathologic diagnosis.

@BIDMC_BreastImg @BIDMCpath #radres #radfellows

@DrJordanaP

56 yo woman with left breast focal asymmetry and calcifications. Screening mammogram. @DrJordanaP

@DrJordanaP

Diagnostic mammogram and ultrasound were performed. A presumed ultrasound correlate was found with calcs and vascularity. What is the next step? What BI-RADS would give? @DrJordanaP

Read 17 tweets

Liza Quintana, MD

@LizaMQuintana

Mar 10, 2020

Breast excision. What is your diagnosis? Would you do stains? #breastpath

Thanks everyone! This is LCIS involving collagenous spherulosis. I did IHC. The e-cad was stronger than I expected but showed granular staining so I followed up with p120 and beta-catenin to illustrate the different stains.

Read 5 tweets

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