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Breast Cancer (Expert Forum)
Surgical Pathology Report
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Surgical Pathology Report
by Stuffie, Sep 03, 2004 12:00AM
A definition of the following would be greatly appreciated.
This is the fifth specimen, and the worst report.Procedure: Right breast biopsy for FS, long stitch lateral and short stitch superior. Frozen section: FS DX Specimen #5 Deep, Inferior, Superior and Medial Margins clear. The Tumor extends to the lateral margin. Final Diagnosis: Right breast biopsy, short stitch superior and long stitch lateral: Residual focus of infiltrating duct carcinoma, 4 MM in diameter. the tumor is focally present at the inked lateral margin of the specimen. Multifocal ductal carcinoma-in-situ, solid type. The ductal carcinoma-in-situ are focally present at the inferior, and deep surgical margins of resection. Also - right sentinel lymph node: lymph node showing a minute focus of atypical cells within a subcapsular sinus suspicious for metastatic carcinoma.
Comment: The sentinel lymph nodes will be sent for immunoperoxidase studies to rule out micrometastases and a report will follow. These are the two clinical findings that I would appreciate your comments on. Upon removal of the tumor the muscle was also scraped. In the fifth specimen, it appears that DCIS is in the muscle which does not make sense. Your reply is eagerly awaited and greatly appreciated. Thank you.
This is the fifth specimen, and the worst report.Procedure: Right breast biopsy for FS, long stitch lateral and short stitch superior. Frozen section: FS DX Specimen #5 Deep, Inferior, Superior and Medial Margins clear. The Tumor extends to the lateral margin. Final Diagnosis: Right breast biopsy, short stitch superior and long stitch lateral: Residual focus of infiltrating duct carcinoma, 4 MM in diameter. the tumor is focally present at the inked lateral margin of the specimen. Multifocal ductal carcinoma-in-situ, solid type. The ductal carcinoma-in-situ are focally present at the inferior, and deep surgical margins of resection. Also - right sentinel lymph node: lymph node showing a minute focus of atypical cells within a subcapsular sinus suspicious for metastatic carcinoma.
Comment: The sentinel lymph nodes will be sent for immunoperoxidase studies to rule out micrometastases and a report will follow. These are the two clinical findings that I would appreciate your comments on. Upon removal of the tumor the muscle was also scraped. In the fifth specimen, it appears that DCIS is in the muscle which does not make sense. Your reply is eagerly awaited and greatly appreciated. Thank you.
Doctor's Answer
by CCF-RN,MSN-JS, Sep 03, 2004 12:00AM
Dear Stuffie, This appears to be a report from a frozen section which usually occurs during surgery, and may dictate additional surgical resection with a more final report. If this is a final report then there is still cancer at the lateral margin. There is no mention of muscle scraping so we are unclear about DCIS in the muscle. DCIS is present at the deep and inferior (bottom) portion of the surgical resection. There is suspicion regarding the sentinel node, but no final diagnosis appears in this part of this report.
