Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA, USA.
Department of Surgery, Tufts Medical Center, Boston, MA, USA.
Mod Pathol. 2018 Jul;31(7):1004-1011. doi: 10.1038/s41379-018-0020-z. Epub 2018 Feb 15.
Oncoplastic surgery provides breast cancer patients with greater aesthetic satisfaction without compromising disease-free survival or overall survival rate. Large volume displacement oncoplastic surgical techniques have become increasingly popular as a strategy for improving aesthetic outcomes and extending the option of breast conservation therapy. They often involve breast reduction or mastopexy reconstructive techniques to facilitate resection of large breast volumes on the side of the breast cancer and accompanied with symmetry contralateral breast reductions or mastopexies. However, dissection of large volume displacement oncoplastic surgical specimens presents unique challenges. Compared with traditional mastectomy specimens, they are relatively complicated, which requires the pathologist to understand the surgical procedure and the anatomy of the specimens. Given this, we introduce the standard anatomical and terminological description for the breast pathologic specimens of five large volume displacement oncoplastic surgical techniques commonly performed in our institution for breast cancer management. The individual surgical specimen is composed of one or several components, which include lateral wall, superior keyhole, medial wall, lateral wing, inferior pole, and medial wing. We also present specimen documentation and sectioning procedures used in our institution. The advantages for the patient provided by large volume reduction oncoplastic surgery must be supported by proper evaluation of the surgical pathology specimen. Therefore, we recommend that each section taken from the oncoplastic specimen be labeled as to its specific location in the specimen components. Standardized nomenclature and technique will assist pathologists in accurately evaluating the surgical margins.
肿瘤整形手术为乳腺癌患者提供了更好的美容满意度，同时又不影响无病生存率或总生存率。大体积移位肿瘤整形手术技术作为改善美容效果和扩大保乳治疗选择的策略越来越受欢迎。它们通常涉及乳房缩小或乳房提升重建技术，以促进乳腺癌侧乳房大量体积的切除，并伴有对侧乳房的对称性缩小或乳房提升。然而，大体积移位肿瘤整形手术标本的解剖具有独特的挑战性。与传统的乳房切除术标本相比，它们相对复杂，这要求病理学家了解手术过程和标本的解剖结构。有鉴于此，我们介绍了我们机构中常用于乳腺癌管理的五种大体积移位肿瘤整形手术技术的乳房病理标本的标准解剖和术语描述。单个手术标本由一个或多个部分组成，包括外侧壁、上钥匙孔、内侧壁、外侧翼、下极和内侧翼。我们还介绍了我们机构中使用的标本记录和切片程序。大体积减少肿瘤整形手术为患者提供的优势必须通过对手术病理标本的适当评估来支持。因此，我们建议从肿瘤整形标本中取出的每一个切片都要标注其在标本成分中的具体位置。标准化的命名法和技术将有助于病理学家准确评估手术切缘。
