[The role of the pathologist in mammography screening]

Within the framework of mammography screening programmes the expertise of the pathologist is embedded in an interdisciplinary diagnostic and therapeutic procedure. The quality of histopathological diagnosis not only depends on the expertise of the pathologist, but also requires skillful co-operation with the radiologist and the gynecologist who are both responsible for determining the medical indications for further radiographic and surgical tests and must ensure appropriate tissue samples are taken for non-palpable lesions. Bearing this process in mind it becomes clear that increased expertise in interventional tissue sampling leads to histological samples which are more representative. If the samples are not representative, their histological evaluation does not permit a conclusive statement on the origin of tissue abnormalities shown by mammography. At the mammography unit in Wiesbaden it was demonstrated that breast tissue punches almost always allow a precise histological diagnosis of tissue abnormalities and are at the same time appropriate for additional immunohistochemistry, such as for hormone receptors on carcinoma cells. Non-representative tissue samples are the exception.