Abstract P6-02-03: The Use of Charcoal Suspension Labeling as an Adjunct in the Detection of Non-Palpable Breast Lesions

Abstract

Abstract Introduction and Objectives: Inert charcoal suspension is used as a tissue marker, which provides innumerous advantages over other labeling methods and techniques, such as dyes and metallic needles. In addition, the use of charcoal does not present problems with regards to its diffusion, labeling the trajectory from the lesion to the skin, being easily identified by both the surgeon and pathologist. The occurrence of morphological alterations due to the use of charcoal is very rare. In contrast, there are still doubts and questions concerning the interference of charcoal labeling with regards to the anatomopathological diagnosis accuracy. The main objectives in this study are to analyze the efficiency of labeling impalpable breast lesions with inert charcoal suspension; to evaluate the morphological alterations associated with its use and to determine whether the use of charcoal labeling hampers with the diagnostic interpretation of the pathologist. Materials and Methods: The study evaluated a total of 135 cases of impalpable breast lesions, previously labeled with charcoal suspension. Histological H/E stained slides containing charcoal pigments were analyzed using optical microscopy, by which both quantitative and qualitative evaluations with regards to inflammatory response and interference in diagnosis were performed. Lymphocyte, giant cells and neutrophils were evaluated and quantified. Moreover, the distribution of the charcoal suspension present in the lesions was evaluated. Results: As to the quantitative and qualitative evaluation of the inflammatory response caused by the use of charcoal labeling, it was observed that granulomas were present in all samples, regardless of the quantity of injected charcoal. Lymphocytic inflammatory response was absent in 5.19% of the samples only, were 82.22% demonstrated discrete intensity and 12.59% was moderate. With regards to acute inflammatory response, 42.96% showed total absence of neutrophilic exudate, were as 42.22% demonstrated discrete and 11.11% moderate, and only 3.7% of cases were intense. Conclusion: This study corroborates the utility and easiness of the charcoal method as a means of efficient labeling of impalpable breast lesions. In addition, this technique is easy to use, has a low cost, high efficiency and does not interfere with the histological analysis. Moreover, it is comfortable for the patient and is of great help in finding and localizing the lesions to both the surgeon and pathologist. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-02-03.