Frozen section analysis in the management of skin cancers

Frozen section analysis is used routinely to ensure complete removal of bas al cell and squamous cell carcinomas of the skin, but the current emphasis on controlling costs raises the question as to which lesions should be eval uated with frozen section histology, A retrospective study of the clinical records and pathological reports of 51 patients selected randomly from a to tal of 225 patients was undertaken to determine the overall impact of froze n section analysis on the surgical management of skin cancers at this insti tution. The results indicate that frozen section analysis was performed on 76% of the 277 lesions evaluated, and that the results of frozen section ex amination were 91.1% accurate in detecting the presence or absence of tumor involvement at the surgical margins. The data also showed that the surgeon s were able to estimate the margin of the skin tumor clinically and remove if: entirely during the first excision 91.1% of the time, The lesions that had not been removed completely with the initial excision were those locate d on the periorbital region, forehead, and cheeks; were recurrent lesions; or were lesions that required more involved reconstruction than primary clo sure. This study shows that frozen section analysis is a valuable tool in s elected situations, but routine use is not indicated for the majority of ba sal and squamous cell carcinomas of the skin.