Intraoperative Frozen Section for Margin Assessment in Breast Conserving Surgery

Abstract

Background and Aims: When excisional biopsy or lumpectomy is performed without margin assessment in early breast cancer,further surgery are required if positive margins exist. We evaluated the role of the intraoperative frozen section in breast conserving surgery (BCS). Clinicopathologic factors associated with re-excision were searched.Material and Methods: 190 tumors in 186 patients with early invasive breast cancer treated by BCS. Breast tumor was excised with 2c mm acroscopic margin, and microscopic margins examined by intraoperative frozen section.Results: After frozen section, 160 cases had negative margins (no re-excision), but 30 patients (16%) underwent re-excision because of close/positive margins. Negative margins were obtained in 24 patients but six patients underwent mastectomy due to persistent involved margins. Local recurrence was 2.1% and systemic recurrence was 2.6% with mean 62 months follow-up. Tu mor type, tumor size, extranodal extension and extensive intraductal component were significant predictors of re-excision by multivariate analysis. Re-excision procedures haven'tanimpact on local recurrence.Conclusions: Intraoperative frozen section is an effective procedure in reducing the need of second operation. We have observed lower recurrence rates than other studies because of our 2cmmacroscopic margin width and >2mmmicroscopic negative margin which obtained by intraoperative frozen section.

Preoperative and intraoperative predictors of positive margins after breast-conserving surgery: a retrospective review

“…This may be due to a lack of power to detect significance in these categories, as others have documented an association with excised volume, use of margin resection, and type of surgery performed (quadrantectomy versus lumpectomy) [9,16]. Some institutions practice intraoperative margin assessment with either touch-prep cytology or frozen section [17,18]. As we do not use these techniques routinely for intraoperative margin assessment, we were not able to assess their contribution.…”

Breast Conservation Surgery: State of the Art

“…The use of intraoperative frozen section for assessment of margins, where available, is helpful in reducing the number of second procedures required to achieve clear margins [33, 34]. A further cavity shave can be taken from any margin found to be positive on intraoperative frozen section.…”

The Succes Of Frozen Section To Show Surgical Margin Involvement During Breast Conservative surgery: Results In 39 Cases

“…Ülkemizde yapılan bir başka çalışmada ise bu oranlar sırasıyla %100,100 ve 100 olarak bildirilmiştir (24).Kendi koşullarımızda elde ettiğimiz %92 doğruluk, %88 duyarlık, %94 lük özgüllük oranlarını ise yeterli bulmaktayız.…”