BIOPSY ENDOMETRIAL CURRETTING

GROSS EXAMINATION : 

 An ellipse of nipple bearing skin with attached axillary tail, 10 cm long and underlying fibro-fatty tissue together measures 16 x 14 x 4 cm and weighs ~ 620 g in toto. A small sized tumour nodule is palpable in the extreme upper outer quadrant lateral to the FNA bruise. Base is inked and the specimen is serially sliced from lateral to medial. Cut surface shows a small coin shaped tumour nodule measuring ~ 1.5 x 1 cm in the upper outer quadrant with a clearance of of ~ 1.2 cm from the inked base margin. 2 cms away from and medial to the tumour is an irregular firm area ( ? satellite tumour deposit). There are 4 detached fatty tags of tissue recovered in the specimen pot; the largest measuring 3 cm across. These reveal portions of? Blood vessel/lymph. The axillary tail is dissected and there are 14 lymph nodes isolated in all including, 1 likely intrmammary node. 

MICROSCOPIC EXAMINATION:

This is breast with a high grade infiltrating duct carcinoma with medullary like features; modified BR score of 9/9 (P3 T3 M3) & showing tumour cell associated necrosis and a prominent stromal host lymphocytic response. Maximum tumour diameter is 5mm. The base margin is free of tumour involvement. Although tumour lympho-vascular invasion is not distinct, it is highly imminent but without large vessel or venous invasion rest of the breast shows background atrophic changes. Of the 14 lymph nodes isolated including 1 probable, intra-mammary node, 6 lymph nodes are involved which include 3 micrometastases and in addition, there are 4 nodes containing perinodal tumour involvement is identified. Tumour pathologic stage: Stage IIIA corresponding to tumour disease category pT 1a N2a Mx.