Meticulous attention to detail and careful clinicopathological correlation are the foundations of Dr Fearnhead’s approach to surgical pathology. She prides herself on staying up to date with ever-changing terminology, diagnostic criteria, and molecular/genetic advances and assays, always cognisant of the impact on oncological decision-making. Her reports are detailed and feature colour images of both macroscopic and microscopic pathology, as well as easy-to-reference summary datasets.

Intraoperative pathology
(frozen section)

Dr Fearnhead spends a portion of most days in theatre rendering on-site assessment of primary pathology and margin status. She uses a free-hand formal sectioning technique which allows for assessment of both architecture and cytology. Although formal haematoxylin and eosin (H&E)-stained sections remain the gold standard for final pathological diagnosis, preliminary intraoperative pathological assessment drastically reduced re-excision rates.

Cytology, including on-site cytology

Non-gyaecological cytopathology is part of Dr Fearnhead’s repertoire, and includes breast, thyroid and lymph node fine needle aspirates (FNA's). Rapid On-Site Assessment of image-guided FNA’s and imprint cytology of image-guided core biopsies is also part of her service.

Foetal and neonatal autopsies

Dr Fearnhead cultivated an interest in foetal and neonatal pathology during her training following attendance at the Placental Pathology for Africa course, which included modules on foetal and neonatal autopsies. This was strengthened during her time as a junior consultant at the National Health Laboratory Services (NHLS), where she collaborated with the Department of Paediatric Surgery at weekly clinicopathological meetings presenting paediatric surgical pathology cases.

Placental examination

A love of placental pathology was born during Dr Fearnhead’s time as a registrar and following attendance of Professor Colleen Wright’s Placental Pathology for Africa course. She had the pleasure of seeing many placentas in her routine practice prior to leaving the State pathology service, and wishes to keep this valuable skill alive.