Maude Abbott Lecture 2024
Integration of Molecular Testing in Pathology Practice; Embracing the Choices
Saturday, March 23, 2024 4:15 – 5:50 PM
Ballroom (400 Level)
Julia A. Bridge, MD
Director, Cytogenetics and FISH
ProPath, Dallas, TX
University of Nebraska Medical Center, Omaha, NE
The expanded complexity of molecular testing has coincided with advances in technology, progress in our understanding of the biological mechanisms that control cell growth and differentiation, and developments in the clinical management of cancer. Correspondingly, the diversity of molecular test options has markedly broadened leading to assay selection challenges for practicing pathologists. In this lecture, concepts of molecular test integration in the evaluation of neoplasia to include review of basic genetic principles (types of genetic alterations with an emphasis on gene fusions), complementation of genetic approaches, test determination, and integration of genetic findings in the context of clinicopathological information will be discussed. Select cases, predominantly mesenchymal neoplasms, will be presented to illustrate the utility of molecular testing in routine practice and serve as useful paradigms.
- Discuss types of genetic alterations.
- Define features of gene fusions.
- Describe genetic approaches for identifying molecular markers to include both their merits and shortcomings.
- Discuss factors that might play a role in molecular test selection.
Dr. Julia A. Bridge completed her residency training in Anatomic Pathology at Kansas University Medical Center. As a pathology resident there, with undergraduate training in mouse tumor karyotyping, she became interested in human cancer cytogenetics and set up a research laboratory to study lymphomas and bone and soft tissue tumors with departmental and, subsequently, extramural funding received as a senior resident. She further developed this focus in the final 6 months of her pathology residency, which were as a Special Fellow in Clinical Cytogenetics at the University of Nebraska Medical Center. She then completed an additional fellowship at the Southwest Biomedical Research Institute under Dr. Avery A. Sandberg, a pioneer in cancer cytogenetics, at the same time as she held her first academic position as a clinical assistant professor in Pathology and Oncology at the University of Kansas.
In 1991, she returned to the University of Nebraska as an associate professor of Pathology, Pediatrics, and Orthopedic Surgery to practice cytopathology, surgical pathology, clinical cytogenetics, and molecular diagnostics and to move her funded research laboratory for continued cytogenetic characterization and molecular profiling of solid tumors with an emphasis on bone and soft tissue tumors. By 1999, she was promoted to professor. In 2019, Dr. Bridge joined the Translational Genomics Research Institute (Phoenix) and in 2021, ProPath (Dallas) while continuing her role in academics and education at the University of Nebraska Medical Center.
Over the years, Dr. Bridge’s lab has provided the initial description of many specific recurrent translocations and/or gene fusions contributing to tumor classification. This lab has also served as a site for molecular test development (including landmark FDA approvals for two novel gene-based tests), as a reference laboratory for the national Children’s Oncology Group, and as an educational hub for students and trainees.
Dr. Bridge is profoundly grateful to her extraordinary mentors for their guidance and encouragement and to her colleagues within and outside of Nebraska for their support and invaluable collaborations. These treasured relationships played a crucial role in shaping her career and are to be shared in this honor.
OGM Image: Ravindra Kolhe