Contact Information

Melinda J. Lerwill, MD - Subspecialty Head, Breast Pathology Service

WRN-2-219
Boston, MA  02114

Phone: 617-726-0691

Email: MLERWILL@mgh.harvard.edu

    Breast Pathology

    The Breast Pathology Service, led by Dr. Melinda Lerwill, provides diagnostic services to Massachusetts General Hospital and outside pathologists in the U.S. and abroad, and to breast cancer researchers at the Mass General, Dana-Farber Cancer Institute, Massachusetts Institute of Technology, and National Institutes for Health. The Breast Pathology Service is fully integrated with the breast clinical services and serves a critical consultative role in the case management of breast cancer patients. The Breast Pathology team has a broad range of expertise from classical histomorphology to molecular pathology, and the research efforts of this group reflect these diverse fields. Significant initiatives are currently underway that focus on molecular pathologic technologies as they pertain to the diagnosis and clinical management of breast cancer patients.

    Faculty

    • Melinda Lerwill, MD - Subspecialty Head, Breast Pathology Service
    • Dennis C. Sgroi, MD
    • Amy Ly, MD
    • Veerle Bossuyt, MD
    • Anthony Guidi, MD

    Clinical Program

    The Breast Pathology Service sees approximately 4,500 case accessions per year. Of these, 3,400 represent in-house breast cases; approximately 50% are excisional biopsies, 25-30% are core biopsies, and 15-20% are mastectomy specimens. Approximately 1,100 outside consultation cases per year are reviewed, including patient referrals, consultation requests from area hospitals, and private consultation material. ER, PR, and HER2 IHC and HER2 FISH are performed within the Mass General Department of Pathology on all in-house breast cancer cases.

    The Breast Pathology Service is split into three clinical services: Breast 1, Breast 2, and Breast 3. Residents are assigned to the Breast 1 service for their core rotations. They are responsible for 4-6 surgical specimens per day, as well as all breast core biopsies and breast skin biopsies. The Breast 2 service covers one-third of the in-house surgical cases and the outside referral cases for the Breast Center Multidisciplinary Conferences. Upper-level residents on elective and visiting fellows rotate on the Breast 2 service. The Breast 3 service covers one-third of the in-house surgical cases and the remaining outside referral cases. Individual pathologists handle private consultations that are directed to them.

    Academic and Research Accomplishments

    Information regarding specific research interests and links to PubMed can be found on individual faculty profiles (see below physician profiles section).

    Teaching and Educational Activities

    Breast Pathology Weekly Conference: All breast pathologists, the breast pathology fellow, and rotating residents review diagnostically challenging cases on a weekly basis.

    Resident Teaching: During daily breast signout, each breast pathology staff member teaches the principles of gross and histological diagnosis to residents. In addition, the staff actively participate in resident teaching conferences. The Breast Pathology Service has developed a comprehensive Breast Manual, reviewing educational objectives, procedural protocols, and classic papers in breast pathology.

    Breast Center Multidisciplinary Conferences: A breast pathologist and/or breast pathology fellow reviews pathology slides of patients who are seen in the clinic. This activity takes places 4 times per week throughout the entire year.

    Graduate Medical Education: The Mass Generalbreast pathology group, in collaboration with Memorial Sloan Kettering Cancer Center, has offered an annual breast pathology course since 2007 entitled "Solving Everyday Problems in Breast Pathology: A Morphologic Approach." The breast pathology faculty frequently teach at a number of other continuing medical education courses, both nationally and internationally.

    Mass General Brigham Breast Pathology Fellowship

    We are pleased to announce the inaugural MGB Breast Pathology Fellowship for academic year 2027-28. The fellowship is a collaborative program between the breast pathology services at Brigham and Women's Hospital (BWH) and Massachusetts General Hospital (MGH), and fellows will rotate at both sites. This one-year fellowship aims to provide comprehensive training in breast pathology, combining the strengths and resources of both institutions to prepare fellows for academic careers devoted to the study of breast pathology.

    Fellowship overview

    Clinical Diagnostic Services
    • The fellowship offers extensive exposure to clinical breast pathology. Combined, the two academic medical centers review over 11,000 breast pathology cases per year, encompassing broad exposure to core biopsies, surgical excisions and mastectomies, and consultations. Case complexity is high. Fellows will develop expertise in diagnostic breast pathology and the interpretation of ancillary studies, learn to recognize diagnostic pitfalls and minimize errors, and gain experience in communicating effectively with clinicians.
    • Fellows will participate in personal consultation services at both institutions, providing diagnoses for challenging breast pathology cases. This includes Dr. Stuart Schnitt's Personal Consultation Service at BWH, which handles over 600 cases annually.
    • Fellows will develop expertise in the interpretation of immunohistochemical tests for breast cancer biomarkers and will gain exposure to HER2 FISH testing.
    Elective and Academic/Research Time
    • Fellows will have dedicated elective time and academic/research time.
    • Fellows are expected to participate in clinical or translational research projects carried out with members of the MGB breast pathology team, including opportunities for collaboration with our colleagues in breast imaging, surgical oncology, radiation oncology, and medical oncology.
    • Fellows are encouraged to prepare abstracts for presentation at national or international meetings.
    Multidisciplinary Education

