Application of intraoperative frozen section examination in the management of female breast cancer in China: a nationwide, multicenter 10-year epidemiological study

Abstract

BackgroundIntraoperative frozen section examination (IFSE) during breast cancer surgery can partly reflect the status of surgical treatment since the surgical method used directly determines the purpose of IFSE use in disease management. This study aims to investigate the application of, changing trends in, and factors influencing IFSE in the management of female breast cancer in China.MethodsWe collected the sociodemographic and clinical data of 4,211 breast cancer patients between 1999 and 2008 and statistically analyzed these data using χ2 or Fisher’s exact tests.ResultsA total of 2,283 (54.22%) patients with breast cancer underwent IFSE. During the 10-year study period, IFSE use was associated with an increase in the number of sentinel lymph node biopsies (SLNB) and breast-conserving surgeries (BS) performed, with significant regional differences noted in this trend (P <0.05). Patients’ education, occupation, age, tumor size estimated by preoperative palpation, and the use of imaging examinations affected the purpose of IFSE use (P <0.05).ConclusionsOur results show that the purpose of IFSE in the surgical treatment of breast cancer in China is gradually approaching that in developed countries. We believe that policymakers must address the differences in breast cancer treatment based on the socioeconomic status of patients. Lastly, the use of IFSE for determining tumor characteristics should be avoided as far as possible, and patient education and breast cancer screening programs tailored to the Chinese population should be established. Our findings may guide the formulation of breast cancer control strategies in China and other low-income countries.

Comparison of Clinicopathological Features and Treatments between Young (≤40 Years) and Older (>40 Years) Female Breast Cancer Patients in West China: A Retrospective, Epidemiological, Multicenter, Case Only Study

“…In terms of treatment options, we compared the two age groups in terms of four aspects: surgery, chemotherapy, radiotherapy and endocrine therapy. First, in the choice of surgical approach, the proportion receiving advanced operation methods such as breast-conserving surgery and sentinel lymph node biopsy, was higher in young patients, which was consistent with our previous research [ 36 ]. This reflects previous findings that showed young patients have a greater desire to keep their original breasts, and are more accepting of advanced operation methods, compared to older patients [ 37 ].…”

The influence on survival of delay in the treatment initiation of screening detected non-symptomatic breast cancer

“…In China, core needle biopsy is not routinely used to make pathologic diagnosis for breast disease because of economic and technical reasons. In most parts of China, diagnostic open excisional biopsy and intraoperative frozen section examination are commonly used to identify the pathology of primary tumors in more than 80% of breast cancer cases 27 . Similarly, in our routine procedure, we will first perform open excisional biopsy for suspicious breast lesions.…”

How accurate is frozen section pathology compared to permanent pathology in detecting involved margins and lymph nodes in breast cancer?

“…Other limitations of this method include prolonging the operation time, high probability of false negatives in patients who have received new joint therapy, are not reliable in specific BC subtypes such as invasive lobular cancer or ductal carcinoma in situ (DCIS), and further add to the health care costs [ 6 ]. Moreover, the clinical application of FS pathology and its limitations is especially important to be evaluated, considering that the use of FS has been growing in many regions of the world for BC [ 7 ].…”