Available Services and Expertise
Dr. Carolina Gutierrez offers comprehensive diagnostic consultation services to physicians and patients at the Baylor/Ben Taub Breast Care Center. Access to the same services for individuals outside the Baylor/Ben Taub system can be arranged by contacting us directly.
Diagnostic Approach and Philosophy
Breast pathology is an evolving science and art. We conform closely to the approach described in Diagnostic Histopathology of the Breast, ed. DL Page and TJ Anderson, First Edition, Churchill Livingston, 1987 – modified to accommodate our own thinking and experience. Our evaluation of breast cancer provides all the information currently considered to be essential for therapeutic decision making, including histological subtype, tumor size, histological grade, mitotic index, status of surgical margins, and status of axillary lymph nodes. We have developed a diagnostic template (see example) and use it in the majority of cases to promote concise standardized terminology and content.
What to Send
Our pathologists need as much information as possible to provide an accurate and comprehensive diagnosis. To facilitate this, please send:
- Complete set of H&E-stained slides
- Representative paraffin block (or corresponding unstained slides) for immunohistochemical evaluation of prognostic/predictive factors (currently ER, PR, Ki67, and HER-2)
- Corresponding pathology reports
- Cover letter giving reason for consult and contact information of requesting physician or individual
- Completed billing form
Cases are routinely evaluated and reported within 48 hours of receiving them. We usually keep one or two representative slides in our files and return all remaining materials by mail to the originating hospital unless requested otherwise.
Where to Send
Physicians requesting consultation within the Baylor/Ben Taub system can send materials through the hospital courier service to the Department of Pathology at Ben Taub Hospital (please write "Attention Dr. Gutierrez" on the requisition slip), or hand deliver them to the Breast Center Pathology Laboratory (Alkek Building, Room 12.10).
Requests by physicians or individuals outside the Baylor/Ben Taub system should be mailed directly to the laboratory:
Breast Center Pathology Laboratory
Attention: Dr. Carolina Gutierrez
Alkek Building, Room N-1210.08
Baylor College of Medicine
One Baylor Plaza
Houston, TX 77030
The cost/billing structure of the Breast Center Pathology Laboratory is based on the Medicare/Medicaid RBRVS reimbursement scale and the AMA Current Procedure Terminology (CPT codes). We bill patients directly, and they are responsible for payment.
Diagnostic Consultation Fees
Procedure: Level IV – low complexity consultation (e.g. gross description, microscopic description, and diagnosis of core biopsy with report)
Procedure: Level V – moderate complexity consultation (e.g. gross description, microscopic description, and diagnosis of excisional biopsy with report)
Procedure: Level VI – high complexity consultation (e.g. gross description, microscopic description, and diagnosis of mastectomy and axillary dissection with report)
Procedure: Consultation and report on referred slides prepared elsewhere
Procedure: Consultation and report on referred material requiring preparation of additional slides (e.g. deeper levels)
Procedure: Consultation and report on referred slides prepared elsewhere requiring comprehensive review of additional medical records
Procedure: Evaluation and report of prognostic/predictive biomarkers (ER, PR, Ki67, and Her2) by immunohistochemistry.
Procedure: Evaluation of HER-2 by fluorescence in situ hybridization (FISH).
CPT: 88365, 88271x2, 88274x2