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Breast Pathology Through the Digital Lens.

Alexis Heller1, Lakshmi Kowtha1, Kriti Tiwari1

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Summary

Digital pathology (DP) enhances breast cancer diagnosis and collaboration using whole slide imaging (WSI). While challenges exist, DP improves accuracy and paves the way for AI in cancer care.

Keywords:
Breast pathologyDigital pathologyImmunohistochemistryNeoplasmsVirtualWorkflow

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Area of Science:

  • Pathology
  • Oncology
  • Medical Imaging

Background:

  • Digital pathology (DP) adoption is transforming diagnostic workflows.
  • Mount Sinai Hospital implemented the Philips IntelliSite Pathology Solution (PIPS) for breast pathology.
  • The transition aims to improve diagnostic accuracy, collaboration, and education.

Purpose of the Study:

  • To evaluate the impact of digital pathology implementation on breast pathology services.
  • To identify the benefits and limitations of using whole slide imaging (WSI) for primary diagnosis.
  • To assess the role of DP in advancing cancer care through AI integration.

Main Methods:

  • Integration of the Philips IntelliSite Pathology Solution (PIPS) for primary diagnostic use.
  • Scanning of glass slides to create high-resolution whole slide images (WSI).
  • Pathologist review, annotation, and digital sharing of WSI for diagnosis and collaboration.

Main Results:

  • Enhanced diagnostic accuracy, improved detection of low-positive staining, and precise tumor/margin measurements.
  • Facilitated immediate slide sharing, efficient sign-outs, and retrospective case reviews.
  • Initial increases in turnaround time were mitigated by increased staffing and scanner availability.

Conclusions:

  • Digital pathology offers significant positive impacts on breast pathology, improving efficiency and diagnostic capabilities.
  • Limitations such as visualizing small crystals and manual stain interpretation require ongoing attention.
  • DP implementation serves as a foundation for developing AI algorithms to predict treatment response and advance cancer care.