Original Contribution| Volume 4, ISSUE 3, P198-202, August 2003

Increased Sectioning of Pathologic Specimens with Ductal Carcinoma In Situ of the Breast: Are There Clinical Consequences?

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      To assess if there has been increased sectioning of pathologic specimens with ductal carcinoma in situ (DCIS), identify sources of this change, and consider the clinical consequences, pathologic data from patients who underwent initial excisional biopsies at our institution and were referred to the radiation oncology department with DCIS from 1992-2002 were retrospectively reviewed. One hundred forty-four of 480 patients with DCIS were eligible for review. Specimen size was recorded as length, to the nearest 0.1 cm, in 3 dimensions. Specimen volume was approximated by the product of the 3 dimensions of the specimen. The primary endpoint was the number of microscopic sections taken from gross specimens, corrected for specimen size. Other analysis included margin status, use of a previous stereotactic needle biopsy, and whether a subsequent repeat excision was performed. Over time, there was an increase in size of the excisional biopsy specimens (mean of 49 cm3 from 1992 to 1994 and 90 cm3 from 2001 to 2002; P = 0.045). Mean numbers of slides per centimeter of specimen were 2.5, 2.7, 3.9, and 5.8 for the intervals 1992–1994, 1995–1997, 1998–2000, and 2001–2002, respectively (P < 0.001 for 1992–1997 vs. 1998–2002). Adjusting for volume, the increase over time in the number of slides per specimen was statistically significant (parameter significance, P < 0.001). For a given volume, the number of slides increased approximately 9.1% per year, on average, during the study period. The positive margin rates were 52%, 46%, 23%, and 25% from 1992 to 1994, from 1995 to 1997, from 1998 to 2000, and from 2001 to 2002, respectively. The degree of sectioning, corrected for specimen length and volume, increased over time.

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        • Winer EP
        • Morrow M
        • Osborne CK
        • et al.
        Malignant tumors of the breast.
        in: Devita VT Hellman S Rosenberg SA Cancer: Principles and Practice of Oncology. Lipincott Williams & Wilkins, Philadelphia2001: 1651-1717
        • Jemal A
        • Murray T
        • Samuels A
        • et al.
        Cancer statistics, 2003.
        CA Cancer J Clin. 2003; 52: 5-26
        • Ernster VL
        • Barclay J
        • Kerlikowske K
        • et al.
        Incidence of and treatment for ductal carcinoma in situ of the breast.
        JAMA. 1996; 275: 913-918
      1. Pathological examination and reporting of breast specimens.
        in: Trott PA Lakhani SR Sloane JP Biopsy Pathology of the Breast (Biopsy Pathology Series, 24). 2nd edition. Edward Arnold, London2001: 10-27
        • Fisher ER
        • Dignam J
        • Tan-Chiu E
        • et al.
        Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) eight-year update of protocol B-17: intraductal carcinoma.
        Cancer. 1999; 86: 429-438
        • Silverstein MJ
        • Lagios MD
        • Groshen S
        • et al.
        The influence of margin width on local control of ductal carcinoma in situ of the breast.
        N Engl J Med. 1999; 340: 1455-1461
        • Solin LJ
        • Fourquet A
        • Vicini FA
        • et al.
        Mammographically detected ductal carcinoma in situ of the breast treated with breast-conserving surgery and definitive breast irradiation: long-term outcome and prognostic significance of patient age and margin status.
        Int J Radiat Oncol Biol Phys. 2001; 50: 991-1002
        • Bijker N
        • Peterse JL
        • Duchateau L
        • et al.
        Risk factors for recurrence and metastasis after breast-conserving therapy for ductal carcinoma-in-situ: analysis of European Organization for Research and Treatment of Cancer trial 10853.
        J Clin Oncol. 2001; 19: 2263-2271
        • Morrow M
        • Schnitt SJ
        Treatment selection in ductal carcinoma in situ.
        JAMA. 2000; 283: 453-455
        • Schnitt SJ
        • Connolly JL
        Processing and evaluation of breast excision specimens: A clinically oriented approach.
        Am J Clin Pathol. 1992; 98: 125-137
        • Owings DV
        • Hann L
        • Schnitt SJ
        How thoroughly should needle localization breast biopsies be sampled for microscopic examination? A prospective mammographic/pathologic correlative study.
        Am J Surg Pathol. 1990; 14: 578-583
        • Fitzgibbons PL
        • Connolly JL
        • Page DL
        in: Compton CC Henson DE Hammond EH Reporting on Cancer Specimens. American College of Pathologists, Chicago2000: 1-18
        • Nakhleh RE
        • Jones B
        • Zarbo RJ
        Mammographically directed breast biopsies. A college of American Pathologists Q-probe study of clinical physician expectations and of specimen handling and reporting characteristics in 434 institutions.
        Arch Pathol Lab Med. 1997; 121: 11-18
        • Morrow M
        • Venta L
        • Stinson T
        • et al.
        Prospective comparison of stereotactic biopsy and surgical excision as diagnostic procedures for breast cancer patients.
        Ann Surg. 2001; 233: 537-541
        • White RR
        • Halperin TJ
        • Olson Jr, JA
        • et al.
        Impact of core needle breast biopsy on the surgical management of mammographic abnormalities.
        Ann Surg. 2001; 233: 769-777