M. Noguchi et al., INTRAOPERATIVE HISTOLOGIC ASSESSMENT OF SURGICAL MARGINS AND LYMPH-NODE METASTASIS IN BREAST-CONSERVING SURGERY, Journal of surgical oncology, 60(3), 1995, pp. 185-190
The diagnostic value of intraoperative histologic examination of froze
n sections of surgical margins and axillary lymph nodes (AX) was inves
tigated in 95 patients with breast cancer who underwent breast-conserv
ing surgery. The periphery of the excised breast tissue was peeled lik
e an orange and examined histologically by frozen section. The results
were compared with examination by permanent section. Evaluation of su
rgical margins by frozen section resulted in a diagnostic accuracy of
87%, a sensitivity of 96%, and a specificity of 84%. Enlarged or harde
ned AXs were sampled from the axillary pad which was derived from a co
mplete AX dissection. Histologic examination using frozen section was
performed during surgery. After the operation, the remaining AXs were
removed from the axillary pad by hand dissection and histologically ex
amined on permanent section. A diagnostic accuracy of 97%, a sensitivi
ty of 77%, and a specificity of 100% were achieved in the diagnosis of
AX involvement on frozen section. It was therefore concluded that int
raoperative histologic examination of frozen sections may be useful in
the determination of involvement of the surgical margins and the AXs
in patients with breast cancer. (C) 1995 Wiley-Liss, Inc.