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

World Journal of Surgical Oncology

Zahra Mehdipour Namdar¹  Peyman Arasteh¹  Sedigheh Tahmasebi¹  Sogol Sedighi¹  Aida Salehi Nobandegani¹  Majid Akrami¹  Vahid Zangouri²  Navid Omidifar³  Abdolrasoul Talei³ 

[1] Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;Surgical Oncology Division, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran;Clinical Education Research Center, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran;

关键词: Breast cancer;    Frozen sections;    Pathology;    Margins of excision;    Lymph node;   

DOI  :  10.1186/s12957-021-02365-5

来源: Springer

【 摘 要 】

BackgroundFrozen section (FS) pathology has multiple limitations, and different institutions report variable experiences with the use of FS for diagnosis of tumor involvement. We aimed to compare the FS accuracy with that of permanent pathology (gold standard) regarding marginal involvement and lymph node status using data from the largest breast cancer registry in Iran.MethodsIn this retrospective study, women who had both FS and permanent pathology reports were included. The two pathology reports were cross compared with regard to the involvement of tumor margins and sentinel lymph nodes.ResultsOverall, 2786 patients entered the study. Mean age of patients was 48.96±11.44 years. A total of 1742 margins were analyzed. Accordingly, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FS pathology for detection of involvement of involved margins were 78.49%, 97.63%, 65.1%, and 98.7%, respectively. The accuracy and area under the curve (AUC) for FS pathology were 96.61% and 0.73 (95% CI: 0.64–0.831), respectively.A total of 1702 sentinel lymph node biopsies were assessed. Sensitivity, specificity, PPV, and NPV, of FS pathology for detection of lymph node involvement, were 87.1%, 98%, 95.5%, and 93.3%, respectively. Accuracy and AUC of FS for diagnosis of involved lymph nodes were 94.1% and 0.926 (95% CI: 0.909–0.942), respectively.ConclusionFrozen pathology is a suitable method for identifying involved sentinel lymph nodes in patients with breast cancer, but this method has a less than optimum efficacy for detecting and confirming marginal involvement.

【 授权许可】

CC BY