Department of Histopathology, Nottingham University Hospitals, Nottingham, UK.
Histopathology. 2010 Apr;56(5):573-80. doi: 10.1111/j.1365-2559.2010.03518.x.
Standard margin assessment of breast carcinoma surgical specimens uses radial sections perpendicular to the margin. Shave sections assess a larger surface area of margin than radial sections. The aim was to assess the value of additional shave sections of the margin.
Both types of section were used to assess 471 wide local excision specimens for invasive carcinoma. One hundred and seventy-nine specimens had positive margins: only radial margins were involved (tumour within 5 mm of margin) in 76, only shave margins in 45, and both shave and radial margins in 58. Residual carcinoma was found in re-excision specimens (immediate or later) in 43% when the closest distance to the radial margin was 0-1 mm, 25% for 2-4 mm, 18% for 5-9 mm and 13% for >9 mm. Residual carcinoma was found in 44% of specimens if any shave section was positive and in 9% if all shaves were negative. Residual carcinoma was found in 32% if either radial or shave sections were positive and in 4% if neither was positive.
The combination of radial and shave sections appears to be good at separating patients into two groups with high and low risk of residual carcinoma.
乳腺癌外科标本的标准边缘评估采用垂直于边缘的放射状切片。削边切片比放射状切片评估更大的边缘表面积。目的是评估额外的边缘削边切片的价值。
两种类型的切片均用于评估 471 例广泛局部切除标本中的浸润性癌。179 例标本边缘阳性：仅 76 例有放射状边缘受累（肿瘤距边缘 5 毫米以内），仅 45 例有削边边缘受累，58 例同时有削边和放射状边缘受累。在立即或以后进行的再次切除标本中，当放射状边缘最近距离为 0-1 毫米时，43%的标本中发现残留癌，2-4 毫米时为 25%，5-9 毫米时为 18%，>9 毫米时为 13%。如果任何削边切片阳性，则 44%的标本中发现残留癌，如果所有削边均为阴性，则为 9%。如果放射状或削边切片中有任何一个阳性，则 32%的标本中发现残留癌，如果两个均为阳性，则为 4%。
放射状和削边切片的组合似乎可以很好地将患者分为高风险和低风险残留癌的两组。
