Re: mamatone breast biopsies

From:=?iso-8859-1?q?Steve=20Machin=20UK?= <>

Steve Machin UK replies

1. X-Ray the biopsy using a high quality instrument.
2. Fix the biopsy well.
3. Cut the biopsy into 3mm slices.
4. X-Ray these slices.

Now you can see which slices contain the microcalcification.  If no 
microcalcification can be seen then either the biopsy was taken from
the wrong site or the fixative removed the calcium.

5. Process the slices and cut sections.
6. Match the sections with the X-Rays of the slices.

I would avoid decalcification because this make make it difficult for
the pathologist to match the slides to the X-ray.

In my previous lab we sometimes urgently X-Rayed the breast lump
using a Faxitron machine using the same film as our breast screening
department.  In fact they processed the film too.  The surgeon waited
to see these X-Rays to judge if he had removed the right area of
breast by comparing these X-Rays with the ones that had been taken
before the operation. These first X-Rays were used to guide a 
wire into the area of microcalcification.  The wire was very thin and
sharply bent double at the end to form a thin hook.  The hook
prevented the wire from being dislocated so the tip of it accurately
located the lesion.

Some labs ink the cut surfaces of the breast biopsy, before fixation,
so that when sections are made they can see if the tumour is close to
the outer edges of the biopsy.  If it is close then the tumour may
not have been completely removed.

Best Wishes
Steve Machin UK

 --- anatomic pathology <> wrote: > we receive
breast biopsies that have microcalcifications marked by 
> radiologist on x-ray.  These are processed by our routine method
> and cut 
> without decalcification.  They are difficult to cut and often we do
> not find 
> what they think we should.  Then we have to cut through the block
> trying to 
> find this.  I am totaly frustrated with the whole thing.  Is anyone
> else 
> doing these and if so please tell me how you handle this?  I am
> being 
> treated as if I am stupid for not being able to do this the way
> they think 
> it should be .  Thanks
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