Skip to main content
Log in

Frozen-section-guided breast-conserving surgery: Implications of diagnosis by frozen section as a guide to determining the extent of resection

  • Original Articles
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

This study was conducted to analyze retrospectively the results of performing sector resection on 56 breasts in 54 patients with breast cancer. The glands were resected with a 2-cm tumor-free margin on both lateral sides and the distal side, and with more than a 3-cm tumor-free margin on the nipple side. The frequency of positive resection margins for the cancer cells was 7/56 (12.5%) on the nipple side and 12/46 (26.1%) on the lateral sides, with an overall frequency of 15/56 (26.8%). There were positive resected margins for cancer cells on both the nipple and lateral sides in 4/46 patients (9%) Assuming the equivocal margins were positive for cancer cells, an accurate diagnosis by frozen section examination was made in 51 of the 56 operations (91.1%). Additional resection of the margins was performed in all 20 cases of a positive resected margin for cancer cells according to the diagnosis by frozen section. Thereafter, the resected margins became negative in 13 cases (65%), but remained positive in 7 cases (35%). These results show that performing diagnosis by frozen section of the surgical margins is an effective guide to resecting tumors adequately.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Veronesi U, Volterrani F, Luini A, Saccozzi R, Vecchio MD, Zucali R, Galimberti V, Rasponi A, Re ED, Squicciarini P, Salvadori B (1990) Quadrantectomy versus lumpectomy for small size breast cancer. Eur J Cancer 26:671–673

    Google Scholar 

  2. Lagios MD (1992) Pathologic features related to local recurrence following lumpectomy and irradiation. Semin Surg Oncol 8:122–128

    Google Scholar 

  3. Kurz JM (1992) Factors influencing the risk of local recurrence in the breast. Eur J Cancer 28:660–666

    Google Scholar 

  4. Smitt MC, Nowels KW, Zdeblick MJ, Jeffrey S, Carlson RW, Stockdale FE, Goffinet DR (1995) The importance of the lumpectomy surgical margin status in long-term results of breast conservation. Cancer 76:259–267

    Google Scholar 

  5. Vicini FA, Eberlein TJ, Connolly JL, Recht A, Abner A, Schnitt SJ, Silen W, Harris JR (1991) The optimal extent of resection for patients with stage I or 11 breast cancer treated with conservative surgery and radiotherapy. Ann Surg 214:200–204

    Google Scholar 

  6. Holland R, Veling SHJ, Mravunac M, Hendriks JHCL (1985) Histologic multifocality of Tis, T1-2 breast carcinomas, implications for clinical trials of breast-conserving surgery. Cancer 56:979–990

    Google Scholar 

  7. Aspegren K, Holmberg L, Adami HO (1988) Standardization of the surgical technique in breast-conserving treatment of mammary cancer. Br J Surg 75:807–810

    Google Scholar 

  8. Japan Breast Cancer Society (1989) The general rules for clinical and pathological recording of breast cancer. Jpn J Surg 19:612–632

    Google Scholar 

  9. NIH Consensus Conference (1991) Treatment of early-stage breast cancer. JAMA 265:391–395

    Google Scholar 

  10. Veronesi U, Banfi A, Salvadori B, Luini A, Saccozzi R, Zucali R, Marubini E, Vecchio MD, Boracchi P, Marchini S, Merson M, Sacchini V, Riboldi G, Santoro G (1990) Breast conservation is the treatment of choice in small breast cancer: long-term results of a randomized trial. Eur J Cancer 26:668–670

    Google Scholar 

  11. Fisher B, Redmond C, Poisson R, Margolese R, Wolmark N, Wickerham L, Fisher E, Deutsch M, Caplan R, Pilch Y, Glass A, Shibata H, Lerner H, Terz J, Sidorovich L (1989) Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 320:822–828

    Google Scholar 

  12. Van Dongen JA, Bartelink H, Fentiman IS, Lerut T, Mignolet F, Olthuis G, Van der Schueren E, Sylvester R, Tong D, Winter J, Van Zijl K (1992) Factors influencing local relapse and survival and results of salvage treatment after breast-conserving therapy in operable breast cancer: EORTC trial 10801, breast conservation compared with mastectomy in TNM stage I and 11 breast cancer. Eur J Cancer 415:801–805

    Google Scholar 

  13. Kurtz J M, Amalric R, Brandone H, Ayame Y, Jacquemier J, Pietra JC, Hans D, Pollet IF, Breassac C, Spitalier JM (1989) Local recurrence after breast-conserving surgery and radiotherapy. Cancer 63:1912–1917

    Google Scholar 

  14. Lagios MD, Richards VE, Rose MR, Yee E (1983) Segmental mastectomy without radiotherapy. Cancer 52:2173–2179

    Google Scholar 

  15. Ghossein NA, Alpert S, Barba J, Pressman P, Stacey P, Lorenz E, Shulman M, Sadarangani GJ (1992) Importance of adequate surgical excision prior to radiotherapy in the local control of breast cancer in patients treated conservatively. Arch Surg 127:411–415

    Google Scholar 

  16. Macmillan RD, Purushotham AD, Mallon E, Ramsay G, George WD (1994) Breast-conserving surgery and tumour bed positivity in patients with breast cancer. Br J Surg 81:56–58

    Google Scholar 

  17. Noguchi M, Minami M, Earashi M, Taniya T, Miyazaki I, Mizukami Y, Nonomura A, Nishijima H, Takanaka T, Kawashima H, Saito Y, Takashima C, Nakamura S, Michigishi T, Yokoyama K (1995) Pathologic assessment of surgical margins on frozen and permanent sections in breast-conserving surgery. Breast Cancer 2:27–33

    Google Scholar 

  18. Sauter ER, Hoffman JP, Ottery FD, Kowalyshyn MJ, Litwin S, Eisenberg BL (1994) Is frozen section analysis of reexcision lumpectomy margins worthwhile? Cancer 73:2607–2612

    Google Scholar 

  19. Hermann RE, Grundfest-Broniatowski S, Esselstyn CB (1992) Breast-conserving surgery: How much is enough? Semin Surg Oncol 8:136–139

    Google Scholar 

  20. Frazier TG, Wong RWY, Rose D (1989) Implications of accurate pathologic margins in the treatment of primary breast cancer. Arch Surg 124:37–38

    Google Scholar 

  21. Veronesi U, Farante G, Galimberti V, Greco M, Luini A, Sacchini V, Andreola S, Leoni F, Menard S, Ronco M, Colnaghi MI (1991) Evaluation of resection margins after breast conservative surgery with monoclonal antibodies. Eur J Surg Oncol 17:338–341

    Google Scholar 

  22. Hayward J, Caleffi M (1987) The significance of local control in the primary treatment of breast cancer. Arch Surg 122:1244–1247

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ikeda, T., Enomoto, K., Wada, K. et al. Frozen-section-guided breast-conserving surgery: Implications of diagnosis by frozen section as a guide to determining the extent of resection. Surg Today 27, 207–212 (1997). https://doi.org/10.1007/BF00941646

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00941646

Key Words

Navigation