Having Breast Surgery Succeed for You

Before any surgery, ask your surgeon to promise to “orient the specimen” for the pathologist. This means that the surgeon marks the specimen so that the pathologist knows what are the top, the bottom, and the sides of the tissue in relation to your body.

The goal of breast surgery is to remove a mass or lump from your breast.

The challenge is that the nature of cancer is to grow little extensions or “fingers” of cancer that spread into normal appearing tissue. Therefore, if a mass is a cancer (also called a malignant or cancerous lump), the goal is to remove all of the cancer with a rim of normal tissue. This normal looking tissue around a mass or cancer is called a margin. You need a margin of normal tissue to assure that all of the little extensions or “fingers” of the cancer are removed, too.

After your surgery, a pathologist will examine the tissue to be certain that all of the cancer has been removed.

Sometimes a small amount of cancer, so small it cannot be felt or seen without the pathologist’s microscope, will be at the edge of the tissue. This is called a positive margin.

If there is a positive margin, the surgeon must go back to remove more tissue. This is when it becomes important that the surgeon oriented the specimen.

If the surgeon oriented the specimen, the pathologist can tell your surgeon exactly where the margin is positive and your surgeon can remove just a little more tissue.

However, if your surgeon did not orient the specimen for the pathologist, your surgeon can’t know where to remove more tissue. Then the surgeon will need to remove a lot more tissue all around the site of the cancer and your breast will be unnecessarily deformed.

The surgeon can only orient the specimen at the time when it is removed from your breast. That is why it is important to ask your surgeon to “orient the specimen” during your operation when the cancer is removed.