The value of intraoperative frozen section in wide local excision for breast cancer

• Published in: Surgical Chronicles
• Main Author: Yahya M.A.; Nora J.O.; Suraya O.; Nor S.B.; Nor F.A.R.
• Format: Article
• Language: English
• Published: Surgical Society of Northern Greece 2021
• Online Access: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85118574162&partnerID=40&md5=1e2e53212fb71e8dfe180e00e522c524

Objectives: Wide local excision (WLE) is a better alternative to mastectomy as it preserves the desired cosmetic outcome without compromising the patient survival rate. Margin involvement is the main pitfall for WLE. It leads to reoperation which technically can be more challenging and potentially causes emotional stress to the patient. This study evaluates intraoperative frozen section (FS) in determining the margin status during WLE with the intention to avoid the need for second operation. Method: All breast cancer patients who underwent wide local excision were included in the study. In our institution, intraoperative FS for WLE was started in 2015. This cohort of patients was compared with earlier patients whom WLE were performed without FS. Patients demographic, tumour characteristics, margin status and number of reoperations were analysed. Results: A total of 20 patients aged 43 to 71 years (mean 56 years) were included in this study. Frozen sections were performed on the last eight of the patients. Six patients (30%) had at least one positive margin involvement. Three patients who had no FS were scheduled for reoperation after 2 weeks. Another three patients had FS and cavity shaving in the same operation. Total margins evaluated for FS were 39. Out of these, 6 (15.4%) were positive for malignancy. One (2.6%) was falsely reported as positive for malignancy. Overall sensitivity and specificity of FS in this study were 100% and 96.9%, respectively. Conclusion: FS is a reliable tool in determining adequate margin during WLE. Nevertheless, positive margin at FS should be taken cautiously, especially when it involves decision to convert the surgery to mastectomy. In that case, it could be wise to wait for paraffin section to confirm the margin status. © 2021 Surgical Society of Northern Greece. All rights reserved.