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Mammographic and gross pathologic analysis of breast needle localization specimens. Use of a tissue analysis device.

Histologic diagnosis of a nonpalpable breast lesion requires the following: (1) mammographically directed excision of the suspect lesion, (2) recovery of the target lesion from the tissue specimen, and (3) demonstration of the lesion in histologic section. Recovery of lesional tissue is a function of localization within the specimen, whereas histologic demonstration is a function of localization within the paraffin block. Both localizations are pitfalls enroute to accurate diagnosis of the small mammographic lesion. A technique of specimen analysis is presented that uses a specimen holder to assure precise localization of the lesion within the biopsy tissue. The excised specimen is immobilized within the holder, which incorporates a reference grid visible in the specimen radiograph and on the holder surface. The target lesion can be localized in the reference grid of the specimen radiograph and then excised from the corresponding area of the specimen, which remains in the holder until presented to the gross pathologist. Localization of the lesion within a specific paraffin block(s) will permit additional histologic levels for optimal examination while minimizing histologic work load. The advantages of this approach are discussed and contrasted with variations of standard gross technique.