Accurate specimen marking is crucial during breast cancer surgery to avoid misorientation, which can lead to inadequate re-excision and tumor recurrence. We studied the marking methods at various breast cancer centers to create a tool that would prevent specimen misorientation. An online questionnaire was used to survey 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. Less than half of the surgical teams found specimen mammograms to be unambiguous. In more than 70% of departments, pathologists were uncertain about breast specimen orientation. Ambiguous marking methods caused orientation errors in half of 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 has been developed to anchor breast tissue to a coronal breast scheme as seen in mammography images, providing clear localization information throughout the surgical 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.

Background: Accurate orientation of resected breast specimens is essential for proper pathological evaluation and margin assessment. Misorientation may compromise analysis, lead to imprecise re-excisions, and increase the risk of local recurrence. This study aims to evaluate a novel specimen plate designed to maintain consistent tissue orientation and compares its effectiveness to traditional suture marking. Methods: In a single-center, prospective, randomized two-arm trial, 56 specimens were oriented with the new plate and 54 with conventional sutures. Outcomes included intraoperative imaging interpretation, specimen handling, and pathological assessment, with a focus on orientation accuracy and margin evaluation. Results: The specimen plate significantly reduced misorientation (p < 0.01) and improved interpretation during intraoperative imaging. Pathologists reported greater ease in identifying direction and tumor-free zones, leading to a more accurate margin assessment. Non-R0 resections requiring re-excision were fewer with the specimen plate (8.9%) compared to suture marking (22.2%). Conclusions: The newly developed specimen plate can offer a reliable solution for improving specimen orientation in breast cancer surgery; however, further validation in multicenter studies is needed to confirm its applicability across diverse surgical settings. By ensuring consistent orientation and enhancing diagnostic interpretation, it may help reduce re-excisions and improve patient safety.

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.

Background: Accurate orientation of resected breast specimens is crucial for proper pathological evaluation and reliable margin assessment. Misorientation can compro-mise margin analysis, potentially leading to imprecise re-excisions and increasing the risk of local recurrence. This study aims to evaluate a new specimen plate designed to maintain consistent tissue orientation and compare its effectiveness with traditional suture marking techniques. Methods: A single-center, prospective, randomized two-arm trial compared the efficacy of the novel specimen plate (n=56) with conven-tional suture marking (n=54) during pathological examinations. The study assessed the impact on specimen handling, intraoperative imaging interpretation, and pathological outcomes, focusing on orientation clarity, margin assessment, and ease of tissue eval-uation. Results: The specimen plate demonstrated superior performance in maintaining clear orientation during intraoperative imaging and facilitated accurate margin as-sessment, significantly lowering (p< 0.01) misorientation rate compared to suture marking. Pathologists reported improved ease at identifying direction and extent of tumor-free zones and enhanced diagnostic accuracy. Number of non-R0 resections re-quiring re-excisions was significantly lower in the specimen plate group in comparation with the suture markings (8,9% vs. 22,2%) indicating the former’s potential to improve surgical outcomes. Conclusions: The novel specimen plate offers a reliable solution for improving specimen orientation in breast cancer surgery. By ensuring consistent ori-entation and enhancing diagnostic clarity, it can contribute to better surgical accuracy, reduce re-excisions, and ultimately improve patient safety. These findings support the specimen plate as an effective tool for enhancing outcomes in breast cancer treatment.