Lavinia P. Middleton, M.D.
Department of Anatomical Pathology, Division of Pathology-Lab Medicine Div
About Dr. Middleton
Dr. Middleton is a breast pathologist with strong interest and expertise in quality and process improvement. A leader in her field, Dr. Middleton is actively involved in clinical and transitional research and has publications in leading pathology journals on the morphology and clinical features of breast cancer and quality. She has published book chapters relating to breast cancer disease progression and quality improvement. She has a strong history of mentorship and has mentored local high school students, undergraduates and Medical school students in pathology, infectious diseases, quality, error reduction, human factors engineering, and process improvement for over two decades. Additionally, Dr. Middleton has taught trainees and practicing pathologists on the diagnostic features of breast cancer at the highest level through professional societies including US and Canadian Academy of Pathology and the American Society of Clinical Pathology. In 2016, Dr. Middleton was appointed deputy Chief Medical Officer, Medical Affairs and in this capacity assisted in the credentialing, competency assessment, and metric evaluation of MD Anderson Faculty and Advanced Care Providers. Dr. Middleton has an increasingly complex and varied experience in leading teams at the interface of quality, clinical operations and medicine. Currently Dr. Middleton is the Co-Chair of the Division of Pathology's Strategic Operational Priority Working Group Committee, linking the Division of Pathology's strategy with the institutional strategy to improve early detection, diagnosis, and response to therapy.
Present Title & Affiliation
Primary Appointment
Professor, Department of Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
Education & Training
Degree-Granting Education
| 1993 | George Washington School of Medicine and Health Sciences, Washington, USA, MD, Medicine |
| 1989 | Yale College, New Haven, CT, USA, BS, Biology |
Board Certifications
| 2014 | American Board of Medical Quality |
| 1997 | American Board of Pathology, Anatomic Pathology |
| 1994 | National Board of Medical Examiners |
Experience & Service
Administrative Appointments/Responsibilities
Divisional Director, Quality Operations, The University of Texas MD Anderson Cancer Center, Houston, TX, 2012 - 2019
Quality Officer, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 2009 - 2016
Medical Director, Surgical Pathology Support Services, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 2006 - 2012
Medical Director, Quality Assurance, Department of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 2001 - 2015
Steering Committee, The University of Texas M.D. Anderson Cancer Center, Houston, TX, 2000 - 2002
Institutional Committee Activities
Coordinator, American College of Surgeons Site Visit Committee, 2020 - 2022
Member, Institutional Patient Safety Committee, 2014 - 2020
Board Member, Secretary, UT MD Anderson Cancer Center Practice Network, 2012 - 2018
Member, Credentials Committee of the Medical Staff, 2011 - 2019
Member, Executive Billing Compliance Committee, 2010 - Present
Member, Professional Liability Committee, 2010 - Present
Member, Molecular Targets and Markers Testing Facility Steering Committee, 2010 - 2012
Member, Molecular Testing Evaluation Committee, 2010 - 2012
Member, Quality Improvement Assessment Board, 2009 - 2015
Quality Officer for Department of Pathology, Quality Officer, 2009 - 2015
Expert Reviewer, Institutional Focus Review Policy, 2008 - 2009
Honors & Awards
| 2018 | President's Recognition for Faculty Excellence, UT MD Anderson Cancer Center |
| 2010 | Clinical Safety and Effectiveness Alumni Award, 1st Place, The University of Texas System, Austin, TX |
Selected Publications
Peer-Reviewed Articles
- Khazai L, Middleton LP, Goktepe N, Liu BT, Sahin AA. Breast pathology second review identifies clinically significant discrepancies in over 10% of patients. J Surg Oncol 111(2):192-7, 2015. e-Pub 2014. PMID: 25273328.
- Zhang S, Huo L, Arribas E, Middleton LP. Adenomyoepithelioma of the breast with associated atypical lobular hyperplasia: a previously unrecognized association with management implications. Ann Diagn Pathol 19(1):20-3, 2015. e-Pub 2014. PMID: 25631879.
- Middleton LP, Feeley TW, Albright HW, Walters R, Hamilton SH. Second-Opinion Pathologic Review Is a Patient Safety Mechanism That Helps Reduce Error and Decrease Waste. J Oncol Pract 10(4):275-80, 2014. e-Pub 2014. PMID: 24695900.
- Middleton LP, Sneige N, Coyne R, Shen Y, Dong W, Dempsey P, Bevers TB. Most lobular carcinoma in situ and atypical lobular hyperplasia diagnosed on core needle biopsy can be managed clinically with radiologic follow-up in a multidisciplinary setting. Cancer Med 3(3):492-9, 2014. e-Pub 2014. PMID: 24639339.
- Nayak A, Carkaci S, Gilcrease MZ, Liu P, Middleton LP, Bassett RL, Zhang J, Zhang H, Coyne RL, Bevers TB, Sneige N, Huo L. Benign papillomas without atypia diagnosed on core needle biopsy: experience from a single institution and proposed criteria for excision. Clin Breast Cancer 13(6):439-49, 2013. e-Pub 2013. PMID: 24119786.
- Wagar EA, Phipps R, Del Guidice R, Middleton LP, Bingham J, Prejean C, Johnson-Hamilton M, Philip P, Le NH, Muses W. Inpatient preanalytic process improvements. Arch Pathol Lab Med 137(12):1753-60, 2013. PMID: 24283855.
- Li X, Deavers MT, Guo M, Liu P, Gong Y, Albarracin CT, Middleton LP, Huo L. The effect of prolonged cold ischemia time on estrogen receptor immunohistochemistry in breast cancer. Mod Pathol 26(1):71-78, 2013. e-Pub 2012. PMID: 22899286.
- Middleton LP. The Diagnosis of Pleomorphic Lobular Carcinoma In Situ Warrants Complete Excision with Negative Margins. Current Breast Cancer Reports 4(2):99-101, 2012.
