Review Article

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

Figure 5

Analysis of case shown in Figure 4. (a) Asymptomatic 53-year-old woman with linear-casting calcifications on screening mammogram presented with no palpable abnormality. (b) Stereoguided biopsy showed grade 2 DCIS with necrosis. Core biopsy site is highlighted in red. DCIS is highlighted in yellow with maximum extent of 46 mm. Specimen on gross examination was minimally fibrotic and negative for a palpable lesion or gross evidence of DCIS. Specimen radiography guided selection of tissue blocks and large-format section to best demonstrate extent of neoplasm and proximity to superior margin (Arrow). Presurgical MRI was not performed. Conventional margin section selection guided only by gross inspection and palpation could have missed DCIS encroachment on superior margin which measured 1.5 mm. Scale: small divisions = 1.0 mm (H&E).
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(a)
171792.fig.005b
(b)