Large section technique in breast pathology - An appropriate response to breast-conserving surgery

Large block macrosectioning of segmental excision specimens for breast canc er, and especially ductal carcinoma in situ, provides detailed information regarding size of the lesions, extent of spread and margin status which are essential for focal recurrence risk assessment. However, the expansion of this technique has been curbed due to its reputation of being technically d ifficult, lime-consuming, costly and providing slides of poor quality. We a ssessed the feasibility of the large section technique and adapted it to th e everyday practice of a routine pathology laboratory. The time spent cutti ng a large block on a motorized microtome is half the time spent cutting th e great number of conventional blocks needed to assess the same amount of t issue. Finally, 4 mu m-thick stained large preparations of high quality are produced within 3 days after receiving the specimen. Analysis and report a re both move precise and easier since the pathologist is saved the trouble of having to mentally re-assemble a great quantity of numbered small blocks . 805 primary monobloc segmental excision specimens have been examined in t his way over the last 50 months period and we advocate its rise as a standa rd procedure for breast-conserving surgery specimen management.