Intraoperative frozen section for margin assessment in breast conserving surgery

Abstract

Background and Aims: When excisional biopsy or lumpectomy is performed without margin assessment in early breast cancer, further surgery are required if positive margins exist. We evaluated the role of the intraoperative frozen section in breast conserving surgery (BCS). Clinicopathologic factors associated with re-excision were searched. Material and Methods: 190 tumors in 186 patients with early invasive breast cancer treated by BCS. Breast tumor was excised with 2 cm macroscopic margin, and microscopic margins examined by intraoperative frozen section. Results: After frozen section, 160 cases had negative margins (no re-excision), but 30 patients (16%) underwent re-excision because of close/positive margins. Negative margins were obtained in 24 patients but six patients underwent mastectomy due to persistent involved margins. Local recurrence was 2.1% and systemic recurrence was 2.6% with mean 62 months follow-up. Tumor type, tumor size, extranodal extension and extensive intraductal component were significant predictors of re-excision by multivariate analysis. Re-excision procedures haven't an impact on local recurrence. Conclusions: Intraoperative frozen section is an effective procedure in reducing the need of second operation. We have observed lower recurrence rates than other studies because of our 2 cm macroscopic margin width and > 2 mm microscopic negative margin which obtained by intraoperative frozen section.