Meet Melissa Alexander, MD, PhD, FCAP
Regional Medical Director - Medical Diagnostics (Breast)
AstraZeneca

Supporter of the Women's Networking Event at PI Summit 2025
Interviewed on April 11, 2025

Grace:  Hello Dr. Alexander.  I want to start off by saying how wonderful it was to have received your email just days after PI Summit 2024 ended to express AstraZeneca’s interest in supporting the following year’s Women’s Networking Event. Can you tell me what encouraged you and AstraZeneca to make that early commitment?

Dr. Alexander:  I can’t tell you how impressed I was with this trailblazing group of women and hearing the history of how it has grown from a handful of individuals to a room full made me want to support that trajectory. I am not an informaticist by training but I am a pathologist highly motivated to learn this space and I felt warmly welcomed by this group who all come from different career paths.

Grace:  Let’s take a step back and discuss how you came into pathology informatics. From what I recall at our first Women in Pathology Informatics (WPI) virtual meeting, this was not your plan from the outset. Can you share with us your entry into the subspecialty? 

Dr. Alexander:  Sure and you are right it was unintentional but fortuitous. My first job as an attending pathologist was at a small hospital who had adopted early versions of Her2 and Ki-67 IHC image analysis platforms and I began using those as regular tools in my practice. I felt I could easily identify the strengths and weaknesses of the platforms and how they could be improved. Additionally, the frozen section lab was in a separate building far from the pathology department and they had installed a scope with telepathology capabilities where the remote pathologist could even drive the scope which I found fascinating and incredibly useful. All this to say these factors were what piqued my initial interest and curiosity in the DP/CP world. I then took an attending position at a large multi-hospital system who very soon after became one of the first pathology departments in the US to go entirely digital. I had become very comfortable signing out cases digitally when an industry job opportunity presented itself that would allow me to explore DP/CP even further and even potentially help drive its adoption. From there my career has continued along that path and I am now at a pharma company which is developing biomarker algorithms to identify patients who may benefit particular therapies. While I miss regularly signing out cases, I get great satisfaction being part of this revolution in pathology.  

Grace:  How did AstraZeneca draw you further into the field?  What type of work do you do and how does AstraZeneca help fulfill some of your professional goals?

Dr. Alexander:  AstraZeneca has very exciting trials ongoing for breast cancer patients and as a breast pathologist that was the initial draw. But they also have a robust program developing AI biomarkers to select patients for therapies. The predictive biomarkers that are used regularly by pathologists now can be challenging and sometimes time consuming for pathologists especially on busy services like breast. The number of biomarkers for targeted therapies is only going to increase and incorporating AI into biomarker interpretation would have innumerable benefits for both pathologists and most importantly for patients. 

Grace:  As someone looking in, I’ve learned that women still constitute a very small percentage of pathology informatics positions around the world. Can you tell me what have been your observations as someone who works both in academic research and in industry? 

Dr. Alexander:  Indeed it is a small percentage but it is growing similarly to the rest of medicine. The medical school where I graduated from is now more than 50% women which is a trend nationally. My pathology residency class was 50% women and I am part of a very active social media group specifically for women in pathology which has over 1400 members. As the DP/CP revolution in pathology is happening, it is drawing more and more women like me into the field as reflected by this growing group. They can see the future of pathology which will undoubtedly incorporate informatics into regular practice. I can’t wait to follow the career growth of these women! 

Grace:  Who were your mentors along the way? What was the best advice or support they gave you?

Dr. Alexander:  I count myself as unbelievably fortunate for the mentors that I have had along the way. The first was my Dad who was a career physician scientist who was known to take particular interest in supporting career growth for women in science and medicine. He always encouraged me to stay curious and push boundaries. My mentors during my PhD studies really shaped my thinking and taught me how to approach a scientific question. And then the countless pathology mentors especially in the breast field were instrumental in supporting my career growth by way of networking, professional society engagement and encouraging me to continue to evolve.  

Grace:  I have also been struck by how supportive and engaged you, personally, have been with helping the Association for Pathology Informatics establish its new Women in Pathology Informatics (WPI) group by participating as a panelist. What do you hope to see in WPI?  What advice do you have for rising women informaticists?

Dr. Alexander:  Oh I hope you are soon going to need a bigger room for the WPI networking events! I also hope and anticipate eventually seeing some of the members in pathology informatics positions in pathology departments across the country. My advice would be first to network with groups like this and at meetings and find mentors. Follow individuals active in the field on LinkedIn and other social media platforms. Also there are so many free online webinars and educational opportunities to take advantage of through API, DPA, USCAP and CAP to name a few. Finally I’d recommend engaging with the companies who are demo’ing their DP/CP products at meetings. Have them show you a case and how the product works. These smaller companies have groundbreaking technologies and are on the radar of larger companies who may end up partnering with them to bring some of these platforms to market.  

Grace:  Thank you so much for your time.  It was a pleasure speaking with you and thank you so much for sharing your story. And, of course, thank you and AstraZeneca for supporting the Women’s Networking Event at PI Summit this May 20, 2025 from 7:30 pm - 9:30 pm.