The accuracy of frozen-section diagnosis in metastatic breast and colorectal carcinoma to the adnexa

Objective. The objective of our study was to describe the accuracy of intra operative frozen-section diagnosis of carcinoma metastatic to the adnexa in women with a history of breast or colorectal carcinoma. Methods. We conducted a retrospective chart review of all patients with a h istory of breast or colorectal carcinoma who developed histologically prove n pelvic or abdominal metastases between 1988 and 1995, In those patients w hose final histologic review revealed carcinoma metastatic to the adnexa, t he accuracy of the intraoperative frozen-section diagnosis of the adnexal t umor was compared to the final diagnosis. Results, Forty-three patients were identified and in 36 patients the frozen section was obtained from the adnexa. Twenty-one patients (58.3%) had meta static breast carcinoma and 15 (41.7%) had metastatic colorectal carcinoma to the adnexa, Carcinoma in the adnexa was correctly diagnosed by frozen se ction in 35 of 36 patients (97.2%). Metastatic carcinoma was identified at frozen section in 17 of 21 patients (81%) with metastatic breast cancer and 13 of 15 patients (86.7%) with metastatic colorectal cancer. In 3 of 21 pa tients (14.3%) with metastatic breast cancer and in 2 of 15 patients (13.3% ) with metastatic colorectal cancer, the frozen-section diagnosis was carci noma of uncertain origin, One patient had a false-negative frozen section b ecause the small focus of metastatic breast cancer was not sampled at the t ime of frozen section. Conclusion. Intraoperative frozen-section evaluation correctly diagnosed ca rcinoma in the adnexa in 97% of patients, and in over 80% of cases, the car cinoma was diagnosed as being metastatic in origin. (C) 1999 Academic Press .