- Wu Y, Mittendorf EA, Kelten C, Tucker SL, Wei W, Middleton LP, Broglio K, Buchholz TA, Hunt KK, Sahin AA. Occult axillary lymph node metastases do not have prognostic significance in early stage breast cancer. Cancer 118(6):1507-14, 2012. e-Pub 2011. PMID: 22009292.
- Tian Z, Wei B, Tang F, Wei W, Gilcrease MZ, Huo L, Albarracin CT, Resetkova E, Middleton LP, Sahin A, Xing Y, Hunt KK, Chen J, Bu H, Rashid A, Abraham SC, Wu Y. Prognostic significance of tumor grading and staging in mammary carcinomas with neuroendocrine differentiation. Hum Pathol 42(8):1169-77, 2011. e-Pub 2011. PMID: 21334720.
- Downs-Kelly E, Bell D, Perkins GH, Sneige N, Middleton LP. Clinical Implications of Margin Involvement by Pleomorphic Lobular Carcinoma In Situ. Arch Pathol Lab Med 135(6):737-43, 2011. PMID: 21631266.
- Langsner RJ, Middleton LP, Sun J, Meric-Bernstam F, Hunt KK, Drezek RA, Yu TK. Wide-field imaging of fluorescent deoxy-glucose in ex vivo malignant and normal breast tissue. Biomed Opt Express 2(6):1514-23, 2011. e-Pub 2011.
- Arun BK, Granville LA, Yin G, Middleton LP, Dawood S, Kau SW, Kamal A, Hsu L, Hortobagyi GN, Sahin AA. Glutathione-S-Transferase-Pi Expression in Early Breast Cancer: Association With Outcome and Response to Chemotherapy. Cancer Invest 28(5):554-9, 2010. e-Pub 2010. PMID: 20210524.
- Dominici LS, Kuerer HM, Babiera G, Hahn KM, Perkins G, Middleton LP, Ramirez MM, Yang W, Hortobagyi GN, Theriault RL, Litton JK. Wound Complications from Surgery in Pregnancy-Associated Breast Cancer (PABC). Breast Dis 31(1):1-5, 2010. e-Pub 2010. PMID: 20519803.
- Rosbach KJ, Shin D, Muldoon TJ, Quraishi MA, Middleton LP, Hunt KK, Meric-Bernstam F, Yu TK, Richards-Kortum RR, Yang W. High-resolution fiber optic microscopy with fluorescent contrast enhancement for the identification of axillary lymph node metastases in breast cancer: a pilot study. Biomed Opt Express 1(3):911-922, 2010. e-Pub 2010. PMID: 21258518.
- Wagner J, Boughey JC, Garrett B, Babiera G, Kuerer H, Meric-Bernstam F, Singletary E, Hunt KK, Middleton LP, Bedrosian I. Margin assessment after neoadjuvant chemotherapy in invasive lobular cancer. Am J Surg 198(3):387-91, 2009. e-Pub 2009. PMID: 19362281.
- Boughey JC, Wagner J, Garrett BJ, Harker L, Middleton LP, Babiera GV, Meric-Bernstam F, Lucci A, Hunt KK, Bedrosian I. Neoadjuvant Chemotherapy in Invasive Lobular Carcinoma May Not Improve Rates of Breast Conservation. Ann Surg Oncol 16(6):1606-1611, 2009. e-Pub 2009. PMID: 19280264.
- Middleton LP, Price KM, Puig P, Heydon LJ, Tarco E, Sneige N, Barr K, Deavers MT. Implementation of American Society of Clinical Oncology/College of American Pathologists HER2 Guideline Recommendations in a tertiary care facility increases HER2 immunohistochemistry and fluorescence in situ hybridization concordance and decreases the number of inconclusive cases. Arch Pathol Lab Med 133(5):775-780, 2009. PMID: 19415952.
- Loya A, Guray M, Hennessy BT, Middleton LP, Buchholz TA, Valero V, Sahin AA. Prognostic significance of occult axillary lymph node metastases after chemotherapy-induced pathologic complete response of cytologically proven axillary lymph node metastases from breast cancer. Cancer 115(8):1605-1612, 2009. e-Pub 2009. PMID: 19197997.
- Yi M, Meric-Bernstam F, Middleton LP, Arun BK, Bedrosian I, Babiera GV, Hwang RF, Kuerer HM, Yang W, Hunt KK. Predictors of contralateral breast cancer in patients with unilateral breast cancer undergoing contralateral prophylactic mastectomy. Cancer 115(5):962-71, 2009. PMID: 19172584.
- Beadle BM, Woodward WA, Middleton LP, Tereffe W, Strom EA, Litton JK, Meric-Bernstam F, Theriault RL, Buchholz TA, Perkins GH. The impact of pregnancy on breast cancer outcomes in women<or=35 years. Cancer 115(6):1174-84, 2009. PMID: 19204903.
- Kuerer HM, Albarracin CT, Yang WT, Cardiff RD, Brewster AM, Symmans WF, Hylton NM, Middleton LP, Krishnamurthy S, Perkins GH, Babiera G, Edgerton ME, Czerniecki BJ, Arun BK, Hortobagyi GN. Ductal Carcinoma In Situ: State of the Science and Roadmap to Advance the Field. J Clin Oncol 27(2):279-88, 2009. e-Pub 2008. PMID: 19064970.
- Mathew J, Perkins GH, Stephens T, Middleton LP, Yang WT. Primary breast cancer in men: clinical, imaging, and pathologic findings in 57 patients. AJR Am J Roentgenol 191(6):1631-9, 2008. PMID: 19020230.
