Download Breast Pathology: A Volume in the Series: Foundations in by Frances P. Malley, Sarah E. Pinder, Anna Marie Mulliga PDF

By Frances P. Malley, Sarah E. Pinder, Anna Marie Mulliga

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Additional info for Breast Pathology: A Volume in the Series: Foundations in Diagnostic Pathology

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Microcalcification may be seen in normal breast cores, for example, within involutional change, although it is essential to discuss this finding with clinical colleagues to determine if it is representative and if the microcalcifications are likely to be radiologically visible. Small foci of microcalcification may be seen histologically that cannot be identified radiologically (<100 micrometers) and the mammographic lesion may potentially have been missed (Figure 3-1). ” There are, however, some lesions that are known to be associated with malignancy in the adjacent breast tissue or are themselves known to be heterogeneous.

Additional representative sampling of the nipple–areolar complex can be taken to determine the presence of Paget’s disease of the nipple; again, this finding is rarely of direct clinical significance once the mastectomy has been performed. n PATHOLOGIC EXAMINATION OF LYMPH NODES Axillary lymph nodes that have been removed should be submitted for careful histologic examination. These may be axillary lymph node clearance/dissection specimens, lymph node sampling, or sentinel lymph node biopsies. Other lymph nodes may also, less commonly, be received such as internal mammary or intramammary lymph nodes.

These changes will be admixed with tumor cells in patients who demonstrate a partial response to therapy. Improved outcome has been shown in patients with a partial response compared to those with positive lymph nodes without evidence of treatment effect. Thus, when present, these therapy-related changes should be recorded in the pathology report. Systems for semiquantitatively assessing the degree of response to chemotherapy have been described. These incorporate an assessment of the cellularity of the tumor compared to the preoperative core biopsy specimen, but no single system has achieved widespread acceptance or substantial evidence-base with regard to subsequent BREAST PATHOLOGY patient outcome and further work is required in this area.

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