Bread loafing is a common method of processing surgical specimens for

histopathology Histopathology (compound of three Greek words: ''histos'' "tissue", πάθος ''pathos'' "suffering", and -λογία '' -logia'' "study of") refers to the microscopic examination of tissue in order to study the manifestations of disease. Spe ...

. The process involves cutting the specimen into 3 or more sections. The cut sections are mounted by embedding in paraffin or frozen medium. The cut edge is then thinly sliced with a microtome or a

cryostat A cryostat (from ''cryo'' meaning cold and ''stat'' meaning stable) is a device used to maintain low cryogenic temperatures of samples or devices mounted within the cryostat. Low temperatures may be maintained within a cryostat by using various ...

. The thin slices are then mounted on a glass slide, stained, and covered with another layer of glass. This method is used to determine the negative

resection margin A resection margin or surgical margin is the margin of apparently non-tumorous tissue around a tumor that has been surgically removed, called " resected", in surgical oncology. The resection is an attempt to remove a cancer tumor so that no portio ...

for skin

tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

s, and is also known as POMA (Post Operative Margin Assessment as referred to by the

National Comprehensive Cancer Network National Comprehensive Cancer Network (NCCN) is an alliance of 32 cancer centers in the United States, most of which are designated by the National Cancer Institute (one of the U.S. National Institutes of Health) as comprehensive cancer centers. It ...

). It has a higher

false negative A false positive is an error in binary classification in which a test result incorrectly indicates the presence of a condition (such as a disease when the disease is not present), while a false negative is the opposite error, where the test result ...

error rate than the

CCPDMA Complete circumferential peripheral and deep margin assessment (CCPDMA) is the preferred method for the removal of certain cancers, especially skin cancers. There are two forms of CCPDMA surgery: Mohs surgery and surgical excision coupled with mar ...

method of tissue processing.Kimjai-Asadi A, et al. Dermatol Surg. 2007 Dec;33(12):1434-9; discussion 1439-41. Margin involvement after the excision of melanoma in situ: the need for complete en face examination of the surgical margins. The error rate is reduced when the

surgical margin A resection margin or surgical margin is the margin of apparently non-tumorous tissue around a tumor that has been surgically removed, called " resected", in surgical oncology. The resection is an attempt to remove a cancer tumor so that no portio ...

is increased, and the error rate is increased when the

is decreased. For this reason, it is not used near the eyelids, and in other cosmetically important areas of the body. Bread loafing false negative error rate can be reduced by "cutting through the block". Basically, the entire surgical specimen is sliced, and mounted. Even though this method will approach

, frequently, about 9 out of 10 sections are discarded. Thus, only 10% of the surgical margin is examined. If the whole "ribbon" was mounted, it would take an inordinate number of glass slides, and not be feasible.

References

{{DEFAULTSORT:Bread Loafing Histopathology