Breast Synoptic Work Aid

Specimen Laterality:

Specimen:

Procedure:

Specimen Integrity:

Lymph node sampling:

Specimen size (cm):

Histologic Type:

Histologic Grade (SBR/Nottingham):

  Glandular/Tubular Differentiation:

  Nuclear Pleomorphism:

  Mitotic Count:

Invasive carcinoma size (cm):

Tumor focality:


Extent of tumor:

Lymphovascular invasion at tumor periphery:

Margins:


Pathologic Staging:







Reference range for Her-2/neu IHC:
Positive: ≥ 3
Equivocal: 1.8-2.9
Negative: <1.8


Reference range for Her-2/neu FISH:
Positive for amplification: >2.2
Equivocal for amplification: 1.8-2.2
Negative for amplification: <1.8