Subspecialized pathology is fundamental to the delivery of comprehensive cancer care. Hoag’s Department of Pathology plays a vital role in each of Hoag Family Cancer Institute’s site-specific programs and in the Precision Medicine Program, providing subspecialized and unique expertise. As Hoag Family Cancer Institute continues to grow and subspecialize even further, the Department of Pathology has concurrently driven proficiency along organ systems, which not only delivers expertise to clinicians, but has driven expertise in molecular testing and precision medicine.

Guided by a patient-first mentality, the Department provides timely pathology services emphasizing quality assurance measures allowing clinicians to take care of patients. Each pathologist makes him or herself available to clinicians to answer questions and discuss results or other issues.


The team is comprised of ten board-certified pathologists. Arrel S. Shapiro, M.D., serves as the fulltime medical director and blood banker. The pathologists maintain subspecialization in multiple different organ sites, including breast, gastrointestinal, head and neck, lung, brain, endocrine, and rare and complex tumors like bone and soft tissue sarcomas. Experienced cytopathologists provide diagnostic services for advanced endoscopy procedures.

Each of Hoag Family Cancer Institute’s 12 tumor boards is enhanced by the participation of one of Hoag’s subspecialized pathologists.


Unique to Hoag’s Pathology Department is a genetic molecular pathologist, David Braxton, M.D., who is a part of Hoag Family Cancer Institute’s Precision Medicine team. He provides key support for laboratory aspects of molecular profiling and serves as a resource to all clinicians requesting consultation services.

Hoag Family Cancer Institute has partnered with Caris Life Sciences for tumor profiling. The molecular pathologist reviews profiling results to detect germline mutations in order to determine if hereditary cancer or hereditary cancer risk is present and notifies the referring physicians so they can make appropriate referrals for genetic counseling and testing.


In early 2018, Hoag acquired a digital pathology scanner. It is the most advanced FDA approved platform for digital pathology and has multiple applications that will improve the efficiency and capabilities of the Pathology Department, including the ability to view high-resolution pathology images in tumor boards. The digital scanner and associated software also allow for quantitative analysis for immunohistochemistry interpretation. The shift from a traditional qualitative approach to a quantitative digital approach is transformative, eliminating bias from interpretations and increasing reproducibility, accuracy, and efficiency.

For more information call: 949-764-5610.