Percutaneous core biopsy of palpable breast lesions: accuracy of frozen section histopathological exam in the diagnosis of breast cancer

Santos, Roberto Luiz Carvalhosa dos; Lasmar, Ricardo Bassil; Fontes, Tereza Maria Pereira; Fonseca, Rachel de Carvalho Silveira de Paula; Saldanha, Paula De Azevedo Brant; Santos, Roberto Faria Carvalhosa Dos

doi:10.1590/s0100-69912014000100003

Cited by 5 publications

(7 citation statements)

References 22 publications

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“…Specificity and PPV was 100% while NPV was 95.45% which was equaled to the findings reported by Tarek et al [20] and Kumar et al [25]. The diagnostic accuracy of frozen section was 98%, similar to that of Dos Santos et al [26]. When FNAC and frozen section were compared, it found that the accuracy of frozen section was more than FNAC which is same as in previous studies [20,25].…”

Section: Discussionsupporting

confidence: 86%

Comparison and Analysis of Results of Fnac and Frozen Section in Diagnosis of Breast Lesions

Butale

Kove

2019

IJMBS

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Background: Breast lesions encompass a wide spectrum of diseases, both neoplastic and non-neoplastic. However, effective treatment of breast lesions necessitates early and conclusive diagnosis. This calls for a multidisciplinary approach which includes clinical assessment, radiological examination and pathological tools like FNAC, Frozen section and Histopathology. The present study was conducted to determine and compare the accuracy of FNAC and intraoperative frozen sections in diagnosis of breast lesions by keeping histopathology as gold standard. Method: This comparative study included 50 samples of breast lesions during the period of two year and that were subjected to FNAC, frozen section and histopathological evaluation. Results: Among 50 cases, 21 (42%) were benign and 29 (58%) were malignant cases according to gold standard. According to FNAC diagnosis, 24 cases were benign and 26 were malignant while according to frozen section diagnosis, 22 cases were benign and 28 were malignant. Among benign category, maximum cases (15;30%) were of fibroadenoma whereas among malignant category maximum cases (27;54%) were of infiltrating duct carcinoma according to gold standard, one case each of tubular and lobular carcinoma. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of FNAC was 89.66%, 100%, 100%, 87.5% and 94% respectively while the sensitivity, specificity, PPV, NPV and accuracy of frozen section was 96.55%, 100%, 100%, 95.45% and 98% respectively. Conclusion: Both FNAC and frozen section have a high diagnostic accuracy in the evaluation of breast lesions; therefore both should be used as tools for the assessment of breast lesions. Keywords: Breast Lesions, Diagnosis, FNAC, Frozen section, Histopathology, Benign, Malignant, Fibroadenoma, Carcinoma

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Section: Discussionsupporting

confidence: 86%

Comparison and Analysis of Results of Fnac and Frozen Section in Diagnosis of Breast Lesions

Butale

Kove

2019

IJMBS

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“…Percutaneous image‐guided biopsy is a minimally invasive and targeted approach to tissue sampling with an overall high diagnostic yield. When compared to open surgical biopsy, image‐guided percutaneous biopsy offers similar diagnostic rates 2–32,49 with overall lower morbidity 3,24,25 . However, up to 15% of these procedures are associated with yielding nondiagnostic tissue.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, percutaneous, image‐guided biopsies have increasingly gained popularity in the diagnostic work‐up of musculoskeletal neoplasms. This technique offers a minimally invasive and targeted approach to tissue sampling, with similar rates of the successful yield of diagnostic tissue, ranging anywhere from 68% to 96% 2–32 . The complications associated with image‐guided biopsies are generally rare and typically self‐limiting 5,6,18,22,33 …”

Section: Introductionmentioning

confidence: 99%

“…One approach to help decrease the rate of nondiagnostic biopsies is to obtain either intraprocedural fresh frozen pathology (FFP) or intraprocedural/point‐of‐care cytology (POCC) at the time of the image‐guided biopsy, to ensure diagnostic tissue has been acquired. Both FFP and POCC have the potential to increase the diagnostic yield of percutaneous biopsy to greater than 90% 4,6,8,10,30,32 . The addition of these adjunct tests, however, can add significant costs.…”

