Why Surgical Pathology Reports Matter for Breast Cancer

What Is the Importance of a Surgical Pathology Report for Breast Carcinoma?

The surgical pathology report is important for managing breast carcinoma, aiding in disease understanding and enhancing communication among medical teams and patients. It plays a vital role in treatment decisions and accurately predicting prognosis. Surgical pathologists’ meticulous evaluation of specimens using specialized techniques is essential for reliable results.

Synopsis

When it comes to managing breast carcinoma disease, the surgical pathology report is critical. It assists medical experts and patients in understanding the true nature of the disease and improves communication among the various members of the medical team and between the medical team and the patient. The surgical pathology report plays a crucial role in the effective management and treatment of breast cancer and other related breast ailments. A precise and thorough surgical pathology report is of utmost importance in accurately predicting the prognosis of breast cancer and other breast conditions. As the surgical pathologist, you are the initial member of the medical team responsible for evaluating a portion of the specimen using specialized techniques and equipment. The meticulous execution of these procedures is paramount to ensure accurate and reliable results.

Surgical Pathology in Breast Diseases

The role of surgical pathology in managing breast diseases is of utmost importance. It not only aids in the diagnosis but also helps in planning the treatment and predicting the outcome of most breast illnesses. The impact of surgical pathology on breast cancer treatment has been significant, as evidenced by the recent advancements in this field. This has led to a growing interest among researchers in understanding the intricacies of surgical pathology in breast cancer management. Furthermore, the findings from surgical pathology assessments can aid in developing new treatments and refining existing ones, leading to improved patient outcomes. 

What is Breast Carcinoma?

One of the most important term used in the report is the precise determination of the term carcinoma or adenocarcinoma. Carcinoma describes cancer that begins in the lining layer or epithelial cells of the breast. Nearly all breast cancers are carcinomas. Most of them are the type of carcinoma that starts in glandular tissues which are called adenocarcinomas. In the breast, it starts in the cells lining the ducts or lobules, when a normal cell becomes a carcinoma cell. If the carcinoma cell is still confined to the breast ducts or lobules, without breaking out and growing into surrounding tissue, it is considered in situ carcinoma. When the cells break out and grow, the patients need to be aware it is invasive or infiltrating carcinoma. When it comes to invasive carcinomas, the tumor cells can spread or metastasize to other parts of the patient’s body.

Types of In Situ Carcinoma

One of the most important aspects of the surgical pathology of breast cancer is in situ carcinoma. It involves: 

  • Ductal carcinoma in situ 
  • Comedocarcinoma 
  • In situ papillary carcinoma 
  • Solid in situ carcinoma 
  • Cribriform in situ carcinoma 
  • Micropapillary in situ carcinoma  
  • Clinging in situ carcinoma 
  • Lobular carcinoma in situ 
  • Invasive carcinoma  
  • Invasive ductal carcinoma 
  • Tubular carcinoma 
  • Papillary carcinoma 
  • Medullary carcinoma 
  • Metaplastic carcinoma 
  • Mucinous carcinoma 
  • Secretory carcinoma 
  • Inflammatory carcinoma 
  • Paget’s disease 
  • Invasive lobular carcinoma 
  • Phyllodes tumor  

Specimen Evaluation

An important step to analyze breast cancer in surgical pathology is to evaluate a portion of cancer that is removed during the biopsy or surgery to see if they have estrogen or progesterone receptors. Also, all newly discovered breast cancers should be tested for HER2/neu because HER2 – positive cancers are much more likely to benefit from treatment with drugs that target the HER2/neu protein like trastuzumab (Herceptin) and lapatinib (Tykerb).

Stereotactic Breast Needle Biopsy Technique

Fine needle aspiration or core needle biopsy versus surgical biopsy still represents a challenge when it comes to breast lesions where you suspect malignancy. Sometimes, it is applied to a sampling of nonpalpable or indistinct breast lesions. Stereotactic breast needle biopsy is a technique that facilitates the precise localization of the lesion within the affected breast, thus enabling its accurate diagnosis.

The Role of Collaboration in Breast Surgical Pathology Reports

Collaboration with the patient’s primary doctor is of crucial importance during the surgical pathology process. As a surgical pathologist, you need to send the patient’s doctor a report that gives a diagnosis for each sample taken. The pathology report is based on a breast biopsy, such as a needle biopsy or an excision biopsy. When it comes to a needle biopsy, a needle is used to remove a sample of an abnormal area. An excision biopsy removes the entire abnormal area, often with some of the surrounding normal tissue. An excision biopsy is a highly effective procedure that closely resembles breast-conserving surgery, which is commonly referred to as a lumpectomy. 

What Does a Surgical Pathology Report Contain?

Surgical pathology of breast carcinoma means that the biological features of the disease and the extent of the disease are the factors that determine the stage of a disease, contribute to risk estimation, and help in the prediction of response to therapy. The report made by you isn’t only a group of basic information. It needs to involve all the key questions important for making the treatment plan. A surgical pathology report in the context of breast carcinoma helps in planning for adjuvant therapy, estimation of prognosis, and outcome prediction. You need to provide all the information required to sustain the quality communication that is needed in treating breast cancer. 

An Open Communication Channel

It is important to inform the patient that if their carcinoma is infiltrating or invasive, it is not a pre-cancer or carcinoma in situ, but rather a genuine cancer. Breast cancer typically originates from the cells that line the ducts or lobules of the breast tissue, wherein a normal cell transforms into a carcinoma cell. If the carcinoma cell is still confined to the breast ducts or lobules, without breaking out and growing into surrounding tissue, it is considered in situ carcinoma. When the cells break out and grow, patients need to be aware it is invasive or infiltrating carcinoma. When it comes to invasive carcinomas, the tumor cells can spread or metastasize to other parts of the body.

Importance of Transparent Communication

The surgical pathology report is a critical component in the management of breast cancer, providing essential information for the accurate staging and selection of appropriate treatment options. It helps in determining the stage of the disease, estimating prognosis, planning further treatment strategy, predicting outcomes, and helping the patient’s care in general. It is not rare that small private and large institutional laboratories practice breast cancer histopathology. Good communication between the members of the team must exist at every stage for the best treatment outcome. The surgical pathology report also contains important information that is critical to the oncologist.  

Combined Effort from a Multidisciplinary Team

When it comes to breast cancer management in surgical pathology, a multidisciplinary team is required. Usually, it consists of a radiologist, breast surgeon, histopathologist, oncologist, and surgical pathologist. When a patient is suspected to have breast cancer, a radiologist usually conducts an initial assessment, followed by an evaluation by a breast surgeon. The final diagnosis and stage of the disease are typically determined by a histopathologist and a surgical pathologist, who work collaboratively to analyze tissue samples obtained during biopsy or surgery.

Conclusion

The surgical pathology report is a crucial part of the surgical pathology of breast carcinoma that involves working with the specimen and making a report that is key to the medical team, and the patient. A surgical pathology report for breast carcinoma is not simply a collection of information to be shared with colleagues and patients. Rather, it represents a commitment to adhering to the highest standards of care and treatment to achieve the best possible outcomes for the patient. The practice of surgical pathology in the context of breast carcinoma is a complex process where every aspect influences another one. The best practice of surgical pathology means the best working environment involving transparent communication. A proper communication channel is not possible without the proper equipment. PreciPoint’s M8 or O8 digital microscopes have the potential to meet all your requirements and facilitate the creation of an optimal work environment for you and your colleagues, ultimately benefiting your patients’ care.