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Annals of Diagnostic Pathology 15 (2011) 291 301

From the Gross Room

A practical approach to grossing breast specimens

Lei Huo, MD, PhD
Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

Abstract The grossing of breast specimens has been evolving over the past few decades. As image-guided core-
needle biopsy has gradually replaced surgical biopsy in the initial assessment of breast lesions, most
patients have a definitive diagnosis at the time of excision. Breast conserving therapy is now well accepted
as a definitive treatment. Neoadjuvant therapy is also selected by a large number of patients. In addition,
since its introduction in the 1990s, sentinel lymph node biopsy has become a standard procedure performed
at the time of excision, as clinically indicated. Based on our institutional experience, practical guidelines for
grossing breast excision specimens, as well as sentinel lymph nodes, are provided in this article.
2011 Elsevier Inc. All rights reserved.

Keywords: Breast; Grossing; Mastectomy; Sentinel lymph node

1. Introduction 2. Radiological marker clips

The grossing of breast specimens has been evolving over
the past few decades. As image-guided core-needle core biopsy
has gradually replaced surgical biopsy in the initial assessment
of breast lesions, most patients have a definitive diagnosis at
the time of excision. Breast conserving therapy is now well
accepted as a definitive treatment procedure. Neoadjuvant
therapy is also selected by a large number of patients. To
provide accurate information for tumor staging and assessment
of treatment response, breast grossing has never been more
dependent on clinicopathologic correlation [1-4]. Clinical and
imaging information regarding the nature, size, and location of
the lesion, and whether there are multiple lesions and their
relative locations, can be obtained by reviewing the medical
record and communicating with the clinicians. Nonpalpable
lesions, often designated by a biopsy marker clip, are best
visualized on specimen radiographs. Accurate gross examina-
tion often relies on the cooperation of pathologists, radiolo-
gists, and surgeons. In addition, since its introduction in the
1990s, sentinel lymph node biopsy has become a standard
procedure performed at the time of excision, as clinically
indicated. In this review, we provide a practical approach to
grossing breast excision specimens and sentinel lymph nodes
based on our institutional experience.
Fax: +1 713 745 5709.
E-mail address: leihuo@mdanderson.org.
1092-9134/$ see front matter 2011 Elsevier Inc. All rights reserved.
doi:10.1016/j.anndiagpath.2011.03.005
A radiological marker clip is commonly placed in the
biopsy site after a core biopsy [5]. The identification of the
clip in a surgical specimen ensures removal of the targeted
lesion and is a crucial step in grossing.
Clips can be identified by gross examination or with the
aid of specimen radiographs. Each clip measures 2 to 3 mm,
and they are available in various shapes (Fig. 1).
Usually, the clip is embedded in the tumor or breast tissue
with biopsy site changes, but the tissue surrounding the clip
may show minimal changes. Sometimes the coating material
around the clip can form a plug, mimicking the appearance of a
tumor (Fig. 2). The clip can also be contained in a microfiber
cylindrical structure present in a biopsy cavity (Fig. 3).
3. Excision
3.1. Partial mastectomy
Partial mastectomy includes excisional biopsy and
segmental mastectomy, or lumpectomy. These can be
performed either with or without needle localization.
Most partial mastectomy specimens are oriented by the
surgeon. This is usually done by placing 2 perpendicular
sutures on the specimen (eg, short suturesuperior, long
suturelateral) (Fig. 4; Fig. 5). The surgeon should be
contacted for clarification before the specimen is further
processed if there is any question regarding the orientation.

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292 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301

arise, the surgeon should be contacted for clarification before

Fig. 1. Examples of radiological marker clips.
If a whole specimen radiograph is to be obtained, orient
the specimen, and take the radiograph before inking.
Measure the specimen in three dimensions. Measure the
attached skin if present.
Examine the surface of the specimen. Although it is
common for breast specimens to have a slightly ragged
surface due to the presence of fat lobules, deep clefts or flaps
of tissue are unusual and may raise the question of what
represents true resection margins. When such questions
the specimen is inked.
Ink the specimen surface black if no orientation is
provided. If the orientation is known, the specimen can be
inked using the following multicolor system: anterior,
yellow; posterior (deep), black; superior, blue; inferior,
green; medial and lateral, red (Fig. 4; Fig. 5).
Blot excess ink.
If localization wires are present, it is the best to remove
them before slicing the specimen. Because of the shapes of
the wires, they often need to be pushed out from the end
embedded within the specimen instead of being pulled from
the free end (Fig. 6).
Serially section the specimen along the lateral-medial
axis. Note the order of the slices and the number of slices
obtained by sectioning. Although thin slices are desirable,
care should be taken not to compromise the presence of all
margins on each slice (most slices, except the ones towards
to medial and lateral ends, should each have the four colors at
the tissue edges). In addition, the specimen should be
sectioned at the same intervals throughout so that the slices

