Andrew Ryan

Anatomical pathologists, with a special interest in #gupath and the impending digital revolution in pathology

[Andrew Ryan @DrAndrewRyan]

@VickersBiostats @uroegg @dr_coops @JGrummet Pt selection for surg not my area so coming back to pathology........ being from a busy uropathology practice (clinical and review), the hardest/least reproducible place to draw a line b/w Ca and B9 is at the interface of 3+3 and low volume pattern 4 #becarefulwhatyouwishfor

[Andrew Ryan @DrAndrewRyan]

@VickersBiostats @uroegg @dr_coops @JGrummet ......and changing name of 3+3 to non-malignant will then makes it more difficult to act on these other non-Gleason features.
"You don't have cancer, but your non-cancer is worryingly large on MRI so we think it should come out" is equally troublesome

[Andrew Ryan @DrAndrewRyan]

@VickersBiostats @uroegg @dr_coops @JGrummet I'm fortunate to work with pro-surveillance surgeons/clinicians and funded MRI, but in our lab in 2022, it's rare to see RadProst from GG1-only coreBxs....and when we do, it's usually because of other concerning features (large volume on imaging or core, imaging mismatch)

[Andrew Ryan @DrAndrewRyan]

@VickersBiostats @uroegg @dr_coops @JGrummet ......and patient education

[Andrew Ryan @DrAndrewRyan]

@VickersBiostats @uroegg @dr_coops I can't help but feel this is trying to solve the wrong problem.

The 'right problem' here is over-investigation and over-treatment

Over-Ix = Improved patient selection/MRI/molecular.
Over-Rx = ...cue Urologists/RadOncs
#uropathology #ProstateCancer

[Andrew Ryan @DrAndrewRyan]

@JGrummet Is a Bx diagnosis of GG1 predictive of increased risk of subsequent >GG1 diagnosis?

[Andrew Ryan @DrAndrewRyan]

@JGrummet @uroegg @drphil_urology I also enjoy this "philosophical debate", but there really isn't much to debate scientifically here.

You would have more chance if you went after the 'non-invasive papillary urothelial carcinoma' first

[Andrew Ryan @DrAndrewRyan]

@JGrummet Looks like you've got a challenge convincing the majority of ueopathologists too
https://t.co/PEnzi5EjGX

[International Society of Urological Pathology @IntSocUropath]

(1/2) Dear ISUP members, thank you for participating in our recent surve about Gleason score 3+3=6 prostate cancer.

“Of 314 respondents, 278 (89%) endorsed retaining the cancer label for GS6, versus 7% who favored renaming.

[Andrew Ryan @DrAndrewRyan]

@JGrummet I'll defer to your expertise on #2-4........but I won't let you get away with #1... breaking science for clinical convenience.

[Andrew Ryan @DrAndrewRyan]

@tomoxl Keep up the amazing work @tomoxl

[Andrew Ryan @DrAndrewRyan]

@DrTravisBrown These are excellent path visuals @DrTravisBrown. Keep up the great work #PathTwitter #BreastPath

[Andrew Ryan @DrAndrewRyan]

@Gleason4plus5 This looks like a report written for a database rather than a urologist. A great reminder that a report is about both the message AND the delivery.

[Andrew Ryan @DrAndrewRyan]

@DrTravisBrown Beautiful images @DrTravisBrown

[Andrew Ryan @DrAndrewRyan]

@Gleason4plus5 Then #gupath could be the only subspeciality where invasive cancers are not called cancer (LG CaP) and non-invasive neoplasms are called cancer (papillary urothelial carcinoma)

[Andrew Ryan @DrAndrewRyan]

@Gleason4plus5 @daninava @daviesbj You're being super tolerant @Gleason4plus5. I am resisting entering but support you entirely.
I think the appropriate saying goes something like "let the cobbler stick to his last" https://t.co/ZuTzzXB4mf

[Andrew Ryan @DrAndrewRyan]

@ReneaTaylor1 @TissuPath @MonashBDI Such a pleasure to be involved in the fantastic work you and the team are doing. Thanks for visiting

[Renea Taylor @ReneaTaylor1]

Celebrated a milestone today with our trusted colleagues and valued collaborators @TissuPath following our 500th fresh tissue for our PDX program. Thank you for your generosity Andrew, Sam, David and all the team. #ProstateCancer #uropathology @MonashBDI

[Andrew Ryan @DrAndrewRyan]

@TommyJohn00 Yep......still selling alcohol 👍

[Andrew Ryan @DrAndrewRyan]

@KCampbellMD @PathologyUAMS @DermpathUAMS @RJCampbellMD @Dr_MikeDeWall @MightyDermPath @JMGardnerMD @AnnaTartMD @redsnapperpath @MikiLindseyMD @AadilAhmedMD C x2 for me