- Gadre SA, Perkins GH, Sahin AA, Sneige N, Deavers MT, Middleton LP. Neovascularization in mucinous ductal carcinoma in situ suggests an alternative pathway for invasion. Histopathology 53(5):545-53, 2008. PMID: 18983463.
- Wang H, Arun BK, Wang H, Fuller GN, Zhang W, Middleton LP, Sahin AA. IGFBP2 and IGFBP5 overexpression correlates with the lymph node metastasis in T1 breast carcinomas. Breast J 14(3):261-7, 2008. e-Pub 2008. PMID: 18373644.
- Nicholas MM, Wu Y, Middleton LP, Gilcrease MZ.. Loss of myoepithelium is variable in solid papillary carcinoma of the breast. Histopathology 51(5):657-665, 2007.
- Boughey JC, Middleton LP, Harker L, Garrett B, Fornage B, Hunt KK, Babiera GV, Dempsey P, Bedrosian I. Utility of ultrasound and fine-needle aspiration biopsy of the axilla in the assessment of invasive lobular carcinoma of the breast. Am J Surg 194(4):450-455, 2007. PMID: 17826054.
- Middleton LP, Perkins GH, Tucker SL, Sahin AA, Singletary SE. Expression of ERalpha and ERbeta in lobular carcinoma in situ. Histopathology 50(7):875-880, 2007.
- Woodward WA, Huang EH, McNeese MD, Perkins GH, Tucker SL, Strom EA, Middleton LP, Hahn K, Hortobagyi GN, Buchholz TA. African-American race is associated with a poorer overall survival rate for breast cancer patients treated with mastectomy and doxorubicin-based chemotherapy. Cancer 107(11):2662-2668, 2006. PMID: 17061247.
- Oh JL, Dryden MJ, Woodward WA, Yu TK, Tereffe W, Strom EA, Perkins GH, Middleton LP, Hunt KK, Giordano SH, Oswald MJ, Domain D, Buchholz TA. Locoregional control of clinically diagnosed multifocal or multicentric breast cancer after neoadjuvant chemotherapy and locoregional therapy. J Clin Oncol 24(31):4971-4975, 2006. PMID: 17075114.
- Hahn KM, Johnson PH, Gordon N, Kuerer H, Middleton LP, Ramirez M, Yang W, Perkins G, Hortobagyi GN, Theriault RL. Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer 107(6):1219-1226, 2006. PMID: 16894524.
- Erguvan-Dogan B, Whitman GJ, Nguyen VA, Dryden MJ, Stafford RJ, Hazle J, McAlee KR, Phelps MJ, Ice MF, Kuerer HM, Middleton LP. Specimen radiography in confirmation of MRI-guided needle localization and surgical excision of breast lesions. AJR Am J Roentgenol 187(2):339-44, 2006. PMID: 16861535.
- Guarneri V, Broglio K, Kau SW, Cristofanilli M, Buzdar AU, Valero V, Buchholz T, Meric F, Middleton LP, Hortobagyi GN, Gonzalez-Angulo AM. Prognostic Value of Pathologic complete response after primary chemotherapy in relation to hormone receptor status and other factors. J Clin Oncol 24(7):1037-1044, 2006. PMID: 16505422.
- Chagpar AB, Middleton LP, Sahin AA, Dempsey P, Buzdar AU, Mirza AN, Ames FC, Babiera GV, Feig BW, Hunt KK, Kuerer HM, Meric-Bernstam F, Ross MI, Singletary SE. Accuracy of physical examination, ultrasonography, and mammography in predicting residual pathologic tumor size in patients treated with neoadjuvant chemotherapy. Ann Surg 243(2):257-264, 2006.
- Giordano SH, Perkins GH, Broglio K, Garcia SG, Middleton LP, Buzdar AU, Hortobagyi GN. Adjuvant systemic therapy for male breast carcinoma. Cancer 104(11):2359-2364, 2005. PMID: 16270318.
- Chagpar A, Middleton LP, Sahin AA, Meric-Bernstam F, Kuerer HM, Feig BW, Ross MI, Ames FC, Singletary SE, Buchholz TA, Valero V, Hunt KK. Clinical outcome of patients with lymph node-negative breast carcinoma who have sentinel lymph node micrometastases detected by immunohistochemistry. Cancer 103(8):1581-1586, 2005. PMID: 15747375.
- Maru D, Middleton LP, Wang S, Valero V, Sahin A. HER-2/neu and p53 overexpression as biomarkers of breast carcinoma in women age 30 years and younger. Cancer 103(5):900-905, 2005. PMID: 15643600.
- Vigneswaran N, Wu J, Muller S, Zacharias W, Narendran S, Middleton LP. Expression analysis of cystatin C and M in laser-capture microdissectioned human breast cancer cells--a preliminary study. Pathol Res Pract 200(11-12):753-762, 2005. PMID: 15792117.
- Recine MA, Deavers MT, Middleton LP, Silva EG, Malpica A. Serous carcinoma of the ovary and peritoneum with metastases to the breast and axillary lymph nodes: a potential pitfall. Am J Surg Pathol 28(12):1646-1651, 2004. PMID: 15577686.
- Wagner AE, Middleton LP, Whitman GJ. Intracystic papillary carcinoma of the breast with invasion. AJR Am J Roentgenol 183(5):1516, 2004. PMID: 15505330.
- Sanati S, Ayala AG, Middleton LP. Lymphoepithelioma-like carcinoma of the breast: report of a case mimicking lymphoma. Ann Diagn Pathol 8(5):309-315, 2004. PMID: 15494940.
- Selinko VL, Middleton LP, Dempsey PJ. Role of sonography in diagnosing and staging invasive lobular carcinoma. J Clin Ultrasound 32(7):323-332, 2004. PMID: 15293298.
- Yared MA, Middleton LP, Meric F, Cristofanilli M, Sahin AA. Expression of c-kit proto-oncogene product in breast tissue. Breast J 10(4):323-327, 2004. PMID: 15239791.