Fig. 2. A clip is identified on the specimen radiograph (A, arrow). The area is firm and well-circumscribed, mimicking a tumor (B, arrow; C). The clip was
removed from this area. The nodule is composed of the coating material around the clip, which appears collagen-like on microscopic examination (D).

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 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301 293

obtained are of equal thickness. This is important for

Fig. 3. A microfiber cylindrical structure in a biopsy cavity (A, arrow). A
clip is present in the structure (B, arrow).
evaluating the size of the lesion, especially when the lateral-
medial dimension is the largest one. Practically, specimens
that are small and fibrotic can be sectioned at 5-mm intervals,
but thicker slices are necessary to keep large, fatty specimens
from getting fragmented.
Infrequently, the superior-inferior axis is the longest axis of
the specimen. If a decision is made to serially section the
specimen along this axis, the ink system should be changed
accordingly as follows: anterior, yellow; posterior (deep),
black; medial, blue; lateral, green; and superior and inferior, red.
If a radiograph is to be obtained on the sliced specimen,
place the slices in order on a plastic plate and indicate the
orientation using metallic markers (Fig. 5).
Identify gross lesions and record the location (which
slices are involved), size, and distance from each margin
for each lesion. If there are multiple lesions, describe the
distance between lesions.
It is important to indicate which slices are grossly
involved by tumor so that if the microscopic examination
shows a discrepancy from the gross description, the size of
the tumor can be adjusted accordingly.
Note calcifications and other radiographically suspicious
areas annotated by the radiologist on the specimen
radiographs. Record the location, estimated size, and
distance from each margin for each area.
Discuss the gross and radiographic findings with the
pathologist and perform frozen sections if necessary.
For permanent sections, submit tissue as instructed by the
pathologist. In principle, small specimens can be submitted

Fig. 4. A right segmental mastectomy specimen can be oriented with 2 sutures and inked in 5 colors (anterior, yellow; posterior (deep), black; superior, blue;
inferior, green; medial and lateral, red). It is then serially sectioned along the lateral-medial axis.

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294 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301

Fig. 6. Examples of localization wires (A). The tip embedded in the tissue, as
shown in the radiograph (B), can cause tissue tearing if the wire is pulled
from the free end.

microscopically. For large tumors, submit the largest

Fig. 5. (A) A left segmental mastectomy specimen oriented as single short
suture superior, double suture lateral, and single long suture deep. Note that
in this case, the ink colors are somewhat obscured by the blue dye used for
sentinel lymph node mapping. This blue dye will dissolve after tissue
processing. (B) The slices are laid out on a plastic plate for radiography, with
the orientations marked. (C) The radiograph is annotated by a radiologist.
(D) Sections can be designated on the inverted image printout, as shown in
the middle slice.
in their entirety. Large specimens may be representatively
submitted to include tumor, radiographically interesting
areas, and pertinent margins.
Submit the entire tumor when the tumor is small (b2
cm). Try to submit a complete cross-section(s) of the
tumor in one cassette if the tumor is small, so that the
size of the invasive carcinoma can be measured
cross-section from one slice, which may take more
than one cassette, and submit at least one section per
additional involved slice. Attempts should be made to
include adjacent normal-appearing tissue in the tumor
sections for the purposes of evaluating lymphovascu-
lar invasion. In addition, submit one section each
from at least the 2 grossly uninvolved slices adjacent
to the tumor (one lateral and one medial to the
tumor) to confirm the absence of disease microscopi-
cally (Fig. 7).
If the slices are thick, one full-thickness section can be
submitted as 2 mirror images after being bisected.
All radiographically suspicious areas should be
submitted. If a non-mass-forming lesion such as
ductal carcinoma in situ is expected, tissue adjacent
to the radiographically annotated areas should also
be sampled.
At least one section from each of the 6 margins should
be submitted. Always submit perpendicular margin
sections. Multiple sections of a close margin(s) can be
submitted. It is better to include a portion of the lesion
when submitting a margin section if the lesion is close
enough to be included so that the distance can be
measured microscopically (Fig. 7).
Segmental mastectomy may be performed on a patient
after neoadjuvant therapy. If residual carcinoma is
difficult to evaluate grossly, a specimen radiograph
may be helpful to identify tissue distortion/density,

