Virtual slide telepathology enables an innovative telehealth rapid breast care clinic

Ana Maria López, Anna R. Graham, Gail P. Barker, Lynne C. Richter, Elizabeth A. Krupinski, Fangru Lian, Lauren L. Grasso, Ashley Miller, Lindsay N. Kreykes, Jeffrey T. Henderson, Achyut K. Bhattacharyya, Ronald S. Weinstein

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


An innovative telemedicine-enabled rapid breast care service is described that bundles telemammography, telepathology, and teleoncology services into a single day process. The service is called the UltraClinics® Process. Because the core services are at 4 different physical locations, a challenge has been to obtain stat second opinion readouts on newly diagnosed breast cancer cases. To provide same day quality assurance rereview of breast surgical pathology cases, a DMetrix DX-40 ultrarapid virtual slide scanner (DMetrix Inc, Tucson, AZ) was installed at the participating laboratory. Glass slides of breast cancer and breast hyperplasia cases were scanned the same day the slides were produced by the University Physicians Healthcare Hospital histology laboratory. Virtual slide telepathology was used for stat quality assurance readouts at University Medical Center, 6 miles away. There was complete concurrence with the primary diagnosis in 139 (90.3%) of cases. There were 4 (2.3%) major discrepancies, which would have resulted in a different therapy and 3 (1.9%) minor discrepancies. Three cases (1.9%) were deferred for immunohistochemistry. In 2 cases (1.3%), the case was deferred for examination of the glass slides by the reviewing pathologists at University Medical Center. We conclude that the virtual slide telepathology quality assurance program found a small number of significant diagnostic discrepancies. The virtual slide telepathology program service increased the job satisfaction of subspecialty pathologists without special training in breast pathology, assigned to cover the general surgical pathology service at a small satellite university hospital.

Original languageEnglish (US)
Pages (from-to)1082-1091
Number of pages10
JournalHuman pathology
Issue number8
StatePublished - Aug 2009


  • Breast cancer
  • Cancer
  • Digital pathology
  • HER-2/neu
  • Immunohistochemistry
  • Mammography
  • Quality assurance
  • Telehealth
  • Telemedicine
  • Telepathology
  • Virtual microscopy
  • Virtual slides

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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