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.
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References
Holck S et al (2004) False-negative frozen section of sentinel lymph node biopsy for breast cancer. Breast 13:42–48
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
Turner RR et al (1999) Intraoperative examination of the sentinel lymph node for breast carcinoma staging. Am J Clin Pathol 112:627–634
Veronesi U et al (2001) Extensive frozen section examination of axillary sentinel nodes to determine selective axillary dissection. World J Surg 25:806–808
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
Kommission Mamma der Arbeitsgemeinschaft Gynäkologische Onkologie in der Deutschen Krebsgesellschaft (2011) Aktuelle Empfehlungen zur Prävention, Diagnostik und Therapie primärer und fortgeschrittener Mammakarzinome. Zuckschwerdt, München
Kreienberg R et al (2012) Interdisziplinäre S3-Leitlinie für die Diagnostik, Therapie und Nachsorge des Mammakarzinoms. Zuckschwerdt, München
Klimberg VS et al (1999) Assessing margin status. Surg Oncol 8:77–84
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
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
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
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
Bussolati G et al (2008) Tissue transfer to pathology labs: under vacuum is the safe alternative to formalin. Virchows Arch 452(2):229–231
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
Micke P et al (2006) Biobanking of fresh frozen tissue: RNA is stable in non-fixed surgical specimens. Lab Invest 86:202–211
Noguchi M et al (1995) Pathologic assessment of surgical margins on frozen and permanent sections in breast conserving surgery. Breast Cancer 2:27–33
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
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
Weber S et al (1997) The role of frozen section analysis of margins during breast conservation surgery. Cancer J Sci Am 3:273–277
Fleming FY et al (2004) Intraoperative margin assessment and re-excision rate in breast conserving surgery. Eur J Surg Oncol 30:233–237
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
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
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
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
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
Cabioglu N et al (2007) Role for intraoperative margin assessment in patients undergoing breast-conserving surgery. Ann Surg Oncol 14:1458–1471
Cendán YC et al (2005) Accuracy of intraoperative frozen-section analysis of breast cancer lumpectomy-bed margins. Am Coll Surg 201:194–198
Dener C et al (2009) Interoperative frozen section for margin assessment in breast conserving energy. Scand J Surg 98:34–40
Deutsche Krebsgesellschaft und Deutsche Gesellschaft für Senologie (2011) Erhebungsbogen für Brustzentren. http://www.krebsgesellschaft.de/index,699.html
European Society of Breast Cancer Specialists (2010) The requirements of a specialist breast unit. http://www.eusoma.org/doc/EusomaBURequirements
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
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
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
Manfrin E et al (2011) Intraoperative frozen section technique for breast cancer: end of an era. Pathologica 103:325–330
Schmidt M et al (2008) Node-negative breast cancer: which patients should be treated? Breast Care 3:237–243
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
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
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
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
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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
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DOI: https://doi.org/10.1007/978-3-319-13957-9_5
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