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Total-Circumference Intraoperative Frozen Section Analysis Reduces Margin-Positive Rate in Breast-Conservation Surgery

Total-Circumference Intraoperative Frozen Section Analysis Reduces Margin-Positive Rate in... ObjectiveOne problem existing in breast-conservation surgery is ipsilateral breast tumour recurrence, and one of its major risk factors is surgical margin positivity. We therefore investigated whether total-circumference surgical margin examination can reduce surgical margin-positive rates.MethodsA total of 122 cases were examined after BCS was performed between March 2004 and March 2006. After partial mastectomy, specimens were taken from the remnant breast side along the total-circumference of the mammary gland (width, approximately 5 mm). Intraoperative frozen section analysis was performed for those specimens. Margin-positive cases were defined as those showing malignancy within 5 mm of the final margin as revealed by final diagnosis.ResultsIf intraoperative frozen section analysis had not been performed, 33 cases (27) would have been diagnosed as margin-positive. However, it reduced the number of margin-positive cases to 12 (9.8), and final margin-positivity rates were thus significantly reduced (P < 0.001). As for the accuracy of intraoperative frozen section analysis, sensitivity was 78.6, specificity was 100, correct diagnosis rate was 95.1, positive predictive value was 100 and negative predictive value was 94.0. False-negatives were caused by the detection of malignancy as revealed in permanent specimens. Margin-positive sites were not limited to the nipple and distal (peripheral) sites, with equivalent margin-positive cases found laterally.ConclusionsTotal-circumference surgical margin examination by IFSA for BCS significantly reduced margin-positive rates from 27 to 9.8. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Japanese Journal of Clinical Oncology Oxford University Press

Total-Circumference Intraoperative Frozen Section Analysis Reduces Margin-Positive Rate in Breast-Conservation Surgery

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References (28)

Publisher
Oxford University Press
Copyright
The Author (2010). Published by Oxford University Press. All rights reserved
Subject
Original Articles
ISSN
0368-2811
eISSN
1465-3621
DOI
10.1093/jjco/hyq006
pmid
20189973
Publisher site
See Article on Publisher Site

Abstract

ObjectiveOne problem existing in breast-conservation surgery is ipsilateral breast tumour recurrence, and one of its major risk factors is surgical margin positivity. We therefore investigated whether total-circumference surgical margin examination can reduce surgical margin-positive rates.MethodsA total of 122 cases were examined after BCS was performed between March 2004 and March 2006. After partial mastectomy, specimens were taken from the remnant breast side along the total-circumference of the mammary gland (width, approximately 5 mm). Intraoperative frozen section analysis was performed for those specimens. Margin-positive cases were defined as those showing malignancy within 5 mm of the final margin as revealed by final diagnosis.ResultsIf intraoperative frozen section analysis had not been performed, 33 cases (27) would have been diagnosed as margin-positive. However, it reduced the number of margin-positive cases to 12 (9.8), and final margin-positivity rates were thus significantly reduced (P < 0.001). As for the accuracy of intraoperative frozen section analysis, sensitivity was 78.6, specificity was 100, correct diagnosis rate was 95.1, positive predictive value was 100 and negative predictive value was 94.0. False-negatives were caused by the detection of malignancy as revealed in permanent specimens. Margin-positive sites were not limited to the nipple and distal (peripheral) sites, with equivalent margin-positive cases found laterally.ConclusionsTotal-circumference surgical margin examination by IFSA for BCS significantly reduced margin-positive rates from 27 to 9.8.

Journal

Japanese Journal of Clinical OncologyOxford University Press

Published: Jun 26, 2010

Keywords: breast cancer breast-conservation surgery frozen section surgical margin

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