Interesting case.

In the USA , most western countries, Asian countries including Japan, India, et al, for breast lesions FNA or core bx is the first initial dx. I know we still do the open biopsy with frozen for breast mass in many hospitals in China. I think it is crazy in term of patient care and difficulty for pathology (frozen fat tissue). We still are using the old method which was not used by most countries for 30 or 40 years. The key is that open biopsy with frozen is not cost effect and is easily to have wrong diagnosis. A lot of patients have segmental mastectomy which may be not necessary. As pathologists we know that it is  difficult for us to make dx based on perminant H@E slides for a lot of cases. How can you make dx for some ADH, low grade DCIS, focal high grade DCIS, focal invasive ca, tubular ca vs adenosis, low grade invasive ca vs. sclerosing adenosis,  et al.

We have 30, 000/year surgical specimes, half of breast cases and half of gynecologic cases. I work here for three years and never do any breast frozen for original dx. All patients have breast core biopsy before they have excisional, segmental or toal mastectomy.

We some times do frozen for sentinel lymph node. Surgens will decide if the axillary lymph nodes 清扫术 should be done.

We inked margins and cut the segmental or mastectomy specimen to evaluate margin grossly, but not frozen of margins.

遇到冰冻这样，我们是不敢直接下恶性的，才28岁，太可怕了，形态看起来挺良的

 PASH:psuedoangiomatous stroma hyperplasia!!!

（PASH:假血管瘤样间质增生__abin译）

血管瘤

 乳腺血管肉瘤

好病例。学习

   We should ask Dr. Zhao's opinion on this case.  I am not convinced.

   （我们应该请教Dr. Zhao对本例的意见。我不确定。__abin译）