Biopsy Interpretation Series

[Rbrav]

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I'm a PGY-3, and I want to start picking up this series. I'll probably get all of them eventually, but right now, I have enough in my book fund for three of them. Any recommendations? I was leaning toward prostate, bladder, and frozen section, and I'll probably get breast when my book fund renews.

 

[Parts Unknown]

Ditch the frozen section and get the breast one. It's waaaaay more useful.

Prostate is solid.

 

[caffeinegirl]

I second the breast biopsy interpretation series...great not just for biopsies for also for all of breast pathology. The authors are great, and they address basically all of the issues that they encounter when reviewing the cases they receive for consult.

 

[Tiki]

I second the breast biopsy interpretation series...great not just for biopsies for also for all of breast pathology. The authors are great, and they address basically all of the issues that they encounter when reviewing the cases they receive for consult.

I third the biopsy breast book! It's great. I also really like the Head and Neck biopsy interpretation book. The GI book looks good, but I've heard it is going to be updated soon (hopefully with color pictures) so I'm holding out.

 

[Rbrav]

Sounds like I should seriously consider getting the breast one now! Why a no-go on the frozen section book? At my program, residents are often too busy cutting and staining the sections to look at the slides with the attending, and I'm concerned about my skill with frozen slides.

 

[KeratinPearls]

Sounds like I should seriously consider getting the breast one now! Why a no-go on the frozen section book? At my program, residents are often too busy cutting and staining the sections to look at the slides with the attending, and I'm concerned about my skill with frozen slides.

What? We have histotechs cutting and staining our slides and we sit with the attending when the slides are ready.

 

[caffeinegirl]

We also had techs cutting frozens for us during work hours. I'm not familiar with the bx interp frozen book...however I know that there was an old Archives of Path&Lab Med issue that dealt with frozens which was pretty good. My advice would be to ask the senior residents in your program what they used for frozens...and maybe take a glance at the books they have.
In my program I didn't use a specific book since we were had a high volume of frozens and had time to look at them.

PS: Knowing how to cut a great frozen is an important skill when you're on your own after residency!

 

[Parts Unknown]

Why a no-go on the frozen section book?

It's just not very helpful. Perhaps if it had a bazillion high quality photos to train your eye against freezing artifact, but it doesn't. The text is not particularly illuminating, and the lesions covered are woefully incomplete. I found a few useful tidbits, but you'll be 100x better off if you simply get more hands-on frozen experience.

 

[icpshootyz]

I second the breast and highly recommend the prostate as well. As for the others I can't say, but the breast book covers >90% of what you'll see on a regular basis. Same w/ prostate. And they're just so much easier than pulling out a big 400p textbook if you don't have to. As for a book on frozens, I guess my thought has always been that the only way to be good at reading frozens was to be good at surg path in general and to simply see a lot of frozens. The artifacts you'll deal w/ are the real obstacle in reading frozens (first year residents cutting frozens is always a treat!) and you simply need to see enough of them to get comfortable. After that, well, obviously you need to know your surg path to know what you're looking at! But get the prostate and breast books.

 

[dermpathdoc]

I'm a PGY-3, and I want to start picking up this series. I'll probably get all of them eventually, but right now, I have enough in my book fund for three of them. Any recommendations? I was leaning toward prostate, bladder, and frozen section, and I'll probably get breast when my book fund renews.

As a dermatopathologist I am underwhelmed by the dermatologic version of the BIS...
I also did not think much of the frozen section version...there was a much better frozen section interpretation book a few years back that went into 2nd edition in early 2000's...

 

[zao275]

What? We have histotechs cutting and staining our slides and we sit with the attending when the slides are ready.

Same here. I actually pushed fairly hard to be able to cut my own frozens but the histotech in the frozen room had worked at our hospital for years. She is very skilled but it's her way or the highway. Her point was that we wouldn't be able to keep up with the high volume of cases that needed cut and I guess she was right. But my point was "What if I don't have a histotech when I am in practice?" I guess I will learn to be good at it then!

The plus was that I spent lots of time looking at frozens rather than just cutting them. I think in the end I would rather look than cut.

 

[KCShaw]

FWIW, I think I've said all this before: At one place I was at, residents didn't always even know a frozen had happened, much less grossed it for frozen, cut/stained the frozen, or looked at it. Residents generally had to go out of the way to collect them at the end of the day and look at them, if they were missed in real time. With enough effort, paying attention, and browbeating the attendings, one could get more involved. That place was organized as private, contracted to take residents.

At the second place, residents answered the frozen section pager and called the attending when it was time. Residents grossed for frozen, cut/stained the frozen, and were expected to look at it with the attending (if not before, if they were running late) in real time unless there was a high volume, then called in the result. If there was a high volume at that moment, residents still reviewed them with the attending as soon as possible before the attending left the room. That place was a more typical academic department. The only variation was sometimes with neuropathology; one of the neuropaths would be called first and the surgpath resident occasionally left out, unless you were on a neuropath rotation, which I -think- everyone had to do. Senior residents were expected to do all the talking/interpretation, unless or until you ran into a brick wall or were going down the wrong path, at which point the attending would pipe in and right the ship.

Basically, although good books always help, there's no substitute for being the on-the-spot dude/dudette looking at a frozen and trying to figure things out while the surgeon is drooling in anticipation, a junior resident is mumbling incoherent possible diagnoses, and your attending is giving you some look between supportive encouragement and "why hasn't he said what it is yet? It's so OBVIOUS!"

 

[ScotchBonnet]

I've got the Breast, Prostate, and Bladder books in this series. I haven't used any of the others but would wholeheartedly recommended these three, particularly breast.