Dermal blood vessel or lymphatic invasion should be documented since its presence is essential for the diagnosis of inflammatory carcinoma. However, while present in a great majority of cases, dermal lymphatic invasion may be difficult to identify and establish by biopsy alone. It should be noted whether the tumor was sectioned prior to receipt, since this may preclude proper marking of the surgical margins of excision as well as ascertaining the dimensions of the specimen or tumor. L. Lymph Nodes Identify all lymph nodes and submit representative sections of each in such a way that the number of nodes involved with metastatic carcinoma can be accurately enumerated in the report. Note whether the nodes are matted and whether tumor extends beyond the capsule.
Extracapsular extension is associated with a higher frequency of axillary recurrence.
Orientation must be done by the surgeon and should be documented in the pathology report. The margins of excision should be marked, usually with ink, taking care to avoid penetration of the ink deep into the specimen. O. Reporting of Margins Macroscopic or microscopic involvement of the surgical margin by invasive carcinoma or DCIS should be noted in the report. If the neoplasm is near the surgical margin, the distance from the margin should be reported. Blocking of tissue should be directed to evaluating the distance from the edge of the tumor to the resection margin, in addition to other sampling.