INTRODUCTION: We developed a study protocol for the examination of non-palpable breast carcinomas detected by mammography with emphasis on evaluation of surgical margins. METHODOLOGY: We reviewed our experience applying the protocol to 52 specimens evaluated by six residents oriented by a breast pathologist. All specimens were submitted to mammography prior to evaluation, which guided gross examination. The specimens were inked and sectioned, oriented by anatomical reference markers, depending on size and lesions detected by mammography. Specimens < 3cm were sectioned in parallel and all tissue sampled. Specimens > 3cm were radially sectioned with a minimum of six samples processed for microscopy. A map of cleavage assigned with block numbers was registered. RESULTS: The majority of surgeries (40 cases; 76.6%) had diagnostic purposes, and 12 (23.4%) were therapeutic procedures. An average of 7.4 blocks was obtained from each specimen. Ductal carcinoma in situ (DCIS), isolated or in association with infiltrating ductal carcinoma, was the most common tumor diagnosed (35/52 cases; 67.3%). Tumors measured from 0.1 to 4cm (average = 1.14 cm). Margins were positive in 22 cases (42.2%). The most common tumor type affecting surgical margins was DCIS (12/22 cases). A re-excision was carried out in 33 cases and residual tumor was found in 17 cases (48.5%). CONCLUSION: Our protocol was considered easy to be used by residents. Although it is not cost saving, because of time-consuming examination, high number of sections sampled, and could imply in two surgical procedures, it is safe for diagnosis and efficient for positive margin detection.
Protocol; Breast cancer; Non-palpable lesions
