Tamás Szabó

Background: Accurate orientation of resected breast specimens is essential for proper pathological evaluation and margin assessment. Misorientation may compromise analysis, lead to imprecise re-excisions, and increase the risk of local recurrence. This study aims to evaluate a novel specimen plate designed to maintain consistent tissue orientation and compares its effectiveness to traditional suture marking. Methods: In a single-center, prospective, randomized two-arm trial, 56 specimens were oriented with the new plate and 54 with conventional sutures. Outcomes included intraoperative imaging interpretation, specimen handling, and pathological assessment, with a focus on orientation accuracy and margin evaluation. Results: The specimen plate significantly reduced misorientation (p < 0.01) and improved interpretation during intraoperative imaging. Pathologists reported greater ease in identifying direction and tumor-free zones, leading to a more accurate margin assessment. Non-R0 resections requiring re-excision were fewer with the specimen plate (8.9%) compared to suture marking (22.2%). Conclusions: The newly developed specimen plate can offer a reliable solution for improving specimen orientation in breast cancer surgery; however, further validation in multicenter studies is needed to confirm its applicability across diverse surgical settings. By ensuring consistent orientation and enhancing diagnostic interpretation, it may help reduce re-excisions and improve patient safety.

Background: Accurate orientation of resected breast specimens is crucial for proper pathological evaluation and reliable margin assessment. Misorientation can compro-mise margin analysis, potentially leading to imprecise re-excisions and increasing the risk of local recurrence. This study aims to evaluate a new specimen plate designed to maintain consistent tissue orientation and compare its effectiveness with traditional suture marking techniques. Methods: A single-center, prospective, randomized two-arm trial compared the efficacy of the novel specimen plate (n=56) with conven-tional suture marking (n=54) during pathological examinations. The study assessed the impact on specimen handling, intraoperative imaging interpretation, and pathological outcomes, focusing on orientation clarity, margin assessment, and ease of tissue eval-uation. Results: The specimen plate demonstrated superior performance in maintaining clear orientation during intraoperative imaging and facilitated accurate margin as-sessment, significantly lowering (p< 0.01) misorientation rate compared to suture marking. Pathologists reported improved ease at identifying direction and extent of tumor-free zones and enhanced diagnostic accuracy. Number of non-R0 resections re-quiring re-excisions was significantly lower in the specimen plate group in comparation with the suture markings (8,9% vs. 22,2%) indicating the former’s potential to improve surgical outcomes. Conclusions: The novel specimen plate offers a reliable solution for improving specimen orientation in breast cancer surgery. By ensuring consistent ori-entation and enhancing diagnostic clarity, it can contribute to better surgical accuracy, reduce re-excisions, and ultimately improve patient safety. These findings support the specimen plate as an effective tool for enhancing outcomes in breast cancer treatment.

Accurate specimen marking is crucial during breast cancer surgery to avoid misorientation, which can lead to inadequate re-excision and tumor recurrence. We studied the marking methods at various breast cancer centers to create a tool that would prevent specimen misorientation. An online questionnaire was used to survey marking procedures at major breast cancer centers in Hungary, and a tool was developed using a troubleshooting method. Twelve out of twenty units responded (60%). Nine use an institutionally standardized marking system. Less than half of the surgical teams found specimen mammograms to be unambiguous. In more than 70% of departments, pathologists were uncertain about breast specimen orientation. Ambiguous marking methods caused orientation errors in half of the cases, while unclear marking directions caused the rest. Most pathologists (85%) and surgeons (75%) believed that coronal plane specimen mammography would help solve the problem. A plastic specimen plate has been developed to anchor breast tissue to a coronal breast scheme as seen in mammography images, providing clear localization information throughout the surgical process. There is a lack of standardization in breast specimen orientation and marking in Hungary. An optimized orientation toolkit is being developed to ensure consistent interpretation of specimen mammograms by surgeons and pathologists.

Accurate specimen marking is crucial during breast cancer surgery to avoid misorientation, which can cause inadequate re-excision and tumor recurrence. We studied marking methods at various breast cancer centers to create a tool that prevents specimen misorientation. An online questionnaire surveyed marking procedures at major breast cancer centers in Hungary, and a tool was developed using a troubleshooting method. Twelve out of twenty units responded (60\%). Nine use an institutionally standardized marking system. Only half of the surgical teams had clear specimen mammography images. Pathologists were unsure of specimen orientation in 5–10\% of cases in over 75\% of departments. Ambiguous marking methods caused orientation errors in half the cases, while unclear marking directions caused the rest. Most pathologists (85\%) and surgeons (75\%) believed that coronal plane specimen mammography would help solve the problem. A plastic specimen plate was developed to anchor breast tissue to a coronal breast scheme seen in mammographic images, providing clear localization information throughout the surgery process. There is a lack of standardization in breast specimen orientation and marking in Hungary. An optimized orientation toolkit is being developed to ensure consistent interpretation of specimen mammograms by surgeons and pathologists.