A practical approach to grossing breast specimens

The grossing of breast specimens has been evolving over the past few decades. As image-guided core-needle biopsy has gradually replaced surgical biopsy in the initial assessment of breast lesions, most patients have a definitive diagnosis at the time of excision. Breast conserving therapy is now well accepted as a definitive treatment. Neoadjuvant therapy is also selected by a large number of patients. In addition, since its introduction in the 1990s, sentinel lymph node biopsy has become a standard procedure performed at the time of excision, as clinically indicated. Based on our institutional experience, practical guidelines for grossing breast excision specimens, as well as sentinel lymph nodes, are provided in this article.