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 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301 295

Fig. 7. Sampling of a segmental mastectomy specimen with a gross tumor. If a segmental specimen is too large to be submitted in its entirety, submit the largest
cross section of the tumor if it is necessary to measure the tumor microscopically. Submit tissue adjacent to the tumor and submit at least one section of each
margin. Multiple sections of each of the close margins can be submitted. The medial and lateral slices should be sectioned perpendicular to the inked surfaces to
obtain perpendicular margins. Sections are indicated with rectangles. L indicates lateral; M, medial; S, superior; I, inferior; A, anterior; P, posterior (deep).

residual calcifications that may be associated with the portion of the specimen (Fig. 8). The surgeon should be
tumor bed, or biopsy marker clips, all of which may contacted before the specimen is further processed for
guide tissue sampling. If the specimen is too large to be clarification if there is any question regarding the orientation.
submitted in its entirety, sections can be taken to map
out the tumor bed based on the gross and/or
radiographic findings and the original size of the
tumor. Usually, it is necessary to submit multiple
sections of margins in such a case.
Submit representative sections of the remaining breast
tissue, especially fibrous tissue.
Submit representative sections of skin, if present.

If radiographs are taken on the sliced specimen, the

sections can be marked on the film, or if the images are
electronic, the sections can be marked on the printed inverted
images (Fig. 5). Otherwise, a diagram can be created to mark
the sections (Fig. 7).
In the section code, indicate the content of the section
(tumor, area of calcifications, radiographically suspicious
areas or unremarkable breast tissue), its source location (slice
number and location within the slice), and whether it
includes a margin. Indicate the sections that constitute a
complete cross-section of the lesion and sections that
represent mirror images of the same area. In addition,
indicate whether any particular slice is entirely submitted
when the entire specimen is not.

3.2. Mastectomy
The types of mastectomy specimens include total
mastectomy and modified radical mastectomy. They can be
either skin-sparing or non-skin-sparing. Nipple-sparing
mastectomy can also be encountered infrequently.
Mastectomy specimens can be oriented by the surgeon
with 2 perpendicular sutures (eg, short suturesuperior, Fig. 8. A mastectomy specimen can be oriented with 2 sutures (short,
superior; long, lateral), inked with three colors (superior superficial, blue;
long suturelateral), one suture (eg, short suture inferior superficial, orange; posterior [deep], black), and serially sectioned
12 o'clock), or in a modified mastectomy specimen, by along the lateral-medial axis. L indicates lateral; M, medial; S, superior; I,
placing the attached axillary contents in the lateral superior inferior; A, anterior; P, posterior (deep).

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296 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301
Measure the specimen in three dimensions. Measure
the attached skin, areola, and nipple. Note any abnor-
mality of the nipple (retraction, inversion, or irregular
Fig. 9. A skin-sparing specimen that is inked in three colors (superior
superficial, blue; inferior superficial, orange; posterior (deep), black; A), and
serially sectioned along the lateral-medial axis. The slices are laid out (B,
representative slices). The distance of the tumor to the closest margin can be
measured for intra-operative evaluation (C).
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Fig. 10. A modified radical mastectomy specimen using the three-color
system. Note that the axillary tissue is not inked.
surface) or the skin (puckering, ulceration over palpable
tumor or other lesions).
Examine the surface of the specimen. The deep surface of
the specimen is invested by the pectoralis fascia. It may also
contain areas of skeletal muscle, which should be measured
and documented. If it is unclear whether certain areas
represent true resection margins because of the presence of
deep clefts or flaps of tissue, the surgeon should be contacted
for clarification before the specimen is inked.
Ink the specimen surface, except for the skin, using the
following multicolor system: superior superficial, blue;
inferior superficial, orange; posterior (deep), black (Fig. 8;
Fig. 9).
The separation of the superior and inferior aspects of
the superficial surface in a skin-sparing mastectomy
specimen is determined by the horizontal line across
the nipple (Fig. 9).
In a non-skin-sparing mastectomy specimen, this
separation is determined by the tips of the skin ellipse
(Fig. 10).
The surface of the axillary contents of a modified
mastectomy specimen is not inked (Fig. 10).
Blot excess ink.
The axillary contents, if present, are separated from the
remainder of the specimen before further sectioning.
Serially section the specimen perpendicular to the lateral-
medial axis. It is helpful to section with the superficial
surface facing up to avoid tangential slicing. Note the
order of the slices and the number of slices obtained
by sectioning. Although thin slices are desirable, care
should be taken not to compromise the presence of all
margins on each slice (most slices, except for the ones
towards the medial and lateral ends, should each have the
3 colors at the tissue edges). In addition, the specimen
should be sectioned at the same intervals throughout so
 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301 297

