Large-format histology in diagnosing breast carcinoma

Abstract

Large-format histology is a laboratory method that is based on embedding and processing continuous tisssue slices representing the entire cross section of the organ under study.Unlike the standard histological technique, large-format histology enables analysis of the lesion while preserving the surrounding tissue of the entire section surface. Due to this, large-format histology has found its use in diagnostic routine, especially in breast carcinomas. Key morphological prognostic parameters, such as tumour size, tumour extent, tumour multifocality, resection margins, presence and distribution of in situ carcinoma, and response to neoadjuvant therapy are more precisely determined on large sections.Intratumoural and intertumoural heterogeneity are also more easily detected and interpreted, with possibility to perform additional immunohistochemical and molecular analysis on tissue that has been processed for large sections. Large-format histology has found its place in modern breast pathology, especially in multidisciplinary diagnostics and therapy teams where correlation of the findings of multimodality preoperative radiology and those in large-format histological sections enable better therapy planning for each individual patients. ApstraktHistološka tehnika velikog formata je laboratorijska procedura koja omogućava vizualizaciju i patohistološku analizu čitavog preseka organa koji se ispituje. Za razliku od standardne histološke tehnike, histološka tehnika velikog formata omogućava analizu lezije dok je okolno tkivo čitave resekcione površine očuvano. Zahvaljujući ovome, histološka tehnika velikog formata našla je mesto u svakodnevnom rutinskom radu u patologiji, naročito u dijagnostici karcinoma dojke. Ključni prognostički parametri, kao što su veličina tumora, ekstenzija tumora, tumorska multifokalnost, status resekcionih margina, prisustvo i distribucija in situ karcinoma, kao i odgovor na neoadjuvantnu terapiju se mogu preciznije odrediti na velikm rezovima. Intratumorska i intertumorska heterogenost se takođe lakše uočavaju i tumače, uz održanu mogućnost izvođenja dodatnih imunohistohemijskih i molekularnih analiza na tkivu koje je preparirano za velike rezove. Histološka tehnika velikog formata pronašla je svoje mesto u savremenoj patologiji karcinoma dojke, naročito u radu multidisciplinarnih dijagnostičkih i terapijskih timova gde patološko-radiološka 4 korelacija imidžing metoda i velikih rezova omogućava bolje planiranje terapije za svakog pacijenta individualno.

Quality of Life of Bulgarian Breast Cancer Female Patients

“…Using the histotechnical method of largeformat histology in 215 breast neoplasm patients, invasive carcinoma of no special type in 122, ductal carcinoma in situ in 46, and lobular carcinoma in 28 cases have most commonly been identified [10]. Patients with ductal carcinoma in situ at early-stage or locally advanced breast cancer present with increased symptom burden and decreased QoL examined by means of the Edmonton Symptom Assessment System and the Functional Assessment of Cancer Therapy for Breast Cancer [11].…”