Difference between revisions of "Breast grossing"

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*Slicing: [medial-to-lateral, parasagittal cuts].
*Slicing: [medial-to-lateral, parasagittal cuts].
*Number of slices: [number].
*Number of slices: [number].
*Slices sent of x-ray: [yes/no].
*Slices sent to x-ray: [yes/no].
*Calcifications: [present/not identified].
*Calcifications: [present/not identified].



Revision as of 12:34, 11 March 2016

An ink breast lumpectomy specimen. (WC/Ed Uthman)

This article deals with partial mastectomy grossing.

Introduction

A common procedure for breast lesions that are small.

Specimen opening

  • Orientation.
  • Inking.
  • Slicing - medial to lateral.

Protocol

Specimen - type/size/characteristics:

  • Specimen type: partial mastectomy.
  • Specimen orientation: [short-superior, long-lateral, double deep].
  • Surgical guidewire: [present/absent].
  • Specimen size (superior-inferior, medial-lateral, anterior-posterior): [___ x ___ x ___] cm.
  • Surface disruption/intactness: [intact/disrupted at (location) - defect measures ___ cm].
  • Skin: [___ x ___ cm/absent].
  • Inking code: [posterior-black, anterior-yellow, superior-blue, interior-red].‡

Slices:

  • Slicing: [medial-to-lateral, parasagittal cuts].
  • Number of slices: [number].
  • Slices sent to x-ray: [yes/no].
  • Calcifications: [present/not identified].

Tumour:

  • Tumour location in slices: [___ to ___].
  • Tumour size (superior-inferior, medial-lateral, anterior-posterior): [___ x ___ x ___] cm.
  • Closest margin and distance: [___ margin, ___ cm].
  • Distance to other margins: [anterior: [___ cm/not applicable], posterior: [___ cm/not applicable], superior [___ cm/not applicable], inferior [___ cm/not applicable], medial: [___ cm/not applicable], lateral: [___ cm/not applicable].

Other:

  • Uninvolved parenchyma - appearance: [fibrous/fatty].
  • Other findings: [none/description of other findings].

Sections:

  • Margins - on edge if section can be taken with tumour and margin.
  • Tumour - in total if small (<2 cm[1]).

Protocol notes

  • ‡ There is no universally accepted inking protocol. Blue for superior and green for inferior is common, as the sky is blue and the grass is green.
    • Hua[1] suggests: black = posterior, blue = superior, green = inferior, yellow = anterior, red = medial & lateral.

Staging

The important cut-points (at the time of gross) for tumour staging are: 5, 10, 20, 50 mm.

Alternate approaches

See also

Related protocols

References

  1. 1.0 1.1 Huo, L. (Aug 2011). "A practical approach to grossing breast specimens.". Ann Diagn Pathol 15 (4): 291-301. doi:10.1016/j.anndiagpath.2011.03.005. PMID 21745648.

External links