The following types of breast specimens are generally received for histopathological evaluation:
Core needle biopsy
- core needle biopsies;
- excisional biopsy specimens with or without image-guided localization;
- breast tissue removed at lumpectomy, along with the axillary lymph nodes in case of a malignant lesion; and
- mastectomy specimens with axillary lymph nodes.
Core needle biopsy should always be performed under image guidance. The steps of the procedure have been described earlier
Frozen section of breast tissue excised during surgery
Frozen section is an intraoperative consultation in which the tissue sent by the operating surgeon is frozen, sectioned in a cryostat, and stained rapidly with H&E to provide immediate information that is necessary to guide the extent of surgery.
Frozen section of breast tissue is indicated:
- to establish the presence and nature of the lesion when the preoperative FNAC or core needle biopsy results have been benign or doubtful in spite of strong clinical and/or radiological suspicion of malignancy; or
- to determine the adequacy of surgical margins in breast-conserving surgery.
- should be limited to tumours 1 cm or larger where FNAC or core needle biopsy is not diagnostic;
- is recommended only if the resultant diagnosis will have an immediate effect on treatment; and
- is done on a specimen transported fresh from the operating theatre without any fixative.