Manuela Lacerda
IPATIMUP, Portugal
Title: Concerning the changing of diagnostic approach, guidelines, role and importance on decision of the different medical specialties involved ( in the last 30 years) in the setting of a screening and treatment reference hospital
Biography
Biography: Manuela Lacerda
Abstract
In 1978 I started working, as surgical pathologist, in the cancer hospital- Instituto Português de Oncologia Francisco Gentil (IPOFG) - Coimbra, Portugal.
At that time the patients that came to the hospital had large breast tumors and the diagnosis was made by the “triple approach”: The members of the multidisciplinary team were a surgeon, a radio-therapist and a medical oncologist. The pathology report was descriptive.
Frozen section or biopsy of the lesion was mandatory when the first therapeutic approach was surgery or when there was no concordance in the triple approach.
In 1987 the papers and the book published by David L Page and William D. Dupont, became a landmark in the histoclinical approach of breast lesions. The reproducibility of the prognostic index of Nottingham proposed by Elston and Ellis was an important method for the follow-up of breast cancer.
Immunohistochemistry became routine either for differential diagnostic or for therapeutic guidance.
In 1990 a breast cancer screening program in the central zone of Portugal was implemented. It was one of the European pilot projects approved by the European Commission. This program covers a female population (age groups 45-70) of 320,225 women (mammography every two years).
In 1994 I was designated, by the management of the program, to integrate the European Working Group on Breast Screening Pathology that elaborated "European Guidelines for Quality assurance in breast cancer screening and diagnosis - Quality Assurance guidelines for pathology" - European Commission.
The Cancer Registry -Central Zone (R.O.R. –Zona Centro) data show the influence of breast cancer screening on the incidence and mortality of breast cancer.