- Shahar KH, Hunt KK, Thames HD, Ross MI, Perkins GH, Kuerer HM, Strom EA, McNeese MD, Meric F, Schechter NR, Sahin AA, Middleton LP, Buchholz TA. Factors predictive of having four or more positive axillary lymph nodes in patients with positive sentinel lymph nodes: implications for selection of radiation fields. Int J Radiat Oncol Biol Phys 59(4):1074-1079, 2004. PMID: 15234041.
- McGregor DK, Whitman GJ, Middleton LP. Myolipoma of the breast: mammographic, sonographic, and pathologic correlation. Breast J 10(3):259-260, 2004. PMID: 15125757.
- Ivan D, Selinko V, Sahin AA, Sneige N, Middleton LP. Accuracy of core needle biopsy diagnosis in assessing papillary breast lesions: histologic predictors of malignancy. Mod Pathol 17(2):165-171, 2004. PMID: 14631369.
- Middleton LP, Amin M, Gwyn K, Theriault R, Sahin A. Breast carcinoma in pregnant women: assessment of clinicopathologic and immunohistochemical features. Cancer 98(5):1055-1060, 2003. PMID: 12942575.
- Dogan BE, Whitman GJ, Middleton LP, Phelps M. Intracystic papillary carcinoma of the breast. AJR Am J Roentgenol 181(1):186, 2003. PMID: 12818855.
- Ramalingam P, Middleton LP, Tamboli P, Troncoso P, Silva EG, Ayala AG. Invasive micropapillary carcinoma of the breast metastatic to the urinary bladder and endometrium: diagnostic pitfalls and review of the literature of tumors with micropapillary features. Ann Diagn Pathol 7(2):112-119, 2003. PMID: 12715337.
- Gupta D, Middleton LP, Whitaker MJ, Abrams J. Comparison of fluorescence and chromogenic in situ hybridization for detection of HER-2/neu oncogene in breast cancer. Am J Clin Pathol 119(3):381-387, 2003. PMID: 12645340.
- Diaz LK, Hunt K, Ames F, Meric F, Kuerer H, Babiera G, Ross M, Singletary E, Middleton LP, Symmans WF, Krishnamurthy S, Sahin A, Sneige N, Gilcrease MZ. Histologic localization of sentinel lymph node metastases in breast cancer. Am J Surg Pathol 27(3):385-389, 2003. PMID: 12604895.
- Middleton LP, Grant S, Stephens T, Stelling CB, Sneige N, Sahin AA. Lobular carcinoma in situ diagnosed by core needle biopsy: when should it be excised?. Mod Pathol 16(2):120-129, 2003. PMID: 12591964.
- Middleton LP, Chen V, Perkins GH, Pinn V, Page D. Histopathology of breast cancer among African-American women. Cancer 97(1):253-257, 2003. PMID: 12491489.
- Sneige N, Wang J, Baker BA, Krishnamurthy S, Middleton LP. Clinical, histopathologic, and biologic features of pleomorphic lobular (ductal-lobular) carcinoma in situ of the breast: a report of 24 cases. Mod Pathol 15(10):1044-1050, 2002. PMID: 12379750.
- Solorzano CC, Middleton LP, Hunt KK, Mirza N, Meric F, Kuerer HM, Ross MI, Ames FC, Feig BW, Pollock RE, Singletary SE, Babiera G. Treatment and Outcome of Patients with Intracystic Papillary Carcinoma of the Breast. Am J Surg 184(4):364-368, 2002. PMID: 12383904.
- Gupta D, Wolf JA, Rubenchik IA, Middleton LP. Diagnostic pitfalls in fine needle aspiration cytology of atypical apocrine metaplasia in a breast lesion. A case report. Acta Cytol 46(4):749-752, 2002. PMID: 12146046.
- Wang J, Buchholz TA, Middleton LP, Allred DC, Tucker SL, Kuerer HM, Esteva FJ, Hortobagyi GN, Sahin AA. Assessment of histologic features and expression of biomarkers in predicting pathologic response to anthracycline-based neoadjuvant chemotherapy in patients with breast carcinoma. Cancer 94(12):3107-3114, 2002. PMID: 12115341.
- Gupta D, Croitoru CM, Ayala AG, Sahin AA, Middleton LP. E-cadherin immunohistochemical analysis of histiocytoid carcinoma of the breast. Ann Diagn Pathol 6(1):141-147, 2002. PMID: 12089723.
- Yared MA, Middleton LP , Smith TL, Kim HW, Ross MI, Hunt KK, Sahin AA. Recommendations for sentinel lymph node processing in breast cancer. Am J Surg Pathol 26(3):377-382, 2002.
- Gupta D, Merino MI, Farhood A, Middleton LP. Metastases to breast simulating ductal carcinoma in situ: report of two cases and review of the literature. Ann Diagn Pathol 5(1):15-20, 2001.
- Lei JY, Middleton LP, Guo XD, Duray PH, McWilliams G, Linehan WM, Merino MJ. Pigmented renal clear cell carcinoma with melanocytic differentiation. Hum Pathol 32(2):233-236, 2001.
- Middleton LP, Palacios DM, Bryant BR, Krebs P, Otis CN, Merino MJ. Pleomorphic lobular carcinoma: morphology, immunohistochemistry, and molecular analysis. Am J Surg Pathol 24(12):1650-1656, 2000.
- Brown MR, Chuaqui R, Vocke CD, Berchuck A, Middleton LP, Emmert-Buck MR, Kohn EC. Allelic loss on chromosome arm 8p: analysis of sporadic epithelial ovarian tumors. Gynecol Oncol 74(1):98-102, 1999.
