Accuracy of frozen section diagnosis in breast cancer detection

Fessia, L; Ghiringhello, Bruno; Arisio, Riccardo; Botta, Giovanni; Aimone, V

doi:10.1016/s0344-0338(84)80062-x

Cited by 31 publications

(1 citation statement)

References 17 publications

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“…However, even for an experienced pathologist, making an accurate diagnose from frozen sections is difficult, with an approximately 10% to 20% misdiagnosis rate. [ 1 – 3 ] Thus, in some small medical centers or in some developing countries lacking well-trained pathologists, this can be a big challenge. [ 4 , 5 ] Furthermore, intraoperative frozen section diagnosis is time-consuming, resulting in longer time spent in surgery.…”

Section: Introductionmentioning

confidence: 99%

Bioimpedance spectroscopy can precisely discriminate human breast carcinoma from benign tumors

Wan²,

Chen³

et al. 2017

Medicine

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Intraoperative frozen pathology is critical when a breast tumor is not diagnosed before surgery. However, frozen tumor tissues always present various microscopic morphologies, leading to a high misdiagnose rate from frozen section examination. Thus, we aimed to identify breast tumors using bioimpedance spectroscopy (BIS), a technology that measures the tissues’ impedance. We collected and measured 976 specimens from breast patients during surgery, including 581 breast cancers, 190 benign tumors, and 205 normal mammary gland tissues. After measurement, Cole-Cole curves were generated by a bioimpedance analyzer and parameters R0/R∞, fc, and α were calculated from the curve. The Cole-Cole curves showed a trend to differentiate mammary gland, benign tumors, and cancer. However, there were some curves overlapped with other groups, showing that it is not an ideal model. Subsequent univariate analysis of R0/R∞, fc, and α showed significant differences between benign tumor and cancer. However, receiver operating characteristic (ROC) analysis indicated the diagnostic value of fc and R0/R∞ were not superior to frozen sections (area under curve [AUC] = 0.836 and 0.849, respectively), and α was useless in diagnosis (AUC = 0.596). After further research, we found a scatter diagram that showed a synergistic effect of the R0/R∞ and fc, in discriminating cancer from benign tumors. Thus, we used multivariate analysis, which revealed that these two parameters were independent predictors, to combine them. A simplified equation, RF′ = 0.2fc + 3.6R0/R∞, based on multivariate analysis was developed. The ROC curve for RF′ showed an AUC = 0.939, and the sensitivity and specificity were 82.62% and 95.79%, respectively. To match a clinical setting, the diagnostic criteria were set at 6.91 and 12.9 for negative and positive diagnosis, respectively. In conclusion, RF′ derived from BIS can discriminate benign tumor and cancers, and integrated criteria were developed for diagnosis.

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Section: Introductionmentioning

confidence: 99%

Bioimpedance spectroscopy can precisely discriminate human breast carcinoma from benign tumors

Wan²,

Chen³

et al. 2017

Medicine

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Usefulness of the Triple Test Score for Palpable Breast Masses

Morris¹

2001

Arch Surg

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The results of intraoperative consultations in 181 ductal carcinomas in situ of the breast

Liu

Al‐Kaisi

Liu

et al. 1997

Cancer

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respectively. Sampling error was the main reason for the low detection rate, and technical inadequacy was a major factor contributing to interpretive problems. In multivariate regression analysis, FS accuracy was significantly associated with the clinical presentation of a palpable mass (odds ratio [OR] Å 4.16, 95% confidence interval [CI]: 2.04-8.45), the macroscopic finding of a mass (OR Å 3.03, 95% CI: 1.45-6.67), and necrosis (OR Å 3.13, 95% CI: 1.4-6.67). CONCLUSIONS.The authors concluded that the accuracy of FS diagnosis of DCIS was low, mainly due to sampling error. In general, FS examination should not be performed when no lesion/mass is identified by macroscopic examination. Cancer

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Accuracy of frozen section diagnosis in breast cancer detection

Cited by 31 publications

References 17 publications

Bioimpedance spectroscopy can precisely discriminate human breast carcinoma from benign tumors

Bioimpedance spectroscopy can precisely discriminate human breast carcinoma from benign tumors

Usefulness of the Triple Test Score for Palpable Breast Masses

The results of intraoperative consultations in 181 ductal carcinomas in situ of the breast

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