Samimi M, Bonneau C, Lebas P, Michenet P
Pathology Department, Hôpital de la Source, CHR d'Orléans, Orléans Cedex 2, France.
Eur J Radiol. 2009 Feb;69(2):296-9. doi: 10.1016/j.ejrad.2007.10.014. Epub 2008 Feb 21.
The study was performed to substantiate the value of detecting clips in mastectomy specimens as a guide to taking pathological samples.
We performed a retrospective review of 4 cases of mastectomy required after biopsies of microcalcifications. In each case a metallic clip had been inserted at the end of the vacuum core biopsy procedure.
The study included 7 microcalcification clusters with a mean size of 6.7mm corresponding to multifocal or relapsing ductal carcinoma in situ. Gross examination of the mastectomy specimens revealed no evidence of tumoral lesions or fibrous scar tissue. Radiographic examination of the serial slices did not detect any microcalcifications, but confirmed the presence of the clip in the 7 clusters in 4 cases. Histological examination was performed on the areas identified by the clips and detected scar tissue indicating the location of the biopsies and tumoral lesions in all the specimens.
In the pathological management of mastectomy specimens following vacuum core biopsies, gross examination may reveal no abnormalities and slice radiography may fail to detect microcalcifications. In such cases, radiography of the serial slices allows localisation of the metallic clips inserted during the vacuum-assisted biopsy procedure and remains the only way for the pathologist to select mastectomy specimens for microscopic analysis.
本研究旨在证实检测乳房切除标本中的夹子作为获取病理样本指导的价值。
我们对4例微钙化活检后需要进行乳房切除术的病例进行了回顾性研究。在每例病例中,在真空芯针活检程序结束时插入了一个金属夹。
该研究包括7个微钙化簇,平均大小为6.7mm,对应多灶性或复发性导管原位癌。乳房切除标本的大体检查未发现肿瘤病变或纤维瘢痕组织的证据。连续切片的影像学检查未检测到任何微钙化,但证实了4例病例中7个簇中有夹子存在。对夹子所标识区域进行组织学检查,在所有标本中均检测到瘢痕组织,表明活检和肿瘤病变的位置。
在真空芯针活检后的乳房切除标本的病理处理中,大体检查可能未发现异常,切片影像学检查可能无法检测到微钙化。在这种情况下,连续切片的影像学检查可定位在真空辅助活检程序中插入的金属夹,并且仍然是病理学家选择乳房切除标本进行显微镜分析的唯一方法。