Section: Introductionmentioning

confidence: 99%

“…Both FFP and POCC have the potential to increase the diagnostic yield of percutaneous biopsy to greater than 90%. 4,6,8,10,30,32 The addition of these adjunct tests, however, can add significant costs. In an era of increasing fiscal austerity in health care, determining the incremental cost-effectiveness of these adjunct diagnostic strategies becomes increasingly important.…”

Section: Introductionmentioning

confidence: 99%

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Adjunct diagnostic strategies in improving diagnostic yields in image‐guided biopsies of musculoskeletal neoplasms—A cost‐effectiveness analysis

Ramkumar

Kelly

Ramkumar

et al. 2021

Journal of Surgical Oncology

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Background Routine use of adjunct intraprocedural fresh frozen biopsy (FFP) or point‐of‐care (POC) cytology at the time of image‐guided biopsy can improve diagnostic tissue yields for musculoskeletal neoplasms, but these are associated with increased costs. Objective This study aimed to ascertain the most cost‐effective adjunctive test for image‐guided biopsies of musculoskeletal neoplasms. Methods This expected value cost‐effectiveness microsimulation compared the payoffs of cost (2020 United States dollars) and effectiveness (quality‐adjusted life, in days) on each of the competing strategies. A literature review and institutional data were used to ascertain probabilities, diagnostic yields, utility values, and direct medical costs associated with each strategy. Payer and societal perspectives are presented. One‐ and two‐way sensitivity analyses evaluated model uncertainties. Results The total cost and effectiveness for each of the strategies were $1248.98, $1414.09, $1980.53, and 80.31, 79.74, 79.69 days for the use of FFP, permanent pathology only, and POC cytology, respectively. The use of FFP dominated the competing strategies. Sensitivity analyses revealed FFP as the most cost‐effective across all clinically plausible values. Conclusions Adjunct FFP is most cost‐effective in improving the diagnostic yield of image‐guided biopsies for musculoskeletal neoplasms. These findings are robust to sensitivity analyses using clinically plausible probabilities.

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Evolution of Frozen Section in Carcinoma Breast: Systematic Review

Rana

Sharma

et al. 2022

International Journal of Breast Cancer

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Background. The frozen section (FS) has been a good technique in surgical management of breast lesions since many years. But complete agreement and cooperation have not been achieved everywhere among surgeons and pathologists especially in the developing countries. FS undergoes continuous criticism due to various shortcomings but continued to be evaluated especially in developing countries. Objectives. This review was conducted to synthesize information on the use of frozen section in carcinoma breast. Data Sources. The MEDLINE database for frozen section since its origin and its implication in recent breast surgery techniques was studied. Study Eligibility Criteria. Sixty-five articles were reviewed with complete analysis on FS in both benign and malignant breast lesions. Study Appraisal and Synthesis Methods. The analysis of frozen section was done as a diagnostic tool in breast lesions, margin status in breast conservative surgery in carcinoma breast, and sentinel lymph node and use of immunohistochemistry for sentinel lymph node FS. Results. It was analysed that the FS gives accurate results in margin status analysis, decreasing rerecurrence. Conclusion. The accuracy of FSA, low recurrence rate, avoidance of reoperation, and good cosmesis are the key points of its use in breast conservative surgery. Its use in sentinel lymph node biopsy (SLNB) is equivocal. However, application of immunohistochemistry on frozen section of SLNB is an evolving trend in today’s era.

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Percutaneous core biopsy of palpable breast lesions: accuracy of frozen section histopathological exam in the diagnosis of breast cancer

Cited by 5 publications

References 22 publications

Comparison and Analysis of Results of Fnac and Frozen Section in Diagnosis of Breast Lesions

Comparison and Analysis of Results of Fnac and Frozen Section in Diagnosis of Breast Lesions

Adjunct diagnostic strategies in improving diagnostic yields in image‐guided biopsies of musculoskeletal neoplasms—A cost‐effectiveness analysis

Evolution of Frozen Section in Carcinoma Breast: Systematic Review

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