Microcalcifications of the Breast: A Mammographic-Histologic Correlation Study Utilizing a Newly Designed Path/Rad Tissue Tray.
Grant Schafer, Mark Redick, Marc Inciradi, William Smith, Fang Fan, Ossama Tawfik. Kansas Univ Med Ctr, KS
Background: The introduction of screening mammography have brought about a greater knowledge of early breast cancer characteristics. This improvement led to in a new era of breast cancer diagnosis resulting in reduction in size of suspicious lesions and shift from surgical to image guided core needle biopsies (CNB). The reduction in lesional size is best exemplified by the detection of clusters of calcifications. Establishing correlation between histologic and imaging findings is required for accurate diagnosis. Failure to perform proper correlation may result in misdiagnosis and delay of treatment. Currently, there are no standardized multidisciplinary protocols for evaluating such lesions. Pathologists and radiologists generally make their interpretations independently and mostly communicate through written reports, creating uncertainty in diagnosis.
Design: This study was undertaken to standardize the procedure of CNB program in correlating histologic mammographically detectable calcification utilizing a specially designed Path/Rad Tissue Trays. Following mammographic identification of the lesion, CNBs are harvested, placed in Path/Rad Tissue Trays and x-rayed to confirm sampling of the lesion. Images of CNBs with calcifications are marked by the radiologists and sent to the pathologist along with the biopsies. Trays with CNBs are then placed into cassettes and sent to the lab where they are embedded without disturbing orientation.
Results: 19 CNBs with mammographic evidence of calcification were analyzed using the tissue trays and results were correlated with radiologic findings. Identification and localization of targeted microcalcifications was easily accomplished by radiologists and pathologists in 16 of 19 cases. Confirmation of microcalcifations was accomplished following deeper sectioning into tissue blocks from the rest of the discrepant biopsies.
Conclusions: A systematic approach is recommended to standardize reporting of calcifications. The use of Path/Rad Tissue Trays has created a level of concordancy between pathologists and radiologists that previously didn't exist. It improved diagnostic reliability, encouraged communication between pathologists and radiologists and minimized false and/or delay in cancer diagnosis.
Tuesday, March 1, 2011 9:30 AM
Poster Session III # 33, Tuesday Morning