Accuracy of frozen section measurements for the determination of Breslow tumour thickness in primary malignant melanoma

Abstract

Frozen sections can be used for accurate measurements of Breslow tumour thickness. Consequently, intraoperative frozen section diagnosis of thick melanoma immediately followed by excision with wide surgical margins is possible in experienced centres.

Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: A review of the literature

“…The reliability of frozen sections for intraoperatively determining tumor thickness was evaluated for endometrial adenocarcinoma, 67 melanoma, 68 and laryngeal cancer, 69 and accuracy rates were 95%, 98.2%, and 99.3%, respectively.…”

Oncologic clearance with preservation of reconstructive options: literature review and the ‘delayed reconstruction after pathology evaluation (DRAPE)’ technique

“…Paraffin section tissue preparation is the gold standard for tissue diagnosis and the frozen sectioning does not match its efficacy when compared directly . While there are false‐negative rates reported as high as 15%, and false‐positive rates reaching 32.6%, the sensitivity of the technique exceeds that for other reported options . The DRAPE approach uses this gold standard.…”

The universal detection of antigens from one skin biopsy specimen

“…We consider the need for AR preceding immunostaining of formalin‐fixed paraffin‐embedded tissue sections as a major disadvantage, particularly because AR has some major drawbacks and risks for artifacts, like reviewed by a number of investigators 1,3,4,41 . Acetone‐fixed frozen sections, on the other hand, have inferior morphological detail compared with formalin‐fixed paraffin‐embedded sections 5–8 . If the tissue is not processed quickly enough, ice‐crystal artifacts may appear 5,9–11 .…”

“…Furthermore, shrinkage of frozen skin sections is described by Gardner et al 46 However, solely skin cell shrinkage due to formalin fixation and paraffin embedding has been documented previously 10,47,48 . There is also lack of consensus with regard to the ability to accurately determine Breslow tumor thickness of melanomas on frozen sections 7,47,49 . As a result of these problems, pathological interpretation of the frozen specimens is limited and has to be performed by an experienced pathologist 7,8,50,51 .…”

“…However, frozen sections have poor morphology compared with paraffin‐embedded sections. Other disadvantages of frozen sections are the presence of ice‐crystal artifacts, difficulty in cutting and inconvenience of working with frozen tissues 5–11 …”