    The multidisciplinary approach to breast care is crucial for providing comprehensive and effective treatment to patients. It is a cornerstone of the breast pathology fellowship. Fellows will gain exposure to the multidisciplinary aspects of patient management through:

    • Presentation at multidisciplinary conferences, tumor boards, and pathology-radiology correlation conferences to guide patient management
    • Presentation at multidisciplinary case-based teaching conferences with colleagues from breast imaging and breast surgery
    • Multidisciplinary lecture series for fellows with didactic sessions on breast imaging, breast surgery, radiation oncology, and medical oncology
    • Mini-rotations on breast imaging and breast surgery services
    Pathology Conferences
    • Weekly breast pathology consensus conferences
    • Monthly Longwood Breast Interesting Case conference
    • Fellows can attend the teaching sessions for MGB residents, which include unknown case conferences and didactic lectures and which often present advanced material
    • Fellows also have the opportunity to attend Harvard Medical School continuing medical education courses hosted by the department, including annual offerings in Surgical Pathology, Cytopathology, Dermatopathology, and Gastrointestinal Pathology
    • Quality and Safety Rounds
    • Molecular Pathology and Research Conference
    • MGB Pathology Grand Rounds
    Faculty

    Fellows will work closely with the breast pathology faculty at both institutions, who represent leaders in the field in the areas of diagnostics, translational research, molecular research, and medical education.

    • Melinda Lerwill, MD
      Program Director, MGB Breast Pathology Fellowship
      Subspecialty Head, MGH Breast Pathology Service
      mlerwill@mgh.harvard.edu
    • Emily Bachert, MD
      Associate Program Director, MGB Breast Pathology Fellowship
      Associate Program Director for Anatomic Pathology at BWH, MGB Pathology Residency
      sbachert@bwh.harvard.edu
    • Bayan Alzumaili, MD
    • Veerle Bossuyt, MD
    • Deborah Dillon, MD
    • Anthony Guidi, MD
    • Xuefei Hong, MD
    • Susan Lester, MD, PhD
    • Amy Ly, MD
    • Matthew Packer, MD
    • Stuart Schnitt, MD
    • Dennis Sgroi, MD
    • Gulisa Turashvili, MD
    Vacation Time

    Fellows have four weeks of vacation time per year.

    How to apply

    Fellowship application form, additional application materials, and inquires should be submitted by email to: MGBPathologyfellowships@mgb.org

    We will begin accepting applications on May 1, 2025 for academic year 2027-2028. There is no deadline to apply; we will continue accepting applications until we fill all positions. In the summer, information on interviews will be given to selected applicants following review of a complete application.

    Application Materials
    1. CAP Standardized Pathology Fellowship Application
    2. Curriculum Vitae (must be in month/year format 00/0000)
    3. Personal Statement describing career goals and surgical pathology interests
    4. USMLE Steps 1, 2, & 3 Score Report- (Canadian physicians and Doctors of Osteopathy who are eligible for licensure may substitute documentation of successful completion of LMCC/MCCQE and COMLEX examinations, respectively, in lieu of USMLE examinations)
    5. Passport-style photo
    6. Three Letters of Recommendation (one letter must be from your current program director or department chair)
      • Letters of Recommendation should be addressed to:
        Melinda F. Lerwill, MD
        Program Director, MGB Breast Pathology Fellowship
        Department of Pathology, Warren 2
        Massachusetts General Hospital
        55 Fruit Street
        Boston, MA 02114
      • Letters of Recommendation should be emailed by the letter writer to: MGBPathologyfellowships@mgb.org
    7. Copy of MD Degree (International medical graduates only)
    8. Copy of ECFMG Certificate (International medical graduate only)

    A limited number of Surgical Pathology Signout Fellowships may be available at MGH in any given year. If you are interested in the Signout Fellowship program, please see additional information here and address any inquires to Dr. Melinda Lerwill at mlerwill@mgh.harvard.edu.

     

    Physician Profiles

    • Veerle Bossuyt, MD

      • Department of Pathology

    • Melinda Lerwill, MD

      • Associate Pathologist, Massachusetts General Hospital
      • Director, Breast Pathology Service
      • Assistant Professor of Pathology, Harvard Medical School

    • Amy Ly, MD

      • Assistant Pathologist, Massachusetts General Hospital
      • Associate Professor of Pathology, Harvard Medical School

    • Dennis Sgroi, MD

      • Executive Vice Chair of Pathology, Massachusetts General Hospital
      • Professor of Pathology, Harvard Medical School

    The Breast Pathology Service sees approx. 4,500 case accessions per year

    Of these, 3,400 represent in-house breast cases; approx. 50% are excisional biopsies, 25-30% are core biopsies, and 15-20% are mastectomy specimens.

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