New Era Pathologic Techniques in the Diagnosis and Reporting of Breast Cancers

Tucker, F. Lee

doi:10.1053/j.sembd.2009.04.010

Cited by 17 publications

(20 citation statements)

References 40 publications

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“…there are studies showing that the conventional method of -sampling the surgical margins visualises only about 16% of the margin length in a single cross-section of the specimen [14].…”

Section: The Limitations Of the Conventional Pathologic Workupmentioning

confidence: 99%

“…Th is is the reason why many breast experts are reluctant to recognise the importance of breast cancer multifocality and disease extent; the principal that the things we (or our pathologists) do not see -do not exist. Th is destructive attitude is not acceptable in the era of modern radiological investigations and alternative histological methods able to demonstrate the real distribution of the lesions and the real disease extent of breast carcinomas [14][15][16][17][18][19].…”

Section: The Limitations Of the Conventional Pathologic Workupmentioning

confidence: 99%

“…Scientifi c studies have demonstrated that the method of large-format histology is superior to the conventional histological method in documenting tumour size and disease extent and it shows tumour multifocality signifi cantly more often [18]. It also visualises the surgical margins in a much larger extent than the conventional method [14]. Th e cost of the method is of course higher than the cost of the routine sampling method, but is lower than the costs of the methods of the more generous sampling.…”

Section: Large-format Histopathologymentioning

confidence: 99%

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Conventional and non-conventional pathologic workup of specimens with early breast carcinomas

Tot

2011

memo

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memo Pathology workup in early breast cancer 3/2011 short review 163 © Springer-VerlagTh e radiological -surgical parameters (tumour size, lesion distribution, disease extent and surgical margins) and the oncological morphologic parameters (tumour type and grade, hormone receptor status, proliferative activity and TNM stage) are equally important for adequate characterisation of early breast carcinomas. Conventional histopathology methods may be suffi cient in determining oncological parameters while large-format histopathology used in context of systematic radiological -pathological correlation is the only adequate approach in determining the radiological -surgical parameters in modern breast pathology. Th is is particularly valid for the parameters of lesion distribution and disease extent, which prognostic power has recently been evidenced and which are often underestimated if conventional histology methods are used. Th is review will focus on the radiological -surgical parameters in early breast carcinomas, their clinical signifi cance and the optimal methods of their assessment.

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“…there are studies showing that the conventional method of -sampling the surgical margins visualises only about 16% of the margin length in a single cross-section of the specimen [14].…”

Section: The Limitations Of the Conventional Pathologic Workupmentioning

confidence: 99%

Section: The Limitations Of the Conventional Pathologic Workupmentioning

confidence: 99%

Section: Large-format Histopathologymentioning

confidence: 99%

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Conventional and non-conventional pathologic workup of specimens with early breast carcinomas

Tot

2011

memo

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“…Sampling fragments the specimen and destroys the relationships between the multiple tumor foci: the distances between the foci and their distances from the surgical margins are not preserved, prohibiting assessment of disease extent. Thus, the conventional methods used for pathological analysis of breast tissue actually underestimate multifocality and disease extent and do not document tumor size adequately in many cases [32,33]. On the other hand, the advantages of large-format histopathology in this aspect have been repeatedly confirmed [31][32][33][34][35][36][37].…”

Section: Capabilities and Limitations Of The Microscopic Examinationmentioning

confidence: 99%

“…Thus, the conventional methods used for pathological analysis of breast tissue actually underestimate multifocality and disease extent and do not document tumor size adequately in many cases [32,33]. On the other hand, the advantages of large-format histopathology in this aspect have been repeatedly confirmed [31][32][33][34][35][36][37]. Using megacasettes (7.5×5.5 cm) or sampling an entire representative slice of the whole specimen into multiple adjacent conventional small blocks are another option, but still suboptimal, more laborious, and more expensive [37].…”

Section: Capabilities and Limitations Of The Microscopic Examinationmentioning

confidence: 99%

The role of radiological–pathological correlation in diagnosing early breast cancer: the pathologist’s perspective

Tot

Tabár

2010

Virchows Arch

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Early breast carcinoma, defined as purely in situ cancer and invasive carcinomas < 15 mm, represents the most frequent category of breast carcinomas in diagnostic routine in a regularly screened population. These tumors are usually detected with mammography screening and are preoperatively characterized with radiological imaging. The role of pathology in preoperative settings is to help understand the subgross morphology and to confirm malignancy in biopsy material. Postoperatively, the pathologist needs to verify the size of the cancer (defined as the largest dimension of the largest invasive focus), the extent of the disease (defined as the area or the volume of the breast tissue containing all the malignant foci), the distribution of the in situ and invasive lesions (as unifocal, multifocal, or diffuse), and intratumoral and intertumoral heterogeneity (in addition to determining margin status, histologic tumor type, hormone receptor status, and other parameters). Despite their small size, early breast carcinomas often exhibit complex morphology as they are multifocal/diffuse in about 60% and extensive (occupying an area ≥ 4 cm) in 40% of the cases. Routine use of large-format histopathology technique is a prerequisite for detailed correlation of the radiologic and histopathologic findings and for the correct assessment of these parameters. Breast pathologists must be aware of the advantages and disadvantages of the different imaging modalities and have detailed information about the radiological findings before work-up of the operative specimen. Multidisciplinary preoperative and postoperative tumor board meetings are essential in guiding the pathologists and in confirming the radiological findings. Interdisciplinary diagnosis is inevitably becoming the new gold standard in the diagnosis and management of early breast carcinomas.

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The Impact of Mammography Screening on the Diagnosis and Management of Early-Phase Breast Cancer

et al. 2013

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New Era Pathologic Techniques in the Diagnosis and Reporting of Breast Cancers

Cited by 17 publications

References 40 publications

Conventional and non-conventional pathologic workup of specimens with early breast carcinomas

Conventional and non-conventional pathologic workup of specimens with early breast carcinomas

The role of radiological–pathological correlation in diagnosing early breast cancer: the pathologist’s perspective

The Impact of Mammography Screening on the Diagnosis and Management of Early-Phase Breast Cancer

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