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Discovering, Diagnosing and Fighting Cancer

Department of Pathology Careers

The Department of Pathology at Memorial Sloan Kettering is one of the largest in the world, consisting of pathologists, molecular diagnosticians, and researchers with expertise in a range of solid tumor types as well as cytology and hematopathology.

On our team, you’ll use state-of-the-art technology and the most advanced diagnostic techniques to analyze thousands of tissue samples each year. We generate more than 180,000 diagnostic reports annually and have one of the largest academic molecular diagnostics services in the country.

We collaborate with medical teams and specialists throughout MSK to customize treatments for patients based on their individual diagnosis and disease characteristics. Our team also provides diagnostic consultations for healthcare professionals around the world.

Department Specialties

At MSK, we offer clinical autopsy examinations free of charge to families of anyone who had been under the treatment of our doctors at any time during the course of their lives. We strive to determine the effectiveness of their treatment, whether there were any identifiable complications, and the ultimate cause of death.

We also perform research through a medical donation program, called the Last Wish Program. Our researchers analyze tumors that they otherwise would not have been able to access safely while the patient was alive. The information is used to understand cancer and its progression.

Learn more about the Last Wish Program.

 

The cytology service diagnoses approximately 32,500 specimens per year, including gynecologic specimens and non-gynecologic samples, of which approximately 5,500 are imaging-guided fine needle aspirations (FNAs).   About 600 FNAs are performed by the pathologists in our FNA clinic, where we employ ultrasound guidance to more accurately direct biopsies. Learn more about the Fine Needle Aspiration Biopsy Clinic.

Our cytopathologists also use leading-edge telepathology systems so we can rapidly assess biopsies performed remotely at MSK’s regional sites.

 

Pathologists on this team specialize in characterizing tumors based on the genetic changes in their cells. This diagnosis forms the basis for targeted therapies, for which tumors are analyzed and matched with appropriate drugs based on the genetic alterations that are driving cancer growth.

Since 2014, our team has been using MSK-IMPACT – a targeted test for mutations – to analyze the tumor DNA of essentially all MSK patients with advanced cancer. MSK-IMPACT is based on next-generation sequencing. The test allows us to detect hundreds of mutations and other genetic changes in tumors.  Novel next-generation sequencing tests using blood or other fluids, such as MSK-ACCESS, allow detection of mutations in circulating tumor DNA as well, opening the door for “liquid biopsies” for follow-up of tumors after treatment or to characterize tumors when patients are unable to undergo a biopsy procedure.

We also perform dozens of other sophisticated molecular tests on tumor samples. Separate laboratories perform studies for chromosomal alterations using karyotyping and fluorescence in-situ hybridization (Cytogenetics), as well as assessing for hereditary mutations in cancer predisposition genes (Diagnostic Molecular Genetics).

We review about 20,000 samples every year from patients with cancers of the hematolymphoid system, such as lymphomas, leukemias, myelomas, and other lymphoid conditions. For each case, we provide a comprehensive diagnostic report that integrates complex information from morphological assessment, immunohistochemistry and flow cytometric analysis, and cytogenetic and molecular genetic studies. Integration of all of these data allow our hematopathologists to provide the most accurate and insightful diagnoses.

Our laboratories are internationally recognized for their innovation in clinical test development. In particular, we are well regarded for our development of assays to detect minimal residual disease and comprehensive proteomic and genomic analysis, for which we work with the Molecular Diagnostics Service.

Surgical pathology is one of the core functions of the Pathology Department. We analyze samples from surgical procedures and biopsies from all MSK facilities.  At the pathologist’s disposal, we have a diverse test menu of cutting-edge ancillary studies to provide our patients with the most accurate diagnosis and to provide prognostic or therapeutic information as well.

We also perform diagnoses using frozen sections if a quicker diagnosis is needed. We work closely with surgical teams and provide findings that can guide a procedure immediately while surgeries are taking place.

Research in the Experimental Pathology Division is focused on decoding the complex changes that occur in cancer cells. Members of this team investigate the molecular basis for the morphologic features observed when tumor tissue is examined under the microscope.

MSK’s experimental pathologists have pioneered much of the DNA analysis technology that’s used to improve diagnoses and develop personalized treatments. Thanks to this work, we now have extraordinary opportunities to provide insights into what causes cancer to form or progress, and to suggest strategies for blocking it.

Other areas where the team has excelled are in subtyping rare tumors — a feat that has always been challenging on the basis of histology alone  -  and characterizing novel biomarkers for the detection and monitoring of tumors.

Center for Innovation

At MSK, you’ll have access to the Warren Alpert Center for Digital and Computational Pathology. Established in 2017, the Center facilitates novel research and development in digital pathology and algorithmic computational pathology for clinical cancer care and research. We have slides, data and information regarding cancer diagnosis, treatment and research spanning more than 40 years and a digital archive of over 3M images.

The center is also a hub for existing digital pathology efforts to establish a fully digital workflow for our department.

 

Another innovation center is the Precision Pathology Biobanking Center (PPBC), which encompasses our research core facilities such as research histology, immunohistochemistry, and the biorepository of tissues for cancer research.  The PPBC is also involved in evaluating novel technology for pathology research and practice, establishing research collaborations with internal and external investigators, and with commercial entities, and facilitating the development of a federated research database to link tissue samples with annotating pathology and clinical information, which makes them maximally valuable to researchers.

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