|
Breast |
Mastectomy for Neoplasm |
Click the section headings (in blue) to expand or collapse the content
Guideline & Procedure:- Determine the indication for the mastectomy (i.e. resection for cancer vs. prophylaxis due to high risk of cancer development).
- Identify (right or left breast) and orient the specimen.
- Measure: breast, axillary tail, attached skin, nipple and areola, scar and incision.
- Ink the deep margin (and anterior superior and anterior inferior margins if the tumor is at or very close to these margins).
- Evaluate features of the external surface (e.g. scars, incisions, erythema, induration, retraction).
- With skin-side down, make longitudinal parallel sections no thicker than 1 cm intervals, from the posterior surface toward the skin (keep the skin intact so that the specimen can be re-oriented at a later time if necessary). Number each slice consecutively, from lateral toward medial, not including the axillary tail.
- Palpate each slice with your thumb and first index finger for masses and nodularity.
- Identify previous biopsy site and residual tumor (e.g. location, size, shape, border, consistency, cavitation, hemorrhage).
- Submit a portion of the tumor for tumor bank if a large residual tumor is present.
- Handle the previous biopsy site in a way similar to what is described in Breast Re-Excision for Carcinoma .
- Inspect the remaining breast parenchyma and record the ratio of fibrous stroma to fat.
- Separate the axillary contents while retaining their orientation. Dissect in the unfixed state as described in Axillary Lymph Node Dissection.
Suggested Sections for Histology:
|
|