Changes

Jump to navigation Jump to search

Breast biopsy or excision

260 bytes added, 14:29, 23 April 2021
*Determine total specimen '''size'''. {{Comprehensive-begin}}Weight the specimen<ref name=Roychowdhury>{{cite web|url=https://www.pathologyoutlines.com/topic/breastmalignantgrossing.html|title=Grossing (histologic sampling) of breast lesions|author=Monika Roychowdhury|website=Pathologyoutlines.com}} Topic Completed: 1 August 2012. Revised: 19 September 2019</ref>{{Comprehensive-end}}
*'''[[Ink]]''' margins. If sample orientations are marked, use different colors for different directions.<ref name=Roychowdhury/>
*'''Palpate''' the specimen for masses. If felt, estimate the greatest dimension.<ref group=notes>A palpated greatest dimension before cutting is still superior to trying to align cut pieces together or mathematically adding the thicknesses of involved slices.</ref> Compare with radiography if available.<ref name=Roychowdhury/> Confirm the presence of any known biopsy clips, either visibly or by post-operative radiography (in order to confirm that the specimen includes the region of interest).
[[File:Cutting of uneven lumpectomy.jpg|thumb|Cut a lumpectomy in the direction that gives the shortest distance from margin to margin. If a lumpectomy is uneven as shown, cut so that the first and last slice become wedge shaped (because these will later be cut further, perpendicularly to the margin), avoiding a wedge-shape for remaining slices.]]
*'''Serially section''' the specimen.
:*When performing '''triage''' of fresh lumpectomies, generally make slices 1.1 to 1.5 cm thick. When laid down and flattened, this is generally thin enough to allow for fixation over at least 6 hours, and thick enough to be further cut into 2 or 3 slices after fixation. Slices with solid tumors are cut somewhat thinner since they won't flatten as much when laid down.
:*When selecting tissue for submission after fixation, make 3-4 mm thick '''slices'''.<ref name=Roychowdhury/>
*'''Inspect''' for any grossly visible lesions. If found, measure at least the greatest dimension, including stacking slices or mathematically adding of the lesion on the thicknesses of involved slicesslice where it appears largest. {{Moderate-begin}}Also compare it to the greatest gross measurement (including any palpated one) with the greatest measurement of at previous imaging, and note if it confers a staging discrepancy between imaging and gross dimensions, with cutoffs at 0.1 cm, 0.5 cm, 1.0 cm, 2.0 cm, and 5 cm.{{Moderate-end}}
*Submit:<ref name=Roychowdhury/>
:*Entire specimen if it can fit in 3-5 slices.

Navigation menu