Megan Troxell

State of the art for biomarker testing in breast cancer
Estrogen receptor (ER) testing has been utilized as a predictive marker in breast pathology since the 1970’s, with continual advancements in testing methodologies. Immunohistochemistry remains the current clinical standard for  ER, PR, HER2 predictive and prognostic testing in breast cancer.  Considerable efforts have led to improvements in testing standardization and reproducibility.  Recent ASCO/CAP guideline updates for ER, PR and HER2 will be reviewed. The menu of (mostly commercial) molecular tests will be discussed, along with newer target related assays (PI3K).  PD-L1 and Ki-67 assays will be deferred to other sessions.

Biosketch
Dr. Troxell pursued MD and PhD studies at Stanford, studying mutant E-cadherin and epithelial cell-cell junction dynamics. She completed Anatomic Pathology training, including fellowship experience in Surgical pathology, Immunodiagnosis, and Renal Pathology.  She was a member of the pathology faculty and directed the Immunohistochemistry lab at OHSU in Portland, Oregon for over 10 years.  More recently back at Stanford, her focus is breast, renal and GU pathology. She is co-medical director of the Immunodiagnosis laboratory, and works closely with residents and fellows.  She has served on College of American Pathologists Immunohistochemistry committee, along with two CAP immunohistochemistry related guideline committees.

State of the art for biomarker testing in breast cancer