Large format sections (LS) first have been introduced in breast pathology more than a century ago. Since then, they constituted for longtime a research tool to better understand breast microanatomy and the relationship between radiological images and pathological features. Similarly LS have been used to study neoplastic, inflammatory, and degenerative diseases affecting various organs, as brain, lung, gastrointentinal tract, bone, urinary tract, prostate, and placenta. Currently LS are mostly applied to diagnostic routine to better stage tumours such as prostate and breast carcinomas or to correlate radiologic imaging to gross specimens. The purpose of the present paper is to review the historical background and the basis of the applications of LS in surgical pathology, with special emphasis on breast tumours. 1. Introduction Large format sections (synonym macrosections) (LS) comprise an entire histological section of the organ under study. LS allow the histological study of a large part of the organ of interest, that include not only the lesions but also the surrounding tissues possibly inclusive of the entire margins at least along a plane of sectioning. The purpose of the present paper is to review the history and the present practical diagnostic applications of LS. 2. Historical Background LS have been introduced in surgical pathology more than a century ago. The first study based on LS was published in 1906 by Cheatle [1] who realized that most patients were diagnosed to be affected by breast cancer only when the disease was too advanced to be cured. Therefore, as breast was the first organ to be studied, which has generated a large number of papers, this paper will first deal with breast tumours, followed by the application of LS in other organs. Dr. Cheatle used LS in cases of breasts affected by cancer to better understand the relation between the neoplastic mass and the surrounding normal tissue and the possible existence of premalignant changes [1–3]. The relation between breast cancer and the surrounding tissue was the object of a further study in 1939 by Ingleby and Holly [4]. Subsequently, Marcum and Wellings [5] improved and simplified the method which then was applied to study the early phases of breast cancer development [6, 7]. In 1973, Wellings and Jensen [8] analysed cases of in situ and invasive ductal and lobular in situ and invasive carcinoma leading to the proposal that most breast carcinomas arise in the terminal ductular-lobular unit (TDLU), in spite of the different morphological features. These papers were paralleled with
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