In-laboratory breast specimen radiography reduces tissue block utilization and improves turnaround time of pathologic examination

Abstract

Background This study was performed to determine whether in-laboratory specimen radiography reduces turnaround time or block utilization in surgical pathology. Methods Specimens processed during a 48-day trial of an in-lab cabinet radiography device (Faxitron) were compared to a control group of specimens imaged in the mammography suite during a prior 1-year period, and to a second group of specimens not undergoing imaging of any type. Results Cases imaged in the mammography suite had longer turnaround time than cases not requiring imaging (by 1.15 days for core biopsies, and 1.73 days for mastectomies; p < 0.0001). In contrast, cases imaged in-lab had turnaround time that was no longer than unimaged cases (p > 0.05 for core biopsies, lumpectomies and mastectomies). Mastectomies imaged in-lab required submission of fewer blocks than controls not undergoing any imaging (mean reduction of 10.6 blocks). Conclusions Availability of in-lab radiography resulted in clinically meaningful improvements in turnaround time and economically meaningful reductions in block utilization.

The Use of Optical Coherence Tomography for Gross Examination and Sampling of Fixed Breast Specimens: A Pilot Study

“…The imaging tool most commonly used to aid in grossing breast specimens is specimen X-ray, facilitated by the arrival of portable, enclosed devices, such as the Faxitron. Specimen X-ray may be utilized by the gross examiner to identify calcification or a localization marker in order to guide tissue sampling [ 24 ]. However, these applications have their limits: mammography has been shown to underestimate the size of high-volume DCIS when compared to pathologic size estimates by a mean of 1.31 cm [ 25 ].…”