Abstract
Breast cancer subgross morphological parameters (disease extent, lesion distribution, and tumor size) provide significant prognostic information and guide therapeutic decisions. Modern multimodality radiological imaging can determine these parameters with increasing accuracy in most patients. Large-format histopathology preserves the spatial relationship of the tumor components and their relationship to the resection margins and has clear advantages over traditional routine pathology techniques. We report a series of 1000 consecutive breast cancer cases worked up with large-format histology with detailed radiological-pathological correlation. We confirmed that breast carcinomas often exhibit complex subgross morphology in both early and advanced stages. Half of the cases were extensive tumors and occupied a tissue space ≥40 mm in its largest dimension. Because both in situ and invasive tumor components may exhibit unifocal, multifocal, and diffuse lesion distribution, 17 different breast cancer growth patterns can be observed. Combining in situ and invasive tumor components, most cases fall into three aggregate growth patterns: unifocal (36%), multifocal (35%), and diffuse (28%). Large-format histology categories of tumor size and disease extent were concordant with radiological measurements in approximately 80% of the cases. Noncalcified, low-grade in situ foci, and invasive tumor foci <5 mm were the most frequent causes of discrepant findings.
Highlights
Breast cancer is a heterogeneous group of diseases which deviate from each other in natural history, morphology, molecular phenotype, clinical and radiological manifestations, and prognosis
HER-2 status, and proliferative activity are the major determinants of oncological therapy, proper characterization of the subgross morphology of breast carcinoma is essential for planning appropriate surgery and radiation therapy [1,2,3,4]
In addition to purely in situ carcinomas, microinvasive cancers, which have invasive foci
Summary
Breast cancer is a heterogeneous group of diseases which deviate from each other in natural history, morphology, molecular phenotype, clinical and radiological manifestations, and prognosis. Large-format histopathology is based on embedding and processing contiguous tissue slices representing the entire cross section of a segmentectomy specimen, preserving the interrelationships of the components of the tumor, and documenting them together in one plane This advantage makes this method the best approach in correctly assessing the subgross morphological parameters, which facilitates the detailed radiologicalpathological correlation [5, 6, 8,9,10]. The advantages of this method have been observed in a recent cost-benefit analysis [14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
