[英文原版 乳腺 外科] 9 Reading the Pathology Report.pdf

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1、9ReadingthePathologyReportHISTOLOGYTUMORSIZEInvasiveDuctalCarcinomaMARGINSTATUSInvasiveLobularCarcinomaTubularCarcinomaGRADECribriformCarcinomaHORMONERECEPTORANDMedullaryCarcinomaHER-2/NEUEXPRESSIONMucinousCarcinomaLYMPHOVASCULARINVASIONPapillaryCarcinomaSecretoryCarcinomaEXTENSIVEINTRADUC

2、TALMetaplasticCarcinomaCOMPONENTOtherFormsofBreastCancerReadingthePathologyReport:KeyPointsBefamiliarwiththedifferentsubtypesofinvasivebreastcancerandtheimplicationsonsurgicalmanagement.Knowhowmarginsareassessedandtheneedforreexcisionforeitheracloseorpositivemargin.Understandhowtumorsize,g

3、radeandotherhistologicfeaturesmayimpactsurgicaloradjuvanttherapy.Althoughtherearemanyimportantrelation-reportdependsuponafirmgraspoftheshipsamongthevariousmembersofthesurgicalprocedureperformed.Tosucceed,thisbreastcancermultidisciplinaryteam,therela-relationshiprequiresexcellentcommunica-t

4、ionshipbetweenthesurgeonandthepathol-tion,includingtheaccuratelabelingofspeci-ogistisauniqueone.Thetwoarecloselytiedmens,theproperorientationofspecimens,becausethesuccessofsurgicaltherapyisandpossiblythepresenceofthesurgeonindependentupontheaccuracyofthepathologythepathologylaboratorytohel

5、pfacilitatethereport,andtheaccuracyofthepathologyprocess.123124SURGICALFOUNDATIONS:ESSENTIALSOFBREASTSURGERYHistologyThefirstquestionwhenonereceivesapathol-ogyreportbackafterabiopsyiswhattypeofcanceristhis?Specificallyisthisinsituorinvasivediseaseandwhattypeofinvasivecancerisit?Thepatholog

6、yofinsitudiseaseisdiscussedinChapter11.Forinvasivecan-cers,thetwomostcommonhistologictypesareinvasiveductalandinvasivelobular.How-ever,therearemanyothersubtypesthatmayhavedifferentimplicationsintermsofsurgicaloradjuvanttherapy(Box9–1).InvasiveDuctalCarcinomaFigure9–1.Histologyofinvasiveduc

7、talcarcinoma.ThecancercellsformglandularstructureswithInvasiveductalcarcinomaisthemostcom-cellularandnuclearpleomorphism.Thesenestsinfil-montypeofinvasivebreastcancer.Tumorstratethesurroundingbreasttissueinahaphazardcanbeeitherpureinvasiveductalcarcinoma,fashi