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Forensic Pathology in the News



The national shortage of forensic pathologists in municipal medical examiners' offices was addressed in the local news last week.

On July 6, Sen. Chuck Schumer was joined by local representatives at the Monroe County Office of the Medical Examiner to announce the formation of a new forensic pathology fellowship planned for 2019, made possible by a partnership between the county and University of Rochester Medical Center. 

As quoted in the Democrat and Chronicle, Bruce Smoller, M.D., chair of Pathology & Laboratory Medicine at URMC, said, "This will strengthen the reputation of our own pathology program at the medical center, further helping us bring to Rochester the best and brightest medical residents interested in the field." 


Are We on the Heels of a Gene Signature for High-Grade Breast Cancer?


A pathology researcher at the University of Rochester Medical Center believes she’s discovered an important phenomenon in normal-looking breast tissue that could foreshadow an aggressive tumor known as triple-negative breast cancer.

Xi Wang, M.D., recently reported her findings in Human Pathology; she also presented the data at the U.S. and Canadian Academy of Pathology’s annual international meeting in 2016, the largest international meeting in the pathology field. Wang analyzes hundreds of breast tissue samples each month and based on her observations came up with the hypothesis that an alteration in the p53 gene might be the beginning of a cell’s cascade toward becoming fully cancerous.

P53 gene changes as seen under microscopeP53 is a well-known tumor-suppressor gene. When it’s acting as it should, p53 keeps cancer at bay. But when it is mutated, it no longer suppresses cancer cells. It’s frequently mutated in lung cancer and also commonly mutated in a type of high-grade ovarian cancer. In breast cancer, the p53 mutation is detected in less than 25 percent of cases, Wang said, but the frequency is much higher in triple-negative breast cancer, which is much harder to treat.

Her latest research looked at normal/benign tissue samples from women who also carried the BRCA1 or BRCA2 genetic mutations, which increase the chances of getting breast cancer by more than 50 percent, and significant boosts the likelihood that breast cancer will be the triple-negative subtype. Results showed that p53 is more frequently altered in the seemingly “normal” breast tissue in BRCA carriers, compared with the general population. This may help to explain why BRCA carriers are at much higher risk for aggressive cancer.

These p53 mutated breast cells are not proliferating as crazy as tumor cells and have not yet developed into cancer, Wang said. “But they are funny looking and now I will look at them differently because they might be part of a signature for cancer.”

With so many diverse types of breast cancer, it’s important to be able to identify high-grade disease at the earliest point in time to inform treatment decisions.

Although the science is still in its early stages, Wang said, being able to recognize a p53 signature in normal breast cells could someday give high-risk women more information as they are deciding whether to remove their breasts. Currently, however, there is no standard way to screen for p53 mutations in breast tissue.  

Alumni Q&A: Former UR Pathology Resident, Keith Krabill, MD


Keith KrabillHometown: Uniontown, OH. Now lives in Buffalo, NY.

Family: Wife, Bonnie McMichael, and three daughters, Lorna (20), Rebecca (18) and Kathryn (15)

Pathology Residency at URMC: 1991-1995

Education: Completed a six-year BS/MD program at Kent State University and Northeast Ohio Medical University. He then spent two years doing antiviral research.

Current Role: Laboratory Director at the Women and Children's Hospital of Buffalo, Laboratory Director at the Center for Laboratory Medicine in Williamsville, and Director of the Transfusion Service at Kaleida Health. He is also a Clinical Assistant Professor in the Department of Pathology and Anatomical Sciences at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences.

What first inspired you to get into pathology?

My medical school had three pathologists that were role models and teachers (Ray Clarke, Howard Igel and Robert Novak). They were able to show how the pathology department made a difference to all clinicians and patients, and I could see that they practiced pathology in a way that crossed between different medical specialties. 

How would you describe your job to someone who’s never heard of it before?

If a clinician has a question that can be answered with a test, my job is to make that diagnosis or arrange for it to get done. I am often presented with troubleshooting missions – things that went wrong in testing or workflow.  I  think I do this well, but those projects are challenging because I need to understand what was supposed to happen, what appears to have gone wrong, and how to quickly investigate to confirm and correct the problem.  

What does your daily work consist of?

I get to practice both anatomic and clinical pathology across four hospitals in the Buffalo area. Over time, I have had responsibilities and leadership roles at all of them. I got my job originally because I was willing to cover the transfusion service as well as general anatomic pathology. Over time, I’ve been given opportunities to practice Clinical Chemistry, Microbiology and Medical Informatics. The training I had in residency prepared me to help my partners cover areas that they weren’t as comfortable with, so I see something interesting every day.

What advice would you give to pathology residents?

Spend time getting to know your fellow residents. The time you spend helping each other makes the residency more pleasant and the studying easier. In the longer term, your fellow residents will become a network of friends and references. A senior resident linked me to the job I have today, and his guidance on what to expect as a junior attending helped me avoid early problems.

How do you like to spend your free time? Do you have any hobbies or interests?

My children are convinced that I spend my free time deleting spam. When it’s quiet, I spend my free time reading (mystery and science fiction) and running (distance running, but slow).

Event Recap: Pathology Research Day 2017


Poster SessionThe Department of Pathology and Laboratory Medicine hosted its annual Research Day event on Monday, June 12, 2017.

The day-long event featured a wide variety of oral and poster presentations by Pathology graduate students and residents on research topics ranging from osteoarthritis, to lymphoma, pregnancy, and much more.

Perry J. Blackshear, MD, D. Phil, gave the keynote address. He is the Deputy Chief of Signal Transduction Laboratory and Head of the Post-Transcriptional Gene Expression Group for the National Institute of Environmental Health Sciences.

Year out fellow, Michelle PitchAn awards dinner followed the event, in which faculty recognized top presentations and gave a special sendoff to departing residents and fellows. Pathology Chair, Dr. Bruce Smoller, also gave two special awards to faculty. 

Graduate Program Awards

  • Outstanding academic Excellence by a First Year Student - Olivia Marola
  • Outstanding Contribution to the Pathology PhD Program - Richard Bell

Travel Awards

Oral Presentation

  • Sarah Catheline

Poster Presentations

  • Richard Bell
  • Jerry Saunders III
  • Zachary Murphy
  • Brianna Shares

Residency Awards

Oral Presentations

  • Third place - Hani Katerji, MD
  • Second place - Sohaib Abu-Farsakh, MD
  • First place - Sachica Cheris, MD

Faculty Awards

  • Eric A. Schenk Award for Excellence in Teaching - Luis De Las Casas, MD
  • Chairman's Award - Caroline Dignan, MD

See More: 

View a photo gallery of Research Day

Download list of presentations



Pathology Graduate Student Wins Travel Award for Research Project


Madison DoolittleSecond-year Pathology graduate student Madison Doolittle won second place in the School of Medicine and Dentistry’s graduate student poster competition on May 17.

The annual event, hosted by the Graduate Student Society, includes entries from graduate students across disciplines as an opportunity to showcase their research in their respective fields.

Madison was the lead author the abstract titled, “Investigating the Role of Zbtb40 in the Genetic Regulation of Osteoporosis” in which he and fellow researchers examined the genetic determinants of bone mineral density used to diagnose osteoporosis.

He was awarded a $300 travel scholarship.

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