For permanent sections, submit tissue as instructed by the

pathologist. General guidelines are provided as follows:

Amputate the nipple at the base and submit a

Fig. 11. The nipple is sectioned perpendicular to the anterior surface.
A horizontal section of the nipple base is also taken.
that the slices are of even thickness. This is important for
the evaluation of the size of the lesion, especially when the
lateral-medial dimension is the largest one. Practically,
sectioning at 1-cm intervals can be achieved with some
specimens, but thicker slices may be necessary for large,
fatty specimens.
Radiographs are almost never obtained of the whole
specimen. If a radiograph of the sliced specimen is desired,
place the slices on a plastic plate(s) in order and provide the
orientation using metallic markers.
Identify gross lesions and record the location (clock
position or quadrant in the breast, numbers of involved
slices, and position within the involved slices), size, and
distance from each margin for each lesion (Fig. 9). If there
are multiple lesions, describe the distance between lesions
when they are close to each other.
It is important to indicate which slices are grossly
involved by tumor so that when microscopic examination
shows a discrepancy from the gross description, the size of
the invasive carcinoma can be adjusted accordingly.
Note calcifications and other radiographically suspicious
areas annotated by the radiologist on the specimen
radiographs. Record the location, estimated size, and
distance from each margin for each area.
Describe any other abnormalities and estimate the ratio of
fibrous to adipose tissue in the non-tumor breast
parenchyma.
Discuss the gross and radiographic findings with the
pathologist and perform frozen sections if necessary.
horizontal section of the nipple base. Submit the entire
nipple perpendicular to the base (Fig. 11).
Submit the entire tumor when the tumor is small (less
than 2 cm). Try to submit a complete cross-section(s)
of the tumor in one cassette if the tumor is small
so that the size of the invasive carcinoma can be
measured microscopically. For large tumors, submit
the largest cross-section from one slice, which
may take more than one cassette, and submit at
least one section per additional involved slice.
Attempts should be made to include adjacent
normal-appearing tissue in the tumor sections for
the purposes of evaluating lymphovascular invasion.
Also submit one section each from at least the 2
grossly uninvolved slices adjacent to the tumor (one
lateral and one medial to the tumor) to confirm the
absence of disease microscopically.
If the tumor is small and the slices are thick, one full-
thickness section can be submitted as 2 mirror images
after being bisected.
All radiographically suspicious areas should be
sampled. If a nonmass-forming malignancy such as
ductal carcinoma in situ is expected, tissue adjacent to
radiographically annotated areas should be sampled.
Always submit perpendicular margin sections. At least
1 section each of the 2 superficial margins and the deep
margin should be submitted. If the lesion is close to or
within the most lateral or medial slice, sections
perpendicular to the inked surface of that slice
covering the lesion should be submitted. Multiple
sections of a close margin(s) can be submitted when
indicated by gross and/or radiological examination. It
is better to include a portion of the lesion when

Fig. 12. A slice of a mastectomy specimen after neoadjuvant chemotherapy. Residual tumor is not apparent on gross examination (A), but areas of distortion are
annotated by the radiologist on the specimen radiograph (B). Sections are taken to map out the area and evaluate the close margins (C). Sections are indicated
with rectangles.

