Published 9 June 2009, doi:10.1136/bmj.b2342
Cite this as: BMJ 2009;338:b2342

Letters

Screening at breast reduction

More than a little extra work

The first 150 words of the full text of this article appear below.

We were surprised that no histopathology opinion was sought in discussing the implications of histopathological examination of breast tissue excised during breast reduction surgery.1

Mammographic screening entails radiological examination of the entire breast. "Tissue screening" exclusion of malignancy would entail examining all the tissue histologically since most ductal carcinoma in situ is not visible on gross examination. However, given the available resources, it would be impractical to submit all tissue from breast reduction specimens for histological examination as this would entail many tens of tissue blocks from each case. Even if the entire specimen were submitted, only about 0.15% (a 4 µm section from each 3-4 mm tissue block) would be examined under the microscope.

The commentaries suggested that the specimen should be oriented as this "would seem to need little extra work." However, reduction specimens are often received in multiple pieces, each of which would need to be oriented. . . . [Full text of this article]

Anthony G Douglas-Jones, consultant histopathologist1, Murali Varma, consultant histopathologist1

1 University Hospital of Wales, Heath Park, Cardiff CF14 4XN

douglas-Jones@cf.ac.uk


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