Authors : Yahya Mohd Aripin, Nora Julianna Osman, Norfaezan Abdul Rashid and Siti Aishah Che Md Ali
Abstract: Wide Local Excision (WLE) is a better alternative to mastectomy as it preserves the desired cosmetic outcome without compromising the patient survival rate. Margin involvement is the main pitfall for WLE. It leads to reoperation which technically can be more challenging and potentially causes emotional stress to the patient. This study evaluates intraoperative Frozen Section (FS) in determining the margin status during WLE. All breast cancer patients who underwent wide local excision were included in the study. In our institution, intraoperative frozen section for WLE was started in 2015. This cohort of patients was compared with earlier patients whom WLE were performed without frozen section. Patients demographic, tumour characteristics, margin status and number of reoperations were analysed. A total of 20 patients aged 43-71 years (mean 56 years) were included in this study. Frozen sections were performed on the last eight of the patients. Six patients (30%) had at least one positive margin involvement. Three patients who had no frozen section were scheduled for reoperation after 2 weeks. Another three patients had frozen section and cavity shaving in the same operation. Total margins evaluated for frozen section were 39. Out of these, 6 (15.4%) were positive for malignancy. One (2.6%) was falsely reported as positive for malignancy. Overall sensitivity and specificity of frozen section in this study were 100 and 96.9%, respectively. FS could help surgeon to minimize the extent of excision during WLE to attain the optimal cosmetic outcome. Positive margin at FS should be taken cautiously, especially when it involves decision to convert the surgery to mastectomy. In that case, it could be wise to wait for confirmation of the margin status by paraffin section.
Yahya Mohd Aripin, Nora Julianna Osman, Norfaezan Abdul Rashid and Siti Aishah Che Md Ali, 2019. The Value of Intraoperative Frozen Section in Wide Local Excision for Breast Cancer. Surgery Journal, 14: 1-4.