About our Breast Pathology Service:

A breast biopsy involves the removal of a small sample of tissue from a suspicious area of the breast. The tissue sample is then processed and studied in a laboratory by a pathologist who diagnoses disease and issues a report. This report is used by the requesting physician to manage the disease of the patient. It typically takes only 24-48 hours from laboratory receipt of specimen to the issuing of a pathology report.

Once a sample is received, a breast biopsy specimen requires a minimum of 8 hours in preservative (formalin) in order for the tissue to be properly fixed to maintain the integrity of cell markers which might be needed for further diagnosis.

After the specimen is fixed, a pathologist or histotechnologist examines the specimen and dictates a description as it looks to the naked eye ("gross” or "macroscopic" exam). The tissue is then placed in a tissue processor for 16 hours, embedded in wax, cut into very thin sections and placed on microscope slides. These slides are stained such that the tissue architecture is revealed (H&E stain) and the clinical case, is presented to a pathologist for microscopic examination to determine the diagnosis.

Together with available clinical information and radiology findings, the diagnosis is then summarized in a formal overall report and signed by a pathologist.

Breast Tissue Special Stains

If a pathologist determines that cancer is present, further testing can be performed to determine the molecular profile of the tumor to inform and personalize treatment decisions.

Recently, breast tumors are classified based upon specific molecular markers (e.g., estrogen (ER), progesterone (PR), and HER2/neu receptors). The presence of these markers is correlated with disease-free survival rates and may be used to help determine treatment options.

The process of staining microscope slides for these markers typically takes an additional 24 hours and is called immunohistochemistry. PMI Labs uses FDA approved kits for these breast cancer markers.

Summary

The purpose of the gross examination, the processing of the tissue, and the microscopic examination with conventional and special stains is to enable pathologists to form a specific diagnosis and to predict which therapeutic agents may be useful.