Intraoperative Frozen Section Margin Positive in Breast-Conserving Surgery; Current Status and Ways to Reduce It.

Abstract

Purpose There have been many analyzes of permanent resection margin (PM) in breast conserving surgery (BCS) but few studies have organized the data of intraoperative frozen section margin (FM). We were aimed to focus more on FM and organize the data including FM. Methods A single center, retrospective study was conducted. The electronic medical records of the patients who underwent BCS for breast cancer between January 2015 and December 2015 in Asan Medical Center were reviewed. We investigated the rate of positive FM and the difference in operation time according to the result of FM. Also, we analyzed various patient and tumor related factors which can affect the result of resection margin (RM) including FM. Results 1,110 patients were included in the analysis. FM evaluation was done in 56.5% (627/1110). The rate of positive FM was 12.4% (78/627). The operation time was significantly longer when additional resection was done for positive FM (112.7 ± 32.6 min vs 74.7 ± 22.9 min, p < .001). By univariate analysis, multiplicity, non-mass enhancement (NME) on magnetic resonance imaging (MRI), maximum diameter on MRI, T3, N2-3, invasive lobular carcinoma (ILC), presence of extensive intraductal component (EIC) and presence of ductal carcinoma in situ (DCIS) were factors significantly associated with the result of RM while after multivariate analysis, multiplicity, ILC and presence of EIC showed statistical significance. Conclusions The operation time was significantly longer when additional resection was done for positive FM. Further data collection and organization is needed for standardized predictive tool for FM.