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298 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301

Fig. 13. Sampling of a mastectomy specimen after neoadjuvant treatment with fibrotic areas consistent with tumor bed. Sections (as indicated with rectangles) are
taken from the tumor bed, the surrounding tissue and relevant margins. L indicates lateral; M, medial; S, superior; I, inferior; A, anterior; P, posterior (deep).

submitting a margin section if the lesion is close
enough to be included so that the distance can be
measured microscopically.
In a specimen after neoadjuvant therapy, if residual
carcinoma is difficult to evaluate grossly, a specimen
radiograph may be helpful to identify tissue distortion/
density, residual calcifications that may be associated
with the tumor bed, or biopsy marker clips, all of
which may guide tissue sampling. Sections can be
taken to map out the tumor bed based on the gross and/
or radiographic findings and the original location and
size of the tumor (Fig. 12; Fig. 13).
Submit any additional abnormal areas.
Submit 2 sections of each quadrant that is not involved
by tumor.
Submit representative sections of skin if grossly
involved or close to a tumor. In a specimen of
inflammatory breast cancer, skin sections from
suspicious areas can be submitted to assess residual
tumor in the skin. However, the goal of sampling is not
to assess the skin margins in such a case.
Carefully dissect all lymph nodes from the axillary
contents. Most of the axillary dissection should yield at
least ten lymph nodes. Sometimes a low axillary
dissection is performed, which may contain fewer
lymph nodes. Also examine the most lateral slices of
the breast tissue for additional lymph nodes.
Record the number and size range of the lymph
nodes.
Describe the presence of grossly positive lymph
nodes and matted lymph nodes. Estimate the
number of lymph nodes involved if matted lymph
nodes are present.
Submit all grossly negative lymph nodes and small
positive lymph nodes in their entirety. Do not put
more than one sectioned lymph node in a cassette.
Submit representative sections of large, grossly
positive lymph nodes.
Always leave a small amount of extranodal soft
tissue (a few millimeters) surrounding each lymph
node for the evaluation of extranodal extension.
Indicate in the section code the number of lymph
nodes in each cassette and whether they are entirely
or representatively submitted.
If radiographs are taken on the sliced specimen, the
sections can be marked on the film, or if the images are
electronic, the sections can be marked on the printed inverted

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 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301
Fig. 14. A nipple-sparing mastectomy specimen (A) with 2 clips designating
the location of the nipple (B, arrowhead) and single clips designating the
12-, 3-, 6-, and 9-o'clock areolar areas (B, arrows). The 5 designated areas
are inked green, with a rim of yellow ink (C).
images (Fig. 12). Otherwise, a diagram can be created to
mark the sections (Fig. 13).
In the section code, indicate the content of the section
(tumor, area of calcifications, radiographically suspicious
areas or unremarkable breast tissue), its source location (slice
number and location within the slice), and whether it includes
a margin. When referring to a lesion, be consistent in the use
of the descriptive term in the section code and in the gross
description (eg, do not use nodule if the same lesion is
described as a mass' in the gross description). Indicate the
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299
sections that constitute a complete cross-section of the lesion
and sections that represent mirror images of the same area.
3.3. Nipple-sparing mastectomy
The retroareolar margin is evaluated in nipple-sparing
mastectomy specimens to determine the likelihood of tumor
involvement of the nipple [6]. There is no consensus on
how this margin should be evaluated. One approach for
assessing the retroareolar tissue is provided here in such a
specimen [7].
In an oriented mastectomy specimen (this can be done
with the usual suture designations for orientation), the
nipple-areola complex is marked with sutures and/or clips by
the surgeon to mark the locations of the nipple and the 12-,
3-, 6-, and 9-o'clock areas of the areola. These 5 areas are
inked in green with a surrounding rim of yellow ink, and the
green areas are shaved for en face margins (Fig. 14). These
can be submitted for frozen sections or permanent sections
per the surgeon's request. After these sections are taken, the
same areas can be re-inked yellow, and the remainder of the
specimen is inked and sliced as usual.
One representative perpendicular section of each of
the 5 areas marked by yellow ink is submitted for
permanent sections.
If any of the above sections contains tumor, this
information should be included in the final pathology report,
and the surgeon may decide whether additional tissue of the
nipple-areola complex should be excised.
3.4. Re-excision of margins
Measure the size of the specimen. Measure the size of
skin, if present.
Orient the specimen through information provided by the
surgeon. If no orientation is provided, the entire surface can
be inked black. Usually, a suture or clips are used to
designate the true margin. Care should be taken to ink the
entire true margin, including the peripheral edges, with one
color (black or blue).
If the specimen is oriented by the surgeon to specify
orientations in addition to the true margin, 2 (or more if
necessary) ink colors can be applied to indicate the
orientation (Fig. 15).
Section and submit the specimen sequentially from one
end to the other. Unless otherwise instructed by the
pathologist, always submit perpendicular sections. If small
pieces at the 2 ends of the specimen are submitted en face,
indicate that in the section code.
Ink, section, and submit a re-excision segmental mastec-
tomy specimen in the same manner as a usual segmental
mastectomy specimen. Examine the tissue around the
previous excision cavity for firm areas that may represent
residual tumor.
Submit the entire specimen if it is small. Follow the
pathologist's instruction on how to submit sections if the
specimen is large.
300 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301

