Méchine-Neuville A, Chenard M P, Gairard B, Mathelin C, Bellocq J P
Service d'Anatomie Pathologique, Hôpital de Hautepierre, av. Molière, 67098 Strasbourg Cedex.
Ann Pathol. 2000 May;20(3):275-9.
Large block macrosectioning of segmental excision specimens for breast cancer, and especially ductal carcinoma in situ, provides detailed information regarding size of the lesions, extent of spread and margin status which are essential for local recurrence risk assessment. However, the expansion of this technique has been curbed due to its reputation of being technically difficult, time-consuming, costly and providing slides of poor quality. We assessed the feasibility of the large section technique and adapted it to the everyday practice of a routine pathology laboratory. The time spent cutting a large block on a motorized microtome is half the time spent cutting the great number of conventional blocks needed to assess the same amount of tissue. Finally, 4 mm-thick stained large preparations of high quality are produced within 3 days after receiving the specimen. Analysis and report are both more precise and easier since the pathologist is saved the trouble of having to mentally re-assemble a great quantity of numbered small blocks. 805 primary monobloc segmental excision specimens have been examined in this way over the last 50 months period and we advocate its use as a standard procedure for breast-conserving surgery specimen management.
对乳腺癌,尤其是原位导管癌的节段性切除标本进行大块宏观切片,可提供有关病变大小、扩散范围和切缘状态的详细信息,这些信息对于评估局部复发风险至关重要。然而,由于该技术存在技术难度大、耗时、成本高以及切片质量差的名声,其应用的推广受到了限制。我们评估了大块切片技术的可行性,并将其应用于常规病理实验室的日常实践中。在电动切片机上切割一个大块所花费的时间是切割评估相同数量组织所需的大量传统小块所花费时间的一半。最后,在收到标本后的3天内即可制作出4毫米厚的高质量染色大切片。由于病理学家无需费心在脑海中重新组装大量编号的小切片,分析和报告都更加精确且容易。在过去的50个月里,我们以这种方式检查了805个原发性整块节段性切除标本,我们提倡将其作为保乳手术标本管理的标准程序。