- Middleton LP, Tressera F, Sobel ME, Bryant BR, Alburquerque A, Grases P, Merino MJ. Infiltrating micropapillary carcinoma of the breast. Mod Pathol 12(5):499-504, 1999.
- Sandor V, Reed E, Sarosy G, Middleton LP, Davis P, Kohn E. Synchronous inflammatory breast cancer and advanced ovarian carcinoma: a case with prolonged disease-free survival. Ann Oncol 10(5):585-588, 1999.
- Middleton LP, Merino MJ, Popok SM, Ordonez NG, Ayala AG, Ro JY. Male adnexal tumour of probable Wolffian origin occurring in a seminal vesicle. Histopathology 33:269-274, 1998.
- Quezado MM, Middleton LP, Bryant B, Lane K, Weiss SW, Merino MJ. Allelic loss on chromosome 22q in epithelioid sarcomas. Hum Pathol 29(6):604-608, 1998.
- Middleton LP, Duray PH, Merino MJ. The Historical Spectrum of Hemangiopericytoma: Application of Immunohistochemical Analysis Including Proliferative Markers to Facilitate Diagnosis and Predict Prognosis. Hum Pathol 29(6):636-640, 1998.
- Movsas B, Barrows MC, Steinberg SM, Middleton LP, Okunieff P, Jaffe ES, Epstein AH. Response during radiotherapy may be associated with outcome in mediastinal Hodgkin's disease. Radiat Oncol Investig 6(5):216-225, 1998.
Invited Articles
- Middleton LP. Commentary on: Tubular carcinoma of the breast: further evidence to support its excellent prognosis. Breast Diseases: A Year Book Quarterly 22(1):33-34, 2011.
- Middleton LP. Commentary on: Mucinous carcinoma of the breast is genomically distinct from invasive ductal carcinomas of no special type. Breast Diseases: A Year Book Quarterly 22(2):154-155, 2011.
- Middleton LP. Commentary on: Tubular carcinoma of the breast: results of a large contemporary series. Breast Diseases: A Year Book Quarterly 21(1):53, 2010.
- Middleton LP. Commentary on: Tumor characteristics and patient outcomes are similar between invasive lobular and mixed invasive ductal/lobular breast cancers but differ from pure invasive ductal breast cancers. Breast Diseases: A Year Book Quarterly 21(1):44-45, 2010.
- Middleton LP. Commentary on: Histologic associations and long-term cancer risk in columnar cell lesions of the breast: a retrospective cohort and a nested case-control study. Breast Diseases: A Year Book Quarterly 20(2):169-170, 2009.
- Middleton LP. Commentary on: Should the extent of lobular neoplasia on core biopsy influence the decision for excision?. Breast Diseases: A Year Book Quarterly 19(2):145-146, 2008.
- Middleton LP. Commentary on: Needle core biopsy in the diagnosis of phyllodes neoplasm. Breast Diseases: A Year Book Quarterly 19(1):50, 2008.
- Middleton LP. Commentary on: Age-related lobular involution and risk of breast cancer. Breast Diseases: A Year Book Quarterly 19(1):50-51, 2008.
- Middleton LP. Commentary on: Preoperative profiling of symptomatic breast cancer by diagnostic core biopsy. Breast Diseases: A Year Book Quarterly 18(1):66, 2007.
- Middleton LP. Commentary on: E-Cadherin status in breast cancer correlates with histologic type but does not correlate with established prognostic parameters. Breast Diseases: A Year Book Quarterly 18(1):66, 2007.
- Middleton LP. Commentary on: Placental Cadherin and the Basal Epithelial Phenotype of BRCA1-Related Breast Cancer. Breast Diseases: A Year Book Quarterly 17(2):151, 2006.
- Middleton LP. Commentary on: Pleomorphic lobular carcinoma of the breast: role of comprehensive molecular pathology in characterization of an entity. Breast Diseases: A Year Book Quarterly 17(3):241, 2006.
- Middleton LP. Commentary on: Prediction of BRCA1 status in patients with breast cancer using estrogen receptor and basal phenotype. Breast Diseases: A Year Book Quarterly 17(2):152, 2006.
- Middleton LP. Commentary on: Breast Conservation Therapy for Invasive Lobular Carcinoma: The Impact of Lobular Carcinoma In Situ in the Surgical Specimen on Local Recurrence and Axillary Node Status. Breast Diseases: A Year Book Quarterly 16(2):178, 2005.
- Middleton LP. Commentary on: False-negative core needle biopsies of the breast: an analysis of clinical, radiologic, and pathologic findings in 27 consecutive cases of missed breast cancer. Breast Diseases: A Year Book Quarterly 15(1):45, 2004.
- Middleton LP. Commentary on: P-cadherin as a marker in the differential diagnosis of breast lesions. Breast Diseases: A Year Book Quarterly 15(1):47, 2004.
- Middleton LP. Commentary on: Utility of four-quadrant random sections in mastectomy specimens. Breast Diseases: A Year Book Quarterly 15(2):159-160, 2004.
- Middleton LP. Commentary on: Androgen receptors frequently are expressed in breast carcinomas: potential relevance to new therapeutic strategies. Breast Diseases: A Year Book Quarterly 15(2):161, 2004.
- Middleton LP. Commentary on: The finding of invasive cancer after a preoperative diagnosis of ductal carcinoma-in-situ: causes of ductal carcinoma-in-situ underestimates with stereotactic 14-gauge needle biopsy. Breast Diseases: A Year Book Quarterly 15(2):161, 2004.
- Middleton LP. Commentary on: Clonal analysis of bilateral mammary carcinomas by clinical evaluation and partial allelotyping. Breast Diseases: A Year Book Quarterly 15(2):162, 2004.
- Middleton LP. Commentary on: Pathologic findings from the National Surgical Adjuvant Breast and Bowel Project: twelve-year observations concerning lobular carcinoma in situ. Breast Diseases: A Year Book Quarterly 15(3):274-275, 2004.
