Forum of Pathology

Introduction

Almost any breast lesion may produce diagnostic difficulty and a degree of selectivity is therefore necessary in a seminar such as this. This has been achieved by reference to two main sources: data on consistency of diagnosis from External Quality Assessment schemes in the United Kingdom organised by the National Co-ordinating Group for Breast Screening Pathology and in Europe organised by the European Breast Screening Pathology Group; 1-3 an informed audit of cases sent for second opinion from other departments. It is, perhaps, not surprising that both routes produce similar problem cases which fit into a relatively restricted group of diagnostic categories which can be considered under the headings shown in Table 1.

In practice the pitfalls described below may be avoided or reduced by the application of sound general histopathological principles. These include the application of strict diagnostic protocols and in this respect there is good world-wide agreement for most lesions. Participants in the symposium are referred to the standard breast pathology texts in the reference list, including UK and European breast screening pathology guidelines. 4-8 It is interesting to note that many diagnostic difficulties arise with those lesions where complete agreement on diagnostic criteria has not yet been reached. The aim in this presentation is to emphasise practical points of distinction rather than to provide a comprehensive description of each lesion.

One further general point is pertinent. Experience has shown that in many cases difficulty in diagnosis is related to sub-optimal specimen preparation, mostly poor fixation or tissue processing. A comparatively minor investment of time and effort in improving the technical aspects of the diagnostic process will be rewarded by considerably better quality of preparations and a consequent decrease in unnecessary problem cases.

Index

Organisation:
FORPATH asbl

Coordination:
Dr Bernard Van den Heule

Host:
Labo CMP