Evolution of Frozen Section in Carcinoma Breast: Systematic Review

Rana, Manjit Kaur; Rana, Anubhuti; Sharma, Uttam; Barwal, Tushar Singh; Jain, Aklank

doi:10.1155/2022/4958580

Cited by 4 publications

(1 citation statement)

References 54 publications

(42 reference statements)

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“…Many breast surgeons in the private sector setting in Singapore employ intraoperative frozen section evaluation for margins and SLNs even in the postneoadjuvant setting, to avoid returns to the operating theatre and to facilitate shorter hospital stays. While frozen section analysis is regarded as accurate for margin and sentinel node assessment [84,85], data on its accuracy in the post-neoadjuvant setting are relatively scant. Investigations on intraoperative frozen section analysis of sentinel lymph node biopsy (SLNB) in breast cancer cases following neoadjuvant chemotherapy have demonstrated comparable sensitivity, specificity, and accuracy when compared to nonneoadjuvant cohorts [86][87][88][89][90].…”

Section: Should Frozen Sections Be Conducted Formentioning

confidence: 99%

Challenges and Clinical Relevance of Modern Breast Pathology Reporting: Your Questions Answered

Deb,

Laokulrath,

Chagla

et al. 2024

Pathobiology

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Background: Breast pathology reporting, especially for breast cancer, has evolved through the years, from terse succinct diagnostic conclusions with scant histological details to the current comprehensive reporting guidelines issued by major pathology colleges and bodies, including the International Collaboration on Cancer Reporting. Pathology elements included in reporting guidelines are evidence based and contribute significantly to individualised and personalised patient management. Summary: This article is based on the lively interactive question and answer session that followed the breast pathology segment in the symposium jointly organised by the British Association of Urological Pathology, British Association of Gynaecological Pathologists, British Society of Gastroenterology and the Association of Breast Pathology, in November 2022, titled ‘Personalised histopathology reporting for personalised medicine’. Key Messages: The breast pathology session emphasized the clinical utility of breast pathology data items, incorporating a case-based approach by highlighting the relevance of pathology information in various clinical scenarios. This review included clinico-pathological discussion points on florid lobular carcinoma in situ (LCIS), atypical apocrine adenosis, post-neoadjuvant chemotherapy reporting, atypical ductal hyperplasia (ADH) presenting at the margin, flat epithelial atypia (FEA) vs columnar cell change (CCC), papilloma on core needle biopsy (CNB), margin status, mucocele-like lesion, total duct excision/microdochectomy specimen, and anterior and nipple margins in skin-sparing mastectomy. Effective communication and regular involvement of pathologists in breast multidisciplinary tumour boards are crucial.

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Section: Should Frozen Sections Be Conducted Formentioning

confidence: 99%

Challenges and Clinical Relevance of Modern Breast Pathology Reporting: Your Questions Answered

Deb,

Laokulrath,

Chagla

et al. 2024

Pathobiology

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Electrical lymph node scanning (ELS) system for real-time intra-operative detection of involved axillary lymph nodes in adjuvant breast cancer patients

Abbasvandi,

Mahdavi,

Bayat

et al. 2024

Sci Rep

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Lymph node (LN) status is an essential prognostic factor in breast cancer (BC) patients, with an important role in the surgical and therapeutic plan. Recently, we have been developed a novel system for real-time intra-operative electrical LN scanning in BC patients. The ELS scores were calibrated by pathological evaluation of the LNs. Herein, we evaluated the efficacy of ELS in a prospective study for non-chemo-treated breast cancer patients. This is a prospective study in which ELS scores are blind for pathologists who declare the clearance or involvement of LNs based on permanent pathology as the gold standard. ELS and frozen-section (FS) pathology results were achieved intra-operatively, and samples were sent for the permanent pathology. The score of ELS did not affect the surgeons’ decision, and the treatment approach was carried out based on FS pathology and pre-surgical data, such as imaging and probable biopsies. Patients were recruited from October 2021 through November 2022, and 381 lymph nodes of 97 patients were included in the study. In this study we recruited 38 patients (39.2%) with sentinel lymph node biopsy (SLNB) and 59 patients (60.8%) with ALND. Of the 381 LNs scored by ELS, 329 sentinel LNs underwent routine pathology, while others (n = 52) underwent both FS and permanent pathology. ELS showed a sensitivity of 91.4% for node-positive patients, decreasing to 84.8% when considering all LNs. Using ROC analysis, ELS diagnosis showed a significant AUC of 0.878 in relation to the permanent pathology gold standard. Comparison of ELS diagnosis for different tumor types and LN sizes demonstrated no significant differences, while increasing LN size correlated with enhanced ELS sensitivity. This study confirmed ELS’s efficacy in real-time lymph node detection among non-chemo-treated breast cancer patients. The use of ELS’s pathological scoring for intra-operative LN diagnosis, especially in the absence of FS pathology or for non-sentinel LN involvement, could improve prognosis and reduce complications by minimizing unnecessary dissection.

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The Prevalence of Sentinel Lymph Node Positivity and Implications for the Utility of Frozen Section Diagnosis Following Neoadjuvant Systemic Therapy in Patients with Clinically Node-Negative HER2-Positive or Triple-Negative Breast Cancer

Wanis,

Goetz,

et al. 2024

Ann Surg Oncol

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Evolution of Frozen Section in Carcinoma Breast: Systematic Review

Cited by 4 publications

References 54 publications

Challenges and Clinical Relevance of Modern Breast Pathology Reporting: Your Questions Answered

Challenges and Clinical Relevance of Modern Breast Pathology Reporting: Your Questions Answered

Electrical lymph node scanning (ELS) system for real-time intra-operative detection of involved axillary lymph nodes in adjuvant breast cancer patients

The Prevalence of Sentinel Lymph Node Positivity and Implications for the Utility of Frozen Section Diagnosis Following Neoadjuvant Systemic Therapy in Patients with Clinically Node-Negative HER2-Positive or Triple-Negative Breast Cancer

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