- Middleton LP. Commentary on: Correlation of tumor volume and surface area with lymph node status in patients with multifocal/multicentric breast carcinoma. Breast Diseases: A Year Book Quarterly 15(3):277-278, 2004.
- Middleton LP. Commentary on: Does core needle breast biopsy accurately reflect breast pathology?. Breast Diseases: A Year Book Quarterly 15(3):280, 2004.
- Middleton LP. Commentary on: Pathologic analysis of tumor size and lymph node status in multifocal/multicentric breast carcinoma. Breast Diseases: A Year Book Quarterly 13(4):345, 2003.
- Middleton LP. Commentary on: Excisional biopsy should be performed if lobular carcinoma in situ is seen on needle core biopsy. Breast Diseases: A Year Book Quarterly 14(1):49, 2003.
- Perkins GH, Middleton LP, Buchholz TA. Commentary on: Male Breast Carcinoma, Improving outcomes with optimal local regional treatment. Breast Diseases: A Year Book Quarterly, 2000.
Editorials
- Perkins GH, Middleton LP. Male breast carcinoma, improving outcomes with optimal local regional treatment. Breast Diseases, 2021.
- Perkins GH, Middleton LP. Breast cancer in men. BMJ 327(7409)(7409):239-240, 2003. PMID: 12896911.
Abstracts
- Middleton LP. Proven Methods for Implementation of a Cross Functional Quality Improvement Plan by Empowering Trainees and Using a Team Approach to Impact Patient Care. Presented at the Association of American Medical Colleges Integrating Quality Meeting: Improving Value through Clinical Transformation, Education and Science, Rosemont, IL, 2014.
- Walls AL, Sahin AA, El-Naggar AK, Middleton LP. Basaloid Salivary-Analogue Tumors of the Mammary Gland: Histopathologic Spectrum and Differential Diagnosis. Presented at the 103rd Annual Meeting of the United States & Canadian Academy of Pathology, San Diego, CA, 2014.
- Karak SG, Middleton LP , Min Y, Hunt KK, Sahin AA. Intraoperative Margin Assessment Significantly Improves Quality of Care in Patients Undergoing Breast Conserving Surgery, 2013.
- Khazai L, Middleton LP , Goktepe N, Liu BT, Sahin AA. Breast Pathology Second Review Identifies Clinically Significant Discrepancies in 10% of Cases. Presented at the U.S. and Canadian Academy of Pathology, San Antonio, TX, 2012.
- Li X, Deavers MT, Guo M, Middleton LP, Liu P, Huo L. The Effect of Prolonged Cold Ischemia Time on Estrogen Receptor Detection in Breast Cancer. Presented at the U.S. and Canadian Academy of Pathology, San Antonio, TX, 2012.
- Rosen DG, Middleton LP , Yang WT, Sahin AA. Selection of Breast Core Biopsy Specimens for Tissue Bio-Repository. Presented at the U.S. and Canadian Academy of Pathology, San Antonio, TX, 2012.
- Rosen D, Quraishi MA, Middleton LP, Yang WT, Sahin AA. Relationship between implementation of the American Society of Clinical Oncology/College of American Pathologists guideline recommendations for breast core-needle biopsies and delay in therapy for patients with breast cancer. ASCO 2011 Breast Cancer Symposium, 2011.
- Nayak A, Gilcrease MZ, Middleton LP, Carkaci S, Zhang J, Sneige N, Huo L. Papillomas on Core Needle Biopsy: Analysis of 88 Cases. Presented at the U.S. and Canadian Academy of Pathology, San Antonio, TX, 2011.
- Richards D, Ayala AG, Middleton LP. Carcinoma In Situ Involving Sclerosing Adenosis: Diagnostic Pearls To Aid the Practicing Pathologist. Presented at the U.S. and Canadian Academy of Pathology, San Antonio, TX, 2011.
- Carkaci S, Adrada B, Middleton LP, Krishnamurthy S, Wei W, Yang WT. Ultrasound Features of Axillary Lymph Node Metastasis in Patients with Invasive Lobular Cancer. Presented at the RSNA 96th Scientific Assembly and Annual Meeting, 2010.
- Middleton LP, Puig P, Hamilton S, Routbort M, Luthra R, Rashid A, Reynolds A, Heydon L, Dunn J, Huimin L, Jackson S, Guerrero J, Lewing C, Bowman C, Ponder J, Cook P, Phipps R, Acosta C, Johnson-Hamilton M, Le NH, Woods J. Pre-analytic Process Improvements for Molecular Testing improves Turn Around time for Results. Presented at the CS&E Conference: Building the Bridge at the Quality Chasm, Austin, TX, 2010.
- Middleton LP, Puig P, Jackson S, Kellum L, Burford K, Ninan S, Phipps R, Acosta C, Johnson-Hamilton M, Le NH, Woods J. Process Improvements in Review of Patient’s Pathology Materials Decreases Accessioning Errors. Presented at the CS&E Conference: Building the Bridge at the Quality Chasm, Austin, TX, 2010.
- Wei B, Tian Z, Tang F, Wei W, Gilcrease MZ, Huo L, Albarracin CT, Resetkova E, Middleton LP, Sahin A, Chen J, Abraham SC, Wu Y. Prognostic Factors of Primary Invasive Mammary Neuroendocrine Carcinoma: Clinicopathologic Analysis of 74 Cases. Presented at the U.S. and Canadian Academy of Pathology, Washington, DC, 2010.
- Perkins GH, Babiera GV, Bedrosian I, Gonzalez-Angulo AM, Whitman GJ, Yang WT, Strom EA, Woodward W, Tereffe W, Yu TK, Oh JL, Buchholz TA, Middleton LP. Mucinous Breast Carcinoma: Occult Multifocality/Multicentricity in a Favorable Disease. Presented at the 32nd Annual San Antonio Breast Cancer symposium, 2009.
