Specimen Shrinkage and Its Influence on Margin Assessment in Breast Cancer

Yeap, B H; Muniandy, Suseela; Lee, Suk-Kam; Sabaratnam, Subathra; Singh, Manjit

doi:10.1016/s1015-9584(08)60020-2

Cited by 58 publications

(65 citation statements)

References 19 publications

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“…Docquier PL et.al. (21) and Yaep BH et al (22) suggested that breast specimens undergo shrinkage after histological fixation, losing more than a third of their original closest free margin, whilst the tumour itself does not shrink substantially.…”

Section: Discussionmentioning

confidence: 99%

Clinical Assessment of Axillary Lymph Nodes and Tumor Size in Breast Cancer Compared with Histopathological Examination: A Population‐Based Analysis of 2,537 Women

2012

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Section: Discussionmentioning

confidence: 99%

Clinical Assessment of Axillary Lymph Nodes and Tumor Size in Breast Cancer Compared with Histopathological Examination: A Population‐Based Analysis of 2,537 Women

2012

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“…The practical importance of this is that it may be possible to achieve a more accurate pre-operative sizing, allowing a one stage surgical procedure. Currently about 20% [19] of patients diagnosed on the NHSBSP who undergo a treatment operation require a second procedure, some of which are to remove margins involved by tumour not removed in the primary operation. This percentage could be reduced with more accurate pre-operative estimation of tumour size and shape.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it is well recognised that the processing of histological samples causes shrinkage. The literature gives wide variability in the degree of shrinkage of both the tumour and the specimen margin [19]. The measurements taken from the pathology slides that were used as our gold standard were calculated to take an overall 10% shrinkage into account.…”

Section: Discussionmentioning

confidence: 99%

A pilot study to evaluate assisted freehand ultrasound elasticity imaging in the sizing of early breast cancer: a comparison of B-mode and AFUSON elasticity ultrasound with histopathology measurements

English¹,

Parker

et al. 2011

BJR

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Objective: This pilot study investigates the role of assisted-freehand ultrasound (AFUSON) elasticity imaging of the breast in assessing the contour, size and area of 23 early breast cancers by making comparison of AFUSON with the equivalent B-mode ultrasound images and gold standard histopathology slides. Methods: The B-mode, AFUSON and digitised histopathology slides of three early breast cancers were compared for contour, size and area with histopathology scans. AFUSON features that corresponded to areas of known malignant change on the histopathology slides were regarded as diagnostic. These diagnostic criteria were then applied to the B-mode and AFUSON elasticity images of all 23 breast cancers in the pilot study without having the availability of the histopathology scans for reference. Corresponding diameters were measured and the results were compared with the equivalent measurements on the scans of the histology slides. The results were tabulated in histogram form. Diagnostic confidence levels were evaluated. Results: Size dimension accuracy increased from 66% using B-mode alone to 82% using combined B-mode and AFUSON elasticity images. Tumour area accuracy was also increased. A small number of cases had a striking visual similarity of shape on AFUSON elasticity scans and histopathology slides. Conclusion: In spite of the shortfalls in this study, AFUSON elasticity imaging was capable of acquiring some high-quality images that showed strong correlation between AFUSON elasticity and scans of histology slides. Further studies will be carried out to refine the technique and determine if it has a role in the diagnosis and management of breast cancer. Breast cancer is the most common cancer occurring in women in the Western world. Currently, the lifetime risk of developing breast cancer for UK women is 1:9, and on average 126 new cases are diagnosed each day [1]. Current trends in cancer imaging are aimed towards technological development of non-invasive techniques that provide high diagnostic sensitivity and specificity and also prognostic information about the primary tumour upon which to base treatment regimens. Such developments are taking place notably in ultrasound, CT, MRI and positron emission tomography (PET).Ultrasound elasticity imaging of soft tissues has been developed over the last 20 years and is under evaluation as an additional tool in the ultrasound armamentarium to supplement the diagnostic information obtained during conventional B-mode scanning. It is now found on several currently commercially available ultrasound systems [2][3][4]. These systems rely on freehand ultrasound scanning for its flexibility and simplicity [4][5][6][7][8][9] but like all freehand systems there is significant inter-and intraobserver error [10,11]. During the last 5 years we have developed an elasticity scanning system called assistedfreehand ultrasound (AFUSON) elasticity imaging as a method of reducing this variability by applying semiautomated, measurable external compression during an ultrasound scan. It sho...

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“…The authors cautioned on the sole reliance on microscopic measurements. In a further study, Yeap and colleagues 84 quantified the shrinkage of breast specimens as a result of formalin fixation. Fifty consecutive mastectomy and wide excision specimens were prospectively appraised, and the closest free margins and maximum tumour diameters of fresh, unprepared specimens were recorded.…”

Section: Limitations Of Reference Standard For Imagingmentioning

confidence: 99%

Multicentre randomised controlled trial examining the cost-effectiveness of contrast-enhanced high field magnetic resonance imaging in women with primary breast cancer scheduled for wide local excision (COMICE)

Turnbull

Brown²,

Olivier³

et al. 2010

Health Technol Assess

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Specimen Shrinkage and Its Influence on Margin Assessment in Breast Cancer

Cited by 58 publications

References 19 publications

Clinical Assessment of Axillary Lymph Nodes and Tumor Size in Breast Cancer Compared with Histopathological Examination: A Population‐Based Analysis of 2,537 Women

Clinical Assessment of Axillary Lymph Nodes and Tumor Size in Breast Cancer Compared with Histopathological Examination: A Population‐Based Analysis of 2,537 Women

A pilot study to evaluate assisted freehand ultrasound elasticity imaging in the sizing of early breast cancer: a comparison of B-mode and AFUSON elasticity ultrasound with histopathology measurements

Multicentre randomised controlled trial examining the cost-effectiveness of contrast-enhanced high field magnetic resonance imaging in women with primary breast cancer scheduled for wide local excision (COMICE)

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