Fig. 15. A specimen of an additional margin designated as short suture superior, long suture posterior, and clips at the true margin (left). The anterior and
posterior portions of the true margin are inked in 2 colors (middle). The specimen is serially sectioned and submitted from superior to inferior (right).

3.5. Sentinel lymph node
To determine the number of possible lymph nodes,
palpate the tissue and remove excess adipose tissue. If there
is more than one lymph node, separate the nodes once they
are identified before further removing the adipose tissue
surrounding each node.
Remove excess adipose tissue surrounding each lymph
node (Fig. 16). This is best done by palpating and pressing
down on the fat with one's finger. Leave a small amount of

Fig. 16. Sectioning of a sentinel lymph node. Each node is serially sectioned along the long axis at 2-mm intervals (A). A sentinel lymph node with blue dye (B) is
serially sectioned along the long axis to generate 5 slices (C).

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 L. Huo / Annals of Diagnostic Pathology 15 (2011) 291301 301

Fig. 17. Touch imprints of a sentinel lymph node. Two touch imprint slides are generated from one surface of the slices. A cluster of suspicious cells is identified
on touch prep slide 1 (indicated by a green dot). The corresponding slice can be further examined by analyzing a frozen section of that particular surface.

fat (a few millimeters) around the node for the evaluation of
extranodal extension.
Serially section each node at 2-mm intervals along the
long axis. Small nodes (0.5 cm) can be bisected. Carefully
examine the cut surfaces for areas of firmness or discolor-
ation that may suggest metastasis. If intraoperative evalua-
tion is requested, notify the frozen section staff and the
pathologist of the presence of such areas so that the
corresponding sections can be examined with priority.
If intraoperative touch imprints are to be performed, lay
out the slices, touch one surface of the slices, and then turn
the slices over and touch the other surface. Keep the slices in
order throughout the process so that if suspicious cells are
identified on microscopic examination, the corresponding
slice(s) can be selected for further evaluation by frozen
section (Fig. 17).
For intraoperative frozen section evaluation and perma-
nent sections, submit the entire lymph node tissue unless
otherwise instructed.
Do not place more than one sectioned lymph node in one
cassette or on one touch imprint slide.
If no lymph node is identified in the tissue, the entire
specimen should be submitted for microscopic evaluation.
Indicate the number of lymph nodes, sizes of nodes, and
the appearance of the cut surface in the gross description.
In the section code, include the number of lymph nodes in
each cassette and whether each node has been serially
sectioned or bisected.
4. Conclusion
A thorough gross examination followed by appropriate
tissue submission for microscopic evaluation is crucial to
an accurate pathology diagnosis. Although tumor type,
histologic grade, size, margin status, and lymph node
status remain among the essential elements, in the
new era of personalized medicine, standards for what
should be included in the final pathology report of a
breast specimen are being further refined. To meet the
ever-increasing clinical demands, multidisciplinary par-
ticipation is advocated to facilitate the evaluation of
breast specimens in order to provide adequate information
for patient management.
Acknowledgment
The author would like to thank Kim-Anh Vu for her
excellent support in figure preparation.
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[3] Lester SC. Breast. In: & Lester SC, editor. Manual of Surgical
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[4] Schnitt SJ, Connolly JL. Processing and evaluation of breast excision
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[5] Guarda LA, Tran TA. The pathology of breast biopsy site marking
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