Skip to main content
SpringerLink
Log in

Standardized Processing of Native Tissue in Breast Pathology

  • Chapter
  • First Online:
Book cover Pre-Analytics of Pathological Specimens in Oncology

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 199))

  • 818 Accesses

Abstract

In breast surgery, replacement of intraoperative frozen section by core needle and vacuum biopsies hampers collections of unfixed breast specimens. We practice immediate intraoperative macroscopic analysis of resection margins and vacuum-cooling of breast specimens to enable native tissue asservation for assessment of biological markers and tissue banking of tumor tissue. In addition, slicing of native tissue before formalin fixation guarantees a standardized and uniform fixation. Starting in 2013, more than 350 breast specimens were processed as native specimens in the Institute of Pathology of Hannover Medical School. Breast specimens with an invasive carcinoma and request of an intraoperative resection margin assessment were processed with an immediate intraoperative pathological analysis. All other breast specimens without assessment of an intraoperative resection margin were vacuum-fixed processed. In all cases, native tissue for biomarker analyses and tumor banking could be preserved.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Holck S et al (2004) False-negative frozen section of sentinel lymph node biopsy for breast cancer. Breast 13:42–48

    Article  CAS  PubMed  Google Scholar 

  2. Lyman GH et al (2005) American society of clinical oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol 23:7703–7720

    Google Scholar 

  3. Turner RR et al (1999) Intraoperative examination of the sentinel lymph node for breast carcinoma staging. Am J Clin Pathol 112:627–634

    Google Scholar 

  4. Veronesi U et al (2001) Extensive frozen section examination of axillary sentinel nodes to determine selective axillary dissection. World J Surg 25:806–808

    Google Scholar 

  5. Zurrida S et al (2001) The problem of the accuracy of intraoperative examination of axillary sentinel nodes in breast cancer. Ann Surg Oncol 8:817–820

    Google Scholar 

  6. Kommission Mamma der Arbeitsgemeinschaft Gynäkologische Onkologie in der Deutschen Krebsgesellschaft (2011) Aktuelle Empfehlungen zur Prävention, Diagnostik und Therapie primärer und fortgeschrittener Mammakarzinome. Zuckschwerdt, München

    Google Scholar 

  7. Kreienberg R et al (2012) Interdisziplinäre S3-Leitlinie für die Diagnostik, Therapie und Nachsorge des Mammakarzinoms. Zuckschwerdt, München

    Google Scholar 

  8. Klimberg VS et al (1999) Assessing margin status. Surg Oncol 8:77–84

    Google Scholar 

  9. Osborn JB et al (2011) Costeffectiveness analysis of routine frozen-section analysis of breast margins compared with reoperation for positive margins. Ann Surg Oncol 18:3204–3209

    Google Scholar 

  10. Piroth MO et al (2010) Intraoperative radiotherapy (IORT) with electrons for breast cancer—our experience, current considerations and review of the literature. Geburtsh Frauenheilk 70:219–226

    Article  Google Scholar 

  11. Caruso F et al (2011) Therapeutic mammaplasties: full local control of breast cancer in one surgical stage with frozen section. Eur J Surg Oncol 37:871–875

    Article  CAS  PubMed  Google Scholar 

  12. Rusby JE et al (2008) Immediate latissimus dorsi miniflap volume replacement for partial mastectomy: use of intraoperative frozen sections to confirm negative margins. Am J Surg 196:512–518

    Article  PubMed  Google Scholar 

  13. Bussolati G et al (2008) Tissue transfer to pathology labs: under vacuum is the safe alternative to formalin. Virchows Arch 452(2):229–231

    Article  PubMed  Google Scholar 

  14. Cserni G et al (2004) Metaanalysis of non-sentinel node metastases associated with micrometastatic sentinel nodes in breast cancer. Br J Surg 91:1245–1252

    Article  CAS  PubMed  Google Scholar 

  15. Micke P et al (2006) Biobanking of fresh frozen tissue: RNA is stable in non-fixed surgical specimens. Lab Invest 86:202–211

    Article  CAS  PubMed  Google Scholar 

  16. Noguchi M et al (1995) Pathologic assessment of surgical margins on frozen and permanent sections in breast conserving surgery. Breast Cancer 2:27–33

    Article  PubMed  Google Scholar 

  17. Olson TP et al (2007) Frozen section analysis for intraoperative margin assessment during breast-conserving surgery results in low rates of re-excision and local recurrence. Ann Surg Oncol 14:2953–2960

    Article  CAS  PubMed  Google Scholar 

  18. Park S et al (2011) The impact of a focally positive resection margin on the local control in patients treated with breast-conserving therapy. Jpn J Clin Oncol 41:600–608

    Article  PubMed  Google Scholar 

  19. Weber S et al (1997) The role of frozen section analysis of margins during breast conservation surgery. Cancer J Sci Am 3:273–277

    CAS  PubMed  Google Scholar 

  20. Fleming FY et al (2004) Intraoperative margin assessment and re-excision rate in breast conserving surgery. Eur J Surg Oncol 30:233–237

