Anila K R, Chandramohan K, Mathews A, Somanathan T, Jayasree K
Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Indian J Cancer. 2016 Apr-Jun;53(2):235-238. doi: 10.4103/0019-509X.197732.
Breast conserving surgery (BCS) is increasingly done for early breast cancers in many countries since it has been demonstrated by randomized trials that survival rates after BCS followed by adjuvant therapy are equivalent to those obtained after mastectomy. Frozen section analyses (FSA) is a technique used for intra-operative assessment of margin status in BCS. The aim of this study was to assess the concordance of margin status assessment by FSA and permanent sections and to assess correlation with local recurrence.
A total of 162 patients underwent BCS for in situ or invasive carcinoma with FSA of margins during the year 2008 at our center. The inclusion criteria in this study were patients with intact tumor at the time of surgery. After application of the inclusion criteria, 60 patients could be included in this study.
After frozen section, 20 patients had an initial negative margin. 40 subjects underwent additional excisions at the time of initial surgery because of close or positive margins. Of these 40 patients, in 32 patients a negative margin could be achieved with re-excisions. Pathological analyses of frozen section showed concordance to permanent sections in all cases. At a median follow-up of 40 months, there were no local recurrences.
Intra-operative FSA allows resection of suspicious margins at the time of primary conservative surgery and results in low rates of local recurrence and second surgeries. There is good concordance between results of FSA and the final paraffin section in assessing margin status.
在许多国家，保乳手术（BCS）越来越多地用于早期乳腺癌，因为随机试验已证明，保乳手术加辅助治疗后的生存率与乳房切除术相当。冰冻切片分析（FSA）是一种用于保乳手术中切缘状态术中评估的技术。本研究的目的是评估FSA与永久切片切缘状态评估的一致性，并评估与局部复发的相关性。
2008年，共有162例原位癌或浸润癌患者在我们中心接受了保乳手术并进行了切缘的冰冻切片分析。本研究的纳入标准为手术时肿瘤完整的患者。应用纳入标准后，60例患者可纳入本研究。
冰冻切片后，20例患者初始切缘阴性。40例患者因切缘接近或阳性在初次手术时进行了额外切除。在这40例患者中，32例患者再次切除后切缘阴性。冰冻切片的病理分析在所有病例中均与永久切片一致。中位随访40个月时，无局部复发。
术中FSA可在初次保乳手术时切除可疑切缘，导致局部复发率和二次手术率较低。FSA结果与最终石蜡切片在评估切缘状态方面具有良好的一致性。
