A New Approach to Breast Specimen Orientation: Avoiding Pitfalls with the Specimen Plate Concept

Accurate specimen marking is crucial during breast cancer surgery to avoid misorientation, which can cause inadequate re-excision and tumor recurrence. We studied marking methods at various breast cancer centers to create a tool that prevents specimen misorientation. An online questionnaire surveyed marking procedures at major breast cancer centers in Hungary, and a tool was developed using a troubleshooting method. Twelve out of twenty units responded (60\%). Nine use an institutionally standardized marking system. Only half of the surgical teams had clear specimen mammography images. Pathologists were unsure of specimen orientation in 5–10\% of cases in over 75\% of departments. Ambiguous marking methods caused orientation errors in half the cases, while unclear marking directions caused the rest. Most pathologists (85\%) and surgeons (75\%) believed that coronal plane specimen mammography would help solve the problem. A plastic specimen plate was developed to anchor breast tissue to a coronal breast scheme seen in mammographic images, providing clear localization information throughout the surgery process. There is a lack of standardization in breast specimen orientation and marking in Hungary. An optimized orientation toolkit is being developed to ensure consistent interpretation of specimen mammograms by surgeons and pathologists.