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72 - The magical 3D pathology - the Mother of solid knowledge for a breast imager

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Current breast cancer terminology, which is largely based on cellular features, does not correctly reflect the anatomic structures from which most breast cancers originate. Subgross, thick section histopathology images help bridge the gap between the appearance of breast cancer at preoperative imaging and its appearance on thin section histopathology and has provided crucial visual evidence for the apparent sites of origin of breast cancer subtypes.

Using the large format, subgross, thick section histopathology technique, Jensen et al. concluded that “ductal carcinoma in situ of the human breast is of lobular origin. Progressive distension of ductules [acini] with dysplastic and anaplastic cellular elements leads to unfolding and coalescence of the ductules [acini] within the lobule to form larger ovoid structures. Such lesions falsely appear to be small ducts in conventional histology slides.”

In order to enable a direct comparison of the normal and abnormal breast tissue structure with the thick section histopathology images at a similar image resolution, microfocus magnification of the mammograms and specimen radiographs can be used. Both methods demonstrate fine structural details as well as their alterations by benign and malignant breast diseases without showing cellular details.

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Subtitles available in:

  • English by László Tabár