Re: Stereotactic breast cores

From:RSRICHMOND@aol.com

I hate to keep bringing this up, but this notion of doing frozen sections on 
stereotactic cores needs to die a rapid death.

I don't doubt that the CryoJane system (though I have never seen it) can 
produce sections of near-paraffin quality. That isn't the problem. When you 
cut a frozen section, you lose a lot of the tissue, and then you lose more 
when you embed it in paraffin and recut it. How do we know that the various 
special studies - ERA/PRA and the rest of it - will produce valid results 
after this complex treatment?

Let me emphasize again that the diagnosis of breast cancer on stereotactic 
cores is difficult and full of pitfalls. The patient doesn't need a fast 
diagnosis, she needs a correct diagnosis.

Finally, you may have a CryoJane, but if frozen section becomes the standard 
of care in this area, I will soon have to do it on a broken-down 30 year old 
Minotome with a cracked case with exposed insulation, a failing compressor, 
and a blade I can't get below freezing. Believe me, that's what I have to cut 
frozen sections on in many of the small hospitals I work in.

Bob Richmond
Samurai Pathologist
Knoxville TN



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