MSK Launches Global Online Fellowship in Breast Pathology
The burden of cancer is rapidly rising in low- and middle-income countries (LMICs), with estimations that by 2030, approximately 75% of cancer deaths worldwide will occur in low- and middle-income countries.
MSK’s Global Cancer Disparities Initiatives group (GCDI) has been working hard to bridge this gap in cancer care through education, research, and collaboration with medical professionals around the world. For the past 10 years, this multidisciplinary group has focused on sub-Saharan Africa and done extensive work in Nigeria, mostly on colorectal cancer.
In 2019, the program expanded to include capacity building projects in breast cancer care. It was clear that patient management and quality research studies rely on accurate tissue diagnoses, yet pathologists in LMICs have limited to no access to specialized training. MSK faculty from the Department of Pathology working within GCDI decided to develop an innovative educational program to address this urgent need. The first Global online fellowship in breast pathology, a one year, online educational/telementoring program, launched in September 2022.
“Our main goal for the fellowship is to provide comprehensive training that is really adapted to the local practice,” said Marcia Edelweiss, MD, a pathologist with special interest and training in breast pathology, and director of the fellowship program.
Pilot Program
In some areas of the world, medical professionals including pathologists do not usually specialize in one type of cancer or part of the body – they are generalists helping to diagnose and treat many different diseases. The pilot cohort for this fellowship consisted of two pathologists from Nigeria: Dr Omolade Betiku and Dr Oluwatosin Omoyiola from Obafemi Awolowo University Teaching Hospitals Complex in Ife, Nigeria.
“There’s been a great need for specialization, but how to get it has been a challenge,” said Dr. Omoyiola. “This online telepathology platform has offered us an opportunity to be able to do that.”
In September, to kick off the program, Dr. Edelweiss traveled to Nigeria for a hands-on workshop to show how breast specimens are handled at MSK and trained on how they would be working virtually, sharing information and digital slide images. One unique aspect of the program is that they train using cases from Nigeria. During the weekly meetings, they review digital slides using a telepathology platform and discuss these cases, make diagnoses, and more. The format of this online fellowship simulates somewhat the format of the breast pathology fellowship offered by MSK to US trained pathologists and counts with full support from GCDI leadership and Dr Elenitoba-Johnson, Chair of the Department of Pathology and Laboratory Medicine.
“It has been a huge change,” Dr. Omoyiola said. “It’s changed the quality of our reports. It’s changed even the way how we handle specimens. It’s given us an opportunity to have expert opinions on difficult cases…It’s been very, very good and very, very helpful in advancing our knowledge and increasing the quality of all of our reports and all of our practice.”
Dr. Betiku agreed, saying the trainings have also enhanced the reporting of important details essential to patient care – which are critical to help clinicians plan treatments.
“The writing and documentation for our cases have improved,” she said.
Continued Collaboration
Recently, Dr. Omoyiola traveled to the US for her mandatory observership. She spent three weeks at MSK touring the facilities, working alongside Dr. Edelweiss and attending meetings to see how MSK experts discuss and plan cases. She also traveled with Dr. Edelweiss to present their collaborative research at the United States and Canadian Academy of Pathology meeting in New Orleans.
“It was a bit overwhelming, but it is a good one,” Dr. Omoyiola said. “Coming from one extreme and going to another extreme.”
Dr. Betiku plans to attend her observership at MSK next year if possible.
As the first cohort of the program wraps up, MSK hopes Drs. Betiku and Omoyiola will now help to train others in Nigeria and elsewhere, sharing and spreading the knowledge.
“We are hoping that as part of the process, we are training the future trainers. This is one of our goals” said Dr. Edelweiss. “We’d love for them to become faculty of the online fellowship. This is an important component for the sustainability and expansion of our program. They’re both so dedicated and diligent with the course that I’m sure both of them will."
