TO FREEZE OR NOT TO FREEZE - A COMPARISON OF METHODS FOR THE HANDLINGOF BREAST BIOPSIES WITH NO PALPABLE ABNORMALITY

Recently there have been several editorials suggesting that breast bio psies with small or nonpalpable lesions should not be subjected to fro zen section examination. In this study, the approach of routinely perf orming frozen sections on all breast biopsies was compared to the reco mmended approach of performing frozen sections only on cases with gros s lesions <1.0 cm. From July 1, 1992 through June 30, 1993, there were 444 breast biopsies submitted. Nearly all of these (98%) had frozen s ections performed. Among these cases, there were 14 false-negative fro zen section diagnoses equating to a frozen section sensitivity of 84%, and a frozen section false-negative rate of 3.3%. From July 1, 1994 t hrough June 30, 1995, there were 601 breast biopsies submitted. Of the se cases, 310 contained a gross lesion >1.0 cm and were subjected to f rozen section examination. The remaining 291 cases contained either no distinct lesion or a gross lesion <1.0 cm. These cases were not froze n. Among the 310 cases that were frozen, there were 3 false-negative f rozen section diagnoses equating to a frozen section sensitivity of 96 %, and a frozen section false-negative rate of 1.0%. These findings in dicate that careful gross examination combined with selective freezing of only cases containing a gross lesion >1.0 cm improves frozen secti on accuracy. This study provides statistical support for previous reco mmendations that frozen section examination should be limited to cases with distinct gross lesions >1.0 cm.