Abstract
Large format histology offers several unique advantages over traditional tissue processing. Over 12 years of experience with this technique provide insight into its limitations and benefits. We conducted a prospective multiyear analysis of the potential advantages of large format histology. 656 cases were examined prospectively over an eight-year period. In 172 cases the sign-out pathologist documented an unexpected finding of potential clinical significance as present only on the large format sections and not present on the accompanying standard format slides. These include closer margins, a change in size or extent of disease, and previously undocumented invasive and/or in situ carcinoma. Based on over a decade of experience and eight years of data, our results demonstrate that a quarter of cases had an unexpected finding of potential clinical significance that may not have been fully realized without the use of the large format technique.
Highlights
Large format histology (LFH), a form of tissue processing utilizing large paraffin blocks, a large format microtome, and a large glass slide accommodate a large contiguous portion of breast tissue
In 593/656 (90%) the original sign-out pathologist felt large format histology was helpful in establishing the pathologic diagnosis and allowing for accurate assessment of currently accepted parameters
In 172/656 (26%) of cases an unexpected finding was present on the large format slides which was not seen on the accompanying standard format slides from the same case
Summary
Large format histology (LFH), a form of tissue processing utilizing large paraffin blocks, a large format microtome, and a large glass slide accommodate a large contiguous portion of breast tissue. The methods and history of the large format technique have been documented elsewhere [1,2,3]. Our laboratory has utilized this technique for over 12 years and have realized an advantage afforded by the large format process of examination of a larger continuous intact portion of breast tissue. The typical large format tissue sample measures up to 6.0 × 8.0 × 0.5 cm with a glass slide measuring 12.0 × 8.5 cm as compared to a standard tissue size of 2.0 × 2.5 × 0.3 cm and standard slide measurement of 2.5 × 7.5 cm. Our ongoing experience continues to prove that the large format technique can be successfully incorporated into a community-based practice without significant increases in cost, staffing, or time
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