I joined Fox Chase Cancer Center in 1994 to work with a team of outstanding and dedicated pathologists. My field of medicine, cytopathology, refers to diagnostic techniques that are used to examine cells to determine the cause or nature of disease. Various techniques are used to collect cells from practically every organ or body fluid.

A familiar technique for women is the pap test, in which sample cells are collected from the uterus and examined under the microscope to detect cancer or precancerous conditions of the cervix (the lower, narrow end of the uterus). Early detection and treatment of these conditions have resulted in more than 70% reduction in the rate of cervical cancer in the United States.

Another example is the collection of tissue samples by placing a thin needle in the tumor (fine-needle aspiration). While superficial organs (e.g., breast, thyroid, salivary gland, lymph nodes) can be directly accessed, aspiration of deep organs (e.g., lung, liver, kidney, pancreas) requires radiologic or endoscopic guidance. The advantages of cytopathologic techniques include convenience, low rate of complications and rapid results. Today, sophisticated immunocytochemical, genetic and molecular methods are used to complement morphologic (also known as structural) assessment of the samples.

My interest in cytopathology started during my pathology residency, which led me to pursue a formal cytopathology fellowship in one of the few programs available at the time. Cytopathology is now widely accepted and has become a primary and definitive method for diagnosis and monitoring (surveillance) of cancer.

In addition to my clinical practice, I participate in a variety of research projects. One of the most exciting areas of research in which I have participated in the past decade is the investigation of biomarkers of breast cancer risk in nipple aspirate fluid. In this non-invasive method, a small amount of fluid is obtained from the breast by aspirating the nipple. Cytologic examination, protein assays and molecular studies are performed on the fluid with the objective of finding factors that are associated with precancerous conditions or can predict the risk of cancer development.