Understanding Open Biopsies for Breast Atypia: What to Expect

Question
QUESTION: I had atypical ductal cells with singly overlapping and groups of prominent nucleoli that were loosely cohesive on an FNA, so I recently had an open biopsy. Two masses were taken out.  My breast surgeon said that everything looked ok-looked like fibroadenoma, but I thought that it had to be sent to the pathologist first.  I think that a cancer that has progressed to a more advanced stage then maybe you can see upon open excision - is that correct? can you see atypical cells or an early stage breast cancer or in-situ cancers with the naked eye?

ANSWER: The naked eye is NOT enough! In order to surely understand what kind of lesion you are dealing with a full pathology report of the surgical material that has been removed from you is NECESSARY! If indeed it is a cancer then other tests are needed too in order to determine stage.


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QUESTION: I do appreciate your time and answers.  Does a fibroadenoma look a certain way upon excision? Do they ever take a quick look under the microscope before they send off to a pathologist for a formal report?  I guess I'm just trying to figure out why my surgeon said that things looked ok without the formal pathology report.  Any ideas?

Answer
Well a fibroadenoma does look like a non dangerous tumor (like a fibroadenoma) BUT you can NOT be sure until microscopy is done. No you can not work with a microscope like that. The material has to be sliced in THIN slices (which in turn requires either freezing or paraffine inbedding)and then stained in different ways before you check it with the microscope. I think he just referred to what it looked like, which I think was a little hasty. He could have said: "It did not look dangerous but we will not KNOW until we have the pathology report" and I would have agreed with him.