stereotactic breast biopsies

From:RSRICHMOND@aol.com

Query about stereotactic breast biopsy (Mammotome and other devices) specimens containing microcalcifications.

Here's the pathologist's viewpoint - the calcifications, which are usually quite small, should not impede the microtomist, and the pathologist does need to see them undecalcified whenever possible. (Decalcification may also interfere with subsequent immunohistochemical and cytometric studies.) These specimens are obtained with a large-gauge needle, and often specimen radiography is done to verify that the calcifications have been found. The pathologist needs to see these specimen radiograms. 

It's usually best to cut a number of sections, staining some with H & E, and retaining intervening sections for the special studies, or sometimes staining all of them with H & E to find small lesions. Recuts are fairly often needed.

These are very exacting, time-consuming specimens, with very high diagnostic stakes. Close cooperation among radiologists, radiographic techs, pathologists, and histotechnologists is essential.

Bob Richmond
Samurai Pathologist
Knoxville TN



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