    Article  CAS  PubMed  Google Scholar 

  21. Blair SL et al (2009) Attaining negative margins in breast-conservation operations: is there a consensus among breast surgeons? J Am Coll Surg 209:608–613

    Google Scholar 

  22. Di Novi C et al (2010) Vacuum-based preservation of surgical specimens: an environmentally-safe step towards a formalin-free hospital. Sci Total Environ 408(16):3092–3095

    Google Scholar 

  23. Agnantis NY et al (1984) The reliability of frozen-section diagnosis in various breast lesions: a study based on 3451 biopsies. Recent Results Cancer Res 90:205–210

    Article  CAS  PubMed  Google Scholar 

  24. Bakhshandeh M et al (2007) Use of imprint cytology for assessment of surgical margins in lumpectomy specimens of breast cancer patients. Diagn Cytopathol 35:656–659

    Article  PubMed  Google Scholar 

  25. Balch GC et al (2005) Accuracy of intraoperative gross examination of surgical margin status in women undergoing partial mastectomy for breast malignancy. Am Surg 71:22–27

    PubMed  Google Scholar 

  26. Cabioglu N et al (2007) Role for intraoperative margin assessment in patients undergoing breast-conserving surgery. Ann Surg Oncol 14:1458–1471

    Article  PubMed  Google Scholar 

  27. Cendán YC et al (2005) Accuracy of intraoperative frozen-section analysis of breast cancer lumpectomy-bed margins. Am Coll Surg 201:194–198

    Article  Google Scholar 

  28. Dener C et al (2009) Interoperative frozen section for margin assessment in breast conserving energy. Scand J Surg 98:34–40

    CAS  PubMed  Google Scholar 

  29. Deutsche Krebsgesellschaft und Deutsche Gesellschaft für Senologie (2011) Erhebungsbogen für Brustzentren. http://www.krebsgesellschaft.de/index,699.html

  30. European Society of Breast Cancer Specialists (2010) The requirements of a specialist breast unit. http://www.eusoma.org/doc/EusomaBURequirements

  31. Fukamachi K et al (2010) Totalcircumference intraoperative frozen section analysis reduces margin-positive rate in breast-conservation surgery. Jpn J Clin Oncol 40:513–520

    Article  PubMed  Google Scholar 

  32. Gunia S et al (2010) The changing role of intraoperative mammary frozen sections in breast cancer: comparison of data from East and West Germany before and after reunification. Pathologe 27:346–349

    Article  Google Scholar 

  33. Giuliano AE et al (2011) Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 305:569–575

    Article  CAS  PubMed  Google Scholar 

  34. Manfrin E et al (2011) Intraoperative frozen section technique for breast cancer: end of an era. Pathologica 103:325–330

    CAS  PubMed  Google Scholar 

  35. Schmidt M et al (2008) Node-negative breast cancer: which patients should be treated? Breast Care 3:237–243

    Article  PubMed Central  PubMed  Google Scholar 

  36. Tsujimoto M et al (2007) One-step nucleic acid amplification for intraoperative detection of lymph node metastasis in breast cancer patients. Clin Cancer Res 13:4807–4816

    Article  CAS  PubMed  Google Scholar 

  37. Dongen JA et al (2011) Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European organization for research and treatment of cancer 10801 trial. J Natl Cancer Inst 92:1143–1150

    Article  Google Scholar 

  38. Wasielewski R von et al (2002) Tissue array technology for testing interlaboratory and interobserver reproducibility of immunohistochemical estrogen receptor analysis in a large multicenter trial. Am J Clin Pathol 118:675–682

    Google Scholar 

  39. Wenz F et al (2010) Intraoperative Radiotherapy as a boost during breast-conserving surgery using low-kilovoltage X-rays: the first 5 years of experience with a novel approach. Int J Radiat Oncol Biol Phys 77:1309–1314

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Pathology, Carl Neuberg Straße, 30625, Hannover, Germany

    M. E. Dämmrich & H. H. Kreipe

Authors
  1. M. E. Dämmrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. H. Kreipe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. H. Kreipe .

Editor information

Editors and Affiliations

  1. Institute of Pathology, Charité University Medicine, Berlin, Germany

    Manfred Dietel

  2. Institute of Pathology, University Hospital Leipzig, Leipzig, Sachsen, Germany

    Christian Wittekind

  3. University of Turin Institute of Pathology, Turin, Italy

    Gianni Bussolati

  4. Institute of Pathology, Charité University Medicine, Berlin, Germany

    Moritz von Winterfeld

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Dämmrich, M.E., Kreipe, H.H. (2015). Standardized Processing of Native Tissue in Breast Pathology. In: Dietel, M., Wittekind, C., Bussolati, G., von Winterfeld, M. (eds) Pre-Analytics of Pathological Specimens in Oncology. Recent Results in Cancer Research, vol 199. Springer, Cham. https://doi.org/10.1007/978-3-319-13957-9_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-13957-9_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-13956-2

  • Online ISBN: 978-3-319-13957-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation