Breast Surgery

Large Format Pathology

When a woman has surgery for breast cancer, the biggest question weighing on her mind afterward is, "Did the doctor get it all?" Thanks to a groundbreaking technique known as large-format pathology, patients at Carilion Clinic have a better chance than most of hearing a "yes" to that question.

Carilion Clinic is a pioneer in the use of large-format slides for analyzing breast tissue. This technique detects the smallest of cancers and ensures that all of the cancer is removed with a single surgery.

In the past, if cancerous tissue was found at the edges of the area removed by the surgeon, a second surgery was needed to remove tissue in a wider area. Taking the right amount the first time is not a simple task, since most breast cancer detected today is too small to be seen or felt. At Carilion Clinic, surgeons, radiologists, pathologists, and oncologists have joined forces to make this important job easier.

The key to reducing the number of second surgeries for breast cancer has been the move to large-format slides for analyzing tissue after the operation. Most pathologists look at small portions of the removed tissue on standard 1-inch-by-3-inch slides. At Carilion Clinic, the entire width of tissue is examined on a large-format slide, which is about the size of a DVD case. This allows for inspection of the entire surgical outline, not just a portion.

This technique not only reduces the number of follow-up surgeries required for complete removal of cancerous tissue, it greatly decreases the likelihood of cancer recurrence.

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