title: The pancake phenomenon contributes to the inaccuracy of margin assessment in patients with breast cancer.
abstract: BACKGROUND
  To determine the effect on margin evaluation for patients with breast cancer, we prospectively quantified the "flattening" of the breast specimen after surgical removal.
  
  
  METHODS
  The volume and height of 100 consecutive breast biopsy specimens were recorded independently by the operating surgeon and the pathologist. Five factors were analyzed that were thought to contribute to changes in specimen dimensions: patient age, breast tissue density, mammographic lesion type, specimen size, and the use of compression during specimen radiography.
  
  
  RESULTS
  After surgical removal, mean volume and height of the breast specimens decreased from 46 cm(3) to 29 cm(3) (30%) and from 2.6 cm to 1.4 cm (46%), respectively. Flattening of the breast specimens occurred in all subgroups studied.
  
  
  CONCLUSIONS
  Breast specimens are flattened after surgical removal, losing almost 50% of their original height. This "pancake" phenomenon has important implications for the accuracy of margin analysis.
authors.affiliation: Department of Surgery, New England Medical Center, Boston, MA 02111, USA.
authors.forename: Roger A
authors.initials: RA
authors.lastname: Graham
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Homer
authors.forename: Judith
authors.initials: J
authors.lastname: Katz
authors.forename: Janice
authors.initials: J
authors.lastname: Rothschild
authors.forename: Homa
authors.initials: H
authors.lastname: Safaii
authors.forename: Stacey
authors.initials: S
authors.lastname: Supran
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D046508:Culture Techniques; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity