Pathological examination after mastectomy of breast masses.
1.Pathological examination is the most reliable diagnostic method and cannot be replaced by other examinations;
2.The lump should be completely removed for breast lump biopsy;
3. The main method of pathological examination is immediate frozen section examination;
4.If the pathological examination is malignant tumor, radical surgery should be performed in time in order to prevent the possible spread caused by biopsy surgery.
If it is difficult to judge the tumor at the time of surgery and the mass is small, routine pathological examination is feasible and the treatment plan will be determined by the result.
Pathological biopsy of microscopic breast lesions with breast guide wire localization
Biopsy of breast lesions is an important part of preoperative confirmation of breast cancer diagnosis. For microcalcifications and small nodules of suspected malignancy detected by mammography, the biopsy is often difficult due to the small size of the lesion, which is invisible to the clinician and causes false negative results due to inaccurate positioning.
The radiology department and breast surgery department carry out guidewire-located excisional biopsies of breast lesions, both of which are found to have tiny calcified spots and small nodules on mammography with negative clinical manifestations and no definite abnormal sonographic manifestations on ultrasonography.
Using the mammography machine and the hook-shaped guidewire positioning needle, depending on the location of the target lesion, the shortest surgical resection path was used to successively perform planar and vertical projection, determine the needle entry point and needle depth, adjust the positioning needle depth to the optimal, withdraw the outer cuff needle, leave the hook-shaped positioning guidewire in the tissue, position the guidewire for body surface fixation, and then perform excisional biopsy of the lesion under local anesthesia.
The method of guidewire positioning for excisional biopsy of breast lesions has achieved satisfactory results in the early detection of breast lesions. This method has been proven to compensate for the lack of false negativity of breast puncture biopsy, which is beneficial to the early diagnosis of breast cancer and provides another powerful tool to improve the diagnosis and treatment of breast cancer.
Pathological types named by tissue characteristics
The pathological type of breast cancer refers to the pathomorphological observation of the tumor specimen, and then determine the degree of breast cancer development, tissue origin, change characteristics, differentiation degree, etc. There are many pathological types of breast cancer.
1.Named by tissue origin: e.g. lobular adenocarcinoma, ductal adenocarcinoma;
2. Named according to the tissue characteristics of the lesion: e.g. medullary carcinoma, sclerocarcinoma, simple carcinoma;
3.Named according to the degree of lesion: such as carcinoma in situ, early stage carcinoma, infiltrating carcinoma;
4.Named according to the differentiation degree of cancer cells: undifferentiated carcinoma, low differentiated carcinoma, middle differentiated carcinoma, highly differentiated carcinoma.
Pathological classification of breast cancer cells
1.Non-invasive carcinoma: also known as carcinoma in situ, which refers to the growth of cancer cells confined to the epithelial basement membrane without metastasis. It includes lobular carcinoma in situ and intraductal carcinoma.
2.Early invasive carcinoma: It is the early stage from in situ carcinoma to invasive carcinoma, in which the cancer cells break through the basement membrane of epithelium, but the degree of infiltration is still shallow and metastasis of cancer foci rarely occurs. It includes early infiltration of lobular carcinoma in situ and early infiltration of intraductal carcinoma.
3.Infiltrating cancer: Cancer cells have broken through the limits of epithelial basement membrane and invaded surrounding tissues extensively, so metastasis of cancer foci can easily occur. According to whether the primary site of cancer originates from breast epithelial tissue or other tissues, it is further divided into infiltrative specific cancer and infiltrative non-specific cancer.
4.Invasive non-specific carcinoma: including invasive lobular carcinoma, invasive ductal carcinoma, simple carcinoma, medullary carcinoma, sclerocarcinoma and adenocarcinoma.
5.Infiltrative special carcinoma: including papillary carcinoma, medullary carcinoma, mucinous adenocarcinoma, adenoid cystic adenocarcinoma, sweat adenocarcinoma, squamous cell carcinoma, papillary Pagets disease.
6.Rare carcinoma: including spindle cell carcinoma, carcinosarcoma, indolent cell carcinoma, fibroadenoma carcinoma, etc.