Margin Assessment in Breast Conservative Surgery and Concordance between Frozen and Paraffin Section Results: A Retrospective Study

Abstract

Background: Breast-conserving therapy (BCT) is an alternative to mastectomy for treatment of breast carcinoma. Negative surgical margins minimize the risk of local recurrence after breast-conserving surgery. Intraoperative frozen section analysis (FSA) is one method for margin evaluation. Aim of Study:The study aimed to determine the concordance between results of frozen section examination (FSE) and the final paraffin section in assessing margin status in breast conservative surgery and to study re-excision rates and local control of disease in patients subjected to FSE. Patients and Methods:This was a retrospective cohort study, was carried out on 30 women with early breast cancer undergoing breast conservative surgery; at General Surgery Department, Ain Shams University Hospitals, from June 2021 to June 2022. All patients were subjected to Detailed history taking, clinical examination, lab Investigations and Frozen section analysis. Results:The mean age of the study population was 48.53 ±7.82 years and 63.3% of them were older than 50 years with mean BMI was 25.75kg/m 2 and (56.7%) of them were rural. Regarding adjuvant therapy, 13.3% of the patients underwent chemotherapy, 56.7% of the patients underwent endocrine therapy and 10% underwent both therapies. 30%of the patients had positive margins and underwent additional resections. Out of 21 negative margins by FSA there were 2 of them were positive in final section with false negative of 5%. FSA was significant in assessing margin status with sensitivity of 80%, specificity 95%, NPV 94.5%, PPV 88.9% and accuracy of 90%. Conclusion:There is good concordance between results of FSA and the final paraffin section in assessing margin status. Frozen section diagnosis is an accurate method for the assessment of surgical margin clearance.