Frozen Section Analysis for Intraoperative Margin Assessment During Breast-Conserving Surgery Results in Low Rates of Re-excision and Local Recurrence
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Negative surgical margins minimize the risk of local recurrence after breast-conserving surgery. Intraoperative frozen section analysis (FSA) is one method for margin evaluation. We retrospectively analyzed records of patients who received breast-conserving therapy with intraoperative FSA of the lumpectomy cavity to assess re-excision rates and local control.
Records were retrospectively reviewed for individuals who underwent breast-conserving surgery for ductal carcinoma in situ (DCIS) or invasive carcinoma between 1993 and 2003. Inclusion criteria were a minimum of 2 years follow-up and intact tumor at the time of operation. The major outcome measure was local recurrence. The Kaplan-Meier test was used to evaluate local recurrence rates between groups.
290 subjects with an average age of 57.2 years (range 27–89) underwent 292 lumpectomies with FSA. 11.3% had DCIS, 73.3% had infiltrating ductal, 5.8% had infiltrating lobular, and 9.6% exhibited other forms of invasive carcinoma. 70 subjects underwent additional resection at the time of breast surgery, 16 underwent subsequent re-excision, and 17 underwent subsequent mastectomy. At a median follow-up of 53.4 months (range 5.8–137.8), there were six local recurrences (2.74%) in patients who had breast-conserving procedures and two local recurrences in patients who underwent mastectomy. There were no statistically significant associations among local recurrence rate, tumor size, nodal status, or overall stage. Local recurrences were higher in patients with DCIS compared with invasive carcinoma, and tumors >2cm.
Intraoperative FSA allows resection of suspicious or positive margins at the time of lumpectomy and results in low rates of local recurrence and re-excision. The low local recurrence rate reported here is comparable to those reported with other margin assessment techniques.
KeywordsFrozen section analysis Breast-conserving therapy Surgical margins Re-excision rate Local recurrence
The authors wish to thank the Herman and Gwen Shapiro Foundation and the University of Wisconsin Comprehensive Cancer Center for their support of this work.
- 16.R Development Core Team (2005). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. Vienna, Austria. ISBN 3-900051-00-3, URL http://www.R-project.org
- 23.Leavitt SH, Aeppli DM, Nierengarten ME. The importance of local control in the conservative treatment of breast cancer. Acta Oncol 1995;34:839–44Google Scholar
- 26.Ku NN, Cox CE. Cytology of lumpectomy specimens. Acta Cytol 1992;35:417–21Google Scholar