- Middleton LP, Price KM, Puig P, Heydon LJ, Tarco E, Sneige N, Barr K, Deavers MT. CS&E Guidelines to Improve Her 2 neu Testing and Interpretation. Presented at the CS&E Conference:Building the Bridge at the Quality Chasm, Austin, TX, 2009.
- Gadre SA, Perkins GH, Sahin AA, Sneige N, Deavers MT, Middleton LP. Neovascularization in Mucinous Ductal Carcinoma In Situ Suggests an Alternative Pathway for Invasion. Presented at the U.S. and Canadian Academy of Pathology Meeting, Boston, MA, 2009.
- Shah S, Middleton LP, Bedrosian I, Giordano SH, Yang W, Yu T-K, Woodward W, Oh JL, Tereffe W, Strom EA, Buchholz TA, Perkins GH. Male breast cancer outcomes: validation and modification of a guideline. Presented at the 31st Annual San Antonio Breast Cancer Symposium. San Antonio, TX, 2008.
- Downs-Kelly E, Bell D, Sneige N, Middleton LP. Management of Pleomorphic Lobular Carcinoma In Situ. Presented at the U.S. and Canadian Academy of Pathology Meeting, Denver, CO, 2008.
- F Tang, MZ Gilcrease, CT Albarracin, L Huo, LP Middleton, E Resetkova, Y Wu. Invasive Solid Papillary Carcinoma of the Breast: A Clinicopathologic Analysis of 52 Cases. Presented at the U.S. and Canadian Academy of Pathology Meeting, Denver, CO, 2008.
- Kelten C, MIttendorf EA, Broglio K, Vo T, Middleton LP, Ueno N, Hunt KK, Sahin AA. Clinical significance of occult axillary lymph node metastses in breast cancer patients without adjuvant systemic therapy: a long term retrospective study. Presented at the San Antonio Breast Cancer Symposium. San Antonio, TX, 2007.
- Perkins GH, Middleton LP, Tran R, Garcia SM, Cristofanilli M, Pusztai L, Singletary SE, Strom EA, Woodward WA, Yu TK, Oh JL, Tereffe W, Whitman GJ, Huang E, Allen, PK, Buccholz TA. Concurrent chemoradiation with capecitabine achieves meritable response and local control for inoperable and recurrent neoadjuvant chemotherapy refractory breast cancer. Presented at the San Antonio Breast Cancer Symposium. San Antonio, TX, 2007.
- Middleton LP, Perkins GH, Tucker SL, Sahin AA, Singletary SE.. Expression of ERa and ERb in Lobular Carcinoma in Situ. Presented at the U.S. and Canadian Academy of Pathology Meeting, San Diego, CA, 2007, 2007.
- Nicolas MM, Wu Y, Middleton LP, Gilcrease MZ.. Loss of Myoepithelium and Laminin at the Tumor-Stromal Interface in Circumscribed Solid Papillary Carcinoma of the Breast. Presented at the U.S. and Canadian Academy of Pathology Meeting, San Diego, CA, 2007, 2007.
- Loya A, Guray M, Hennessy B, Middleton LP, Buchholz T, Valero V, Sahin AA.. Detection of Occult Metastatic Carcinoma in Patients Who Had Initial Cytologically Proven Positive Axillary Lymph Nodes with Subsequent Complete Pathologic Response Following Pre-Operative Chemotherapy for Locally Advanced Breast Cancer. An Immunohistochemical Study. Presented at the U.S. and Canadian Academy of Pathology Meeting, Atlanta, GA, 2006, 2006.
- Kim E, Middleton LP, Arun B, Sahin A. Absence of E-cadherin Expression in Invasive Ductal Carcinoma of Breast: A Significant Predictor of Lymph Node Metastasis. Presented at the U.S. and Canadian Academy of Pathology Meeting, Vancouver, British Columbia, 2004.
- Zhang H, Zhai J, Chagpar A, Mirza N, Kuerer HM, Middleton LP, Whitman GJ, Buchholz TA, Hunt KK, Sahin AA. Amount of Tumor Present in Core Needle Biopsy (CNB) Samples: A Significant Predictor of Margin Status in Subsequent Breast-Conserving Surgery (BCS) Specimens in Patients with Ductal Carcinoma In Situ (DCIS). Presented at the U.S. and Canadian Academy of Pathology Meeting, Vancouver, British Columbia, 2004.
- Wang H, Wang H, Middleton LP, Fuller GN, Zhang W, Arun B, Sahin A. The Role of IGFBP2 and IGFBP5 Overexpression in Metastasis of T1 Breast Carcinoma. Presented at the U.S. and Canadian Academy of Pathology Meeting, Vancouver, British Columbia, 2004.
- Woodward WA, Huang E, McNeese MD, Perkins GH, Tucker SL, Strom EA, Schechter NR, Middleton LP, Hunt KK, Hortobagyi, GN, Gwyn KM, Buchholz TA. .African American Women with Breast Cancer Have Worse Overall Survival Than Caucasian and Hispanic Women After Mastectomy and Doxorubicin-Based Chemotherapy: Data From Two Independent Data Sets. Presented at the San Antonio Breast Research Meeting, 2003, 2003.
- Chagpar A, Mirza AN, Buzdar UA, Dempsey P, Ames FC, Babiera GV, Feig BW, Hunt KK, Kuerer HM, Meric-Bernstam F, Middleton LP, Ross MI, Sahin AA, Singletary SE. Accuracy of Physical Examination (PE), Ultrasonography (US) and Mammography (M) in Predicting Residual Pathological Tumor Size in Patients Treated with Neoadjuvant Chemotherapy (NAC) for Breast Cancer. Presented at the San Antonio Breast Research Meeting, 2003.
