Last modified on 16 August 2010, at 16:24
DETAIL TEST SPCH Not provided. DETAIL TEST SPCPT Container A-B: 88305/FR Container C-D: 88307/FR Representative carcinoma in blocks C8-14. DETAIL TEST SPGD A. "Sentinel node number one (hot and blue)-level one", received fresh and placed in formalin is a 2.0 x 1.9 x 1.5 cm aggregate of brown-tan fibrofatty tissue which is bisected for lymph node candidates. Four lymph node candidates are found up to 0.5 cm in greatest dimension and are submitted entirely in block A1. A cytokeratin stain is prospectively requested. B. "Sentinel node number two (hot not blue)-level one", received fresh and placed in formalin is a 1.7 x 1 x 0.6 cm aggregate of yellow-tan fibrofatty tissue which is dissected for lymph node candidates. One lymph node candidate is found (0.8 x 0.6 x 0.4 cm), and is submitted entirely in block B1. A cytokeratin stain is prospectively requested. C. "Right partial mastectomy", received fresh and placed in formalin is an oriented lumpectomy specimen (long suture-lateral, short suture-superior). Based on this orientation, the specimen dimensions are as follows: medial to lateral-4.5 cm, superior to inferior-1.3 cm, anterior to posterior-1 cm. The specimen is inked as follows: anterior-blue, posterior-black, superior-red, inferior-yellow. The specimen is serially sectioned from medial to lateral to reveal an approximately 1.7 x 0.6 x 0.3 cm well defined white-tan firm lesion which is 0.9 cm from the medial margin, 1.2 cm from the lateral margin, 0.3 cm from the anterior margin, 0.4 cm from the posterior margin, 1.4 cm from the superior margin and 1.3 cm from the inferior margin. There is a cystic area (0.6 cm in length x 0.2 cm in diameter) which is consistent with a previous biopsy site. The remainder of the tissue is lobulated tan-yellow with focal areas of blue consistent with sentinel node mapping dye. No biopsy clip is grossly observed. The specimen is entirely submitted from medial to lateral in blocks C1-C17, with the lesion located in blocks C5-C13. Please see accompanying photograph with block diagram. D. "Additional margin-medial", received fresh and placed in formalin is a 4 x 3 x 1.4 cm portion of unoriented tan-yellow fibroadipose breast tissue. One surface has an approximately 2.5 x 1.3 cm area of blue discoloration, consistent with lymph node mapping. This surface is inked blue, the opposite side is inked black, and the specimen is serially sectioned and submitted entirely in blocks D1-D6. A. Jones/slides to Dr. Smith/ DETAIL TEST SPMI Microscopic examination is performed. DETAIL TEST SPDX A. "SENTINEL NODE #1, HOT AND BLUE, LEVEL ONE" (BIOPSY): POSITIVE FOR CARCINOMA, TWO OF FOUR LYMPH NODES (2/4). AN IMMUNOHISTOCHEMICAL STAIN FOR CYTOKERATIN IS POSITIVE. METASTATIC TUMOR DEPOSITS ARE LESS THAN 0.2 MM. B. "SENTINEL NODE #2, HOT NOT BLUE, LEVEL ONE" (BIOPSY): NEGATIVE FOR CARCINOMA, ONE LYMPH NODE (0/1). AN IMMUNOHISTOCHEMICAL STAIN FOR CYTOKERATIN IS NEGATIVE. C. "RIGHT PARTIAL MASTECTOMY" (EXCISIONAL BIOPSY): INVASIVE ADENOCARCINOMA OF THE BREAST. HISTOLOGIC TYPE: DUCTAL WITH LOBULAR FEATURES. NOTTINGHAM COMBINED HISTOLOGIC GRADE: 2 OF 3. TUBULE FORMATION SCORE: 3 NUCLEAR PLEOMORPHISM SCORE: 2 MITOTIC RATE SCORE: 1 GROSS TUMOR SIZE: 1.7 X 0.6 X 0.3 CM. SIZE OF INVASIVE COMPONENT: 1.7 X 0.6 X 0.4 CM. LYMPHATIC/VASCULAR INVASION: ABSENT. MULTIFOCAL TUMOR: ABSENT. IN-SITU CARCINOMA: PRESENT. TYPE OF IN-SITU CARCINOMA: SEE COMMENT. NUCLEAR GRADE OF IN-SITU CARCINOMA: 1 OF 3. NECROSIS: ABSENT. DCIS EXTENDING OUTSIDE INVASIVE TUMOR MASS: ABSENT. SIZE OF IN-SITU CARCINOMA: NOT APPLICABLE. STATUS OF NON-NEOPLASTIC BREAST TISSUE: BIOPSY SITE CHANGES, SCLEROSING ADENOSIS, FIBROADENOMA. SIZE OF BIOPSY: 4.5 X 1.3 X 1 CM. MICROCALCIFICATIONS: ABSENT. SURGICAL MARGIN STATUS: NEGATIVE. ESTROGEN/PROGESTERONE RECEPTOR, CELL CYCLE, EGFR AND HER2/NEU ANALYSIS: PREVIOUSLY PERFORMED. COMMENT: An addendum report will follow immunoperoxidase stains to help evaluate the histologic type of the in situ carcinoma. D. "ADDITIONAL MARGIN-MEDIAL": BENIGN BREAST TISSUE, NEGATIVE FOR IN SITU OR INVASIVE CARCINOMA. MARGINS NEGATIVE FOR TUMOR. DETAIL TEST SPSTAGE PROCEDURE: Excisional biopsy PATHOLOGIC STAGE: pT1c pN0(i+) pMX NOTE: Information on pathology stage and the operative procedure is transmitted to this Institution's Cancer Registry as required for accreditation by the Commission on Cancer. Pathology stage is based solely upon the current tissue specimen being evaluated, and does not incorporate information on any specimens submitted separately to our Cytology section, past pathology information, imaging studies, or clinical or operative findings. Pathology stage is only a component to be considered in determining the clinical stage, and should not be confused with nor substituted for it. The exact operative procedure is available in the surgeon's operative report.