Tucker F Lee
Virginia Biomedical Laboratories, LLC, P.O. Box 510, Wirtz, VA 24184, USA.
Int J Breast Cancer. 2012;2012:171792. doi: 10.1155/2012/171792. Epub 2012 Dec 17.
Modern breast imaging, including magnetic resonance imaging, provides an increasingly clear depiction of breast cancer extent, often with suboptimal pathologic confirmation. Pathologic findings guide management decisions, and small increments in reported tumor characteristics may rationalize significant changes in therapy and staging. Pathologic techniques to grossly examine resected breast tissue have changed little during this era of improved breast imaging and still rely primarily on the techniques of gross inspection and specimen palpation. Only limited imaging information is typically conveyed to pathologists, typically in the form of wire-localization images from breast-conserving procedures. Conventional techniques of specimen dissection and section submission destroy the three-dimensional integrity of the breast anatomy and tumor distribution. These traditional methods of breast specimen examination impose unnecessary limitations on correlation with imaging studies, measurement of cancer extent, multifocality, and margin distance. Improvements in pathologic diagnosis, reporting, and correlation of breast cancer characteristics can be achieved by integrating breast imagers into the specimen examination process and the use of large-format sections which preserve local anatomy. This paper describes the successful creation of a large-format pathology program to routinely serve all patients in a busy interdisciplinary breast center associated with a community-based nonprofit health system in the United States.
现代乳腺成像技术，包括磁共振成像，能越来越清晰地描绘乳腺癌的范围，但病理确诊往往不尽人意。病理结果指导治疗决策，报告的肿瘤特征上的微小差异可能使治疗和分期发生显著变化。在乳腺成像技术不断改进的时代，大体检查切除乳腺组织的病理技术变化不大，仍主要依赖大体检查和标本触诊技术。通常只有有限的成像信息传达给病理学家，一般是以保乳手术中金属丝定位图像的形式。传统的标本解剖和切片送检技术破坏了乳腺解剖结构和肿瘤分布的三维完整性。这些传统的乳腺标本检查方法对与影像学研究的相关性、癌症范围的测量、多灶性和切缘距离施加了不必要的限制。通过将乳腺成像人员纳入标本检查过程以及使用保留局部解剖结构的大幅面切片，可以实现乳腺癌特征的病理诊断、报告及相关性方面的改进。本文描述了在美国一个与社区非营利性卫生系统相关的繁忙跨学科乳腺中心成功创建一个大幅面病理项目，以便为所有患者提供常规服务。