- Giordano SH, Perkins GH, Garcia SM, Middleton LP, Buzdar AU, Hortobagyi GN. Male Breast Cancer: The MD Anderson Experience with Adjuvant Therapy. Presented at the San Antonio Breast Research Meeting, 2003.
- Goncharuk V, Arun B, Middleton LP, Sahin A. Assessment of Actin-Binding Protein Fascin Expression in Stage I and II Invasive Breast Cancer. A Significant Correlation with Aggressive Clinical Behavior. Presented at the US and Canadian Academy of Pathology Meeting Washington, DC, 2003.
- Stephens TW, Radaideh MM, Middleton LP, Stelling CB, Whitman GJ. Benign Breast Calcification That Do Not Require Biopsy. Presented at the American Radiology Society Meeting, 2003.
- Chagpar A, Middleton LP, Sahin AA, Ross MI, Ames FC, Feig B, Kuerer HM, Valero V, Hunt KK. Clinical Outcome of Node Negative Breast Cancer Patients with Micrometastic Disease by Immunohistochemistry. Presented at the 2003 American Society of Clinical Oncology Annual Meeting, 2003.
- Cohn M, Middleton LP, Valero V, Sahin A. Gastrointestinal Metastases of Carcinoma of the Breast. Presented at the US and Canadian Academy of Pathology Meeting, Washington, DC, 2003.
- Gokhale S, Albarracin C, Arun B, Middleton LP, Sahin A. Immunohistochemical Expression of Prostate Specific Antigen in Normal Breast Tissue and Breast Neoplasms. Presented at the US and Canadian Academy of Pathology Meeting, Washington, DC, 2003.
- Krishnamurthy S, Sahin A, Middleton LP, Symmans FW, Gilcrease MG, Sneige N, Singletary ES, Kuerer HM, Ross MI, Hunt KK,. Intraoperative Imprint Cytology for Evaluation of Axillary Sentinel Lymph Nodes in Breast Cancer. Presented at the US and Canadian Academy of Pathology Meeting, Washington, DC,, 2003.
- Gupta D, Perkins GH, Garcia SM, Sahin AA, Middleton LP. Carcinoma of the Male Breast: A Single Institution Clinicopathological Study. Presented at the 2002 ASCP/CAP Annual Meeting, October 2002, Washington DC, 2002.
- Rosenthal SI, Valero V, Middleton LP, Strom EA, Guerra LT, Fuller GN, Cohen DS, Sahin AA. Analysis of Topoisomerase IIa Detection Using Chromogenic In-Situ Hybridization and Immunohistochemistry To Predict the Pathologic Response to Neoadjuvant Chemotherapy in Patients with Locally Advanced Breast Cancer. Presented at the United States and Canadian Academy of Pathology Meeting, February 2002, Chicago, IL, 2002.
- Rosenthal SI, Valero V, Fuller GN, Middleton LP, Sahin AA. Chromogenic In Situ Hybridization of Topoisomerase IIa for Evaluation of Locally Advanced Breast Cancer: A Comparative Study of DNA Amplification and Protein Overexpression. Presented at the United States and Canadian Academy of Pathology Meeting, February 2002, Chicago, IL, 2002.
Book Chapters
- Middleton LP. Quality Improvement plan components and Monitors. In: Quality Management in Anatomic Pathology. 1. College of American Pathologists Publications: Northfield, Illinois, 37-58, 2017.
- Middleton LP. Tubular, Mucinous, and Medullary Carcinoma. In: Advanced Therapy of Breast Disease. 3rd edition. People's Medical Publishing House USA: Shelton, CT, 1097-1098, 2012.
- Middleton LP,. The Unknown Primary Presenting. In: The Breast: Comprehensive Management of Benign and Malignant Diseases. 4th edition. W.B. Saunders: Philadelphia, Chapter 85, 2009.
- Middleton LP,. Surgical management of axillary metastases from occult primary breast cancer. In: MD Anderson Cancer Center Surgical Oncology Series, 2006.
- Bedrosian I, Middleton LP. Advanced Therapy of Breast Disease. In: Tubular Mucinous and Medullary Carcinoma, 2003.
- Middleton LP. Merino MJ. Head and Neck Surgical Pathology. In: Pathology of the thyroid and parathyroid glands. Lippincott-Williams and Wilkins, 350-388, 2001.
- Middleton LP,. Thyroid. In: Multidisciplinary care of head and neck cancer: the MD Anderson approach, 2000.
Letters to the Editor
- Albarracin C, Edgerton ME, Gilcrease MZ, Huo L, Krishnamurthy S, Middleton LP, Resetkova E, Sahin AA, Sneige N, Fraser WS, Wu Y. Is it too soon to start reporting HER2 genetic heterogeneity?. Arch Pathol Lab Med 134: 162-3, 2010.
- Middleton LP, Vlastos G, Mirza NQ, Eva S, Sahin AA. Multicentric mammary carcinoma: evidence of monoclonal proliferation. Cancer 94: 1910-1916, 2002.
- Middleton LP, Vlastos G, Mirza NQ, Singletary SE, Sahin AA. Multicentric mammary carcinoma: evidence of monoclonal proliferation. Cancer 94: 1910-1916, 2002.
- Yared M, Middleton LP, Sahin AA. Sentinel Lymph Node Histopathology in Breast Cancer. Am J Surg Pathol 26: 1368, 2002.
Grant & Contract Support
| Title: | Breast / Ovarian Moonshot Prevention Project C: Preventing Breast Cancer in Women with Precancerous Breast Lesions: Implementing a Program Improvement Project to Maximize Breast Cancer Preventive Therapy |
| Funding Source: | MoonShot |
| Role: | Collaborator |
Patient Reviews
CV information above last modified August 27, 2024