Imaging-Assisted Large-Format Breast Pathology: Program Rationale and Development in a Nonprofit Health System in the United States

Table 2

Summary of limitations of conventional pathologic technique in the diagnosis and reporting of breast carcinomas in breast-conserving surgical specimens.

(i) Gross inspection and palpation have insufficient sensitivity to guide section submission of imaging-only detected neoplasia, including DCIS and multifocal invasive carcinoma
(ii) Complete imaging data, including MRI features are not available to pathologists at time of specimen evaluation
(iii) Spatial 3D integrity of the specimen is lost through sectioning, section submission and histopathologic examination
(iv) Margin evaluation is often reliant on gross inspection and palpation, even for imaging-only detected disease
(v) Lack of standardization of methods to measure DCIS extent, multifocality, and margins
(vi) Suboptimal correlation between pathology and pre-surgical imaging studies