Research Article Effect of Formalin Fixation on Surgical Margins in Breast Cancer Surgical Specimen Masooma Zaidi, 1 Shaista Khan, 2 Najiha Bilal Farooqi, 2 Kashif Abbas, 3 and Romana Idrees 2 1 Queen Alexandra Hospital, Southwick Hill Road, Portsmouth Hampshire PO6 3LY, UK 2 Te Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan 3 Islam Medical and Dental College, Pasrur Road, Sialkot, Pakistan Correspondence should be addressed to Masooma Zaidi; drmasoomazaidi2003@gmail.com Received 18 February 2014; Revised 7 July 2014; Accepted 3 September 2014; Published 2 October 2014 Academic Editor: Marie-Christine Mathieu Copyright © 2014 Masooma Zaidi et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Margin analysis in breast surgery is an important predictor of local recurrence and can have vital impact on the postoperative treatment planning. Objective. Te aim was to assess the mean reduction in the closest tumor-free surgical margin in millimeters of breast cancer specimens following formalin fxation. Materials and Methods. We conducted a cross-sectional study at the Aga Khan University Hospital from March 30, 2010 to January 20, 2011. One hundred consecutive breast tumour surgical specimens which had macroscopically visible tumour were included. Te cancer type included both in situ and invasive cancers. Excluded were the patients who had previous surgery or systemic/radiation therapy. Te closest tumor-free margin was recorded and compared with the margin afer formalin fxation.  value of <0.05 was considered signifcant. Results. Te mean age of our 100 patients was 53 years with the majority of the patients having undergone mastectomy for predominantly invasive ductal carcinoma. Following formalin fxation, the mean reduction of the closest tumor-free margin was noted as 2.14 mm which was found statistically signifcant. Conclusion. Considerable shrinkage of tumor-free surgical margins of breast cancer specimen was noted afer formalin fxation. Tis inference can have implications on the postoperative management plan. 1. Introduction Breast cancer is the most common cancer in women world- wide [1–3]. Approximately 1 million cases are diagnosed each year of which 42% are from the developing world [1]. Pakistan shows the highest reported incidence of breast cancer from Asia, as per the available literature [4, 5]. It is the most common malignancy found among women in Pakistan [6, 7]. Surgery is an essential component of the management of breast cancer. Tere has been a recent paradigm shif in the surgical management of breast cancer from radical surgery to breast conserving therapy (BCT) with better cosmetic results. For early invasive cancer, survival rates, afer BCT, are comparable to those obtained afer radical mastectomy [8]. In BCT patients, however, there is a risk of local recurrence. Among the predictors of local recurrence, surgical margin analysis has proven to be the strongest [8–11]. Despite a few recent guidelines [12], no clear consensus has been reached globally regarding the surgical margin analysis [10, 11, 13]. Specimen shrinkage during tissue processing is well known. However, few studies support this for breast specimen [14–16]. Results from a recent study actually contradicted this shrinkage phenomenon for breast tissue [17]. Tis prompted us to conduct a cross-sectional study on breast cancer specimen, to fnd out the efect of formalin on the closest tumor-free surgical margin. 2. Materials and Methods Te study was carried out at a tertiary care hospital over a period of ten months. We carried out a cross-sectional study on a hundred breast specimens. Nonprobability con- secutive sampling technique was used for data collection. Our inclusion criteria involved all patients with histopatho- logically proven breast cancer undergoing surgery as the primary treatment modality. Tese patients were undergoing diferent surgical procedures, namely, wide local excisions, quadrantectomies, and all types of mastectomy (including Hindawi Publishing Corporation International Journal of Breast Cancer Volume 2014, Article ID 121838, 5 pages http://dx.doi.org/10.1155/2014/121838