在单一门诊手术中心接受保乳手术患者的冰冻切片：5年经验

Frozen sections in patients undergoing breast conserving surgery at a single ambulatory surgical center: 5 year experience.

作者信息

Jorns J M, Daignault S, Sabel M S, Myers J L, Wu A J

机构信息

University of Michigan, Department of Pathology, 1500 East Medical Center Drive 2G332 UH, Ann Arbor, MI 48109, USA.

University of Michigan, Comprehensive Cancer Center, Biostatistics Core, USA.

出版信息

Eur J Surg Oncol. 2017 Jul;43(7):1273-1281. doi: 10.1016/j.ejso.2017.01.237. Epub 2017 Feb 6.

DOI:10.1016/j.ejso.2017.01.237

PMID:28215733

Abstract

OBJECTIVES

To evaluate outcomes of our breast frozen section (FS) practice in its first 5 years, including our specialized FS of margins (FSM) procedure for breast conserving therapy (BCT) patients.

METHODS

One thousand two hundred and forty eight patients undergoing 1303 breast FSM and/or sentinel lymph node (SLN) FS were included. Clinicopathologic features were assessed by chart review.

RESULTS

Use of SLN FS declined, from 43.5% of FS cases before to 19.2% of FS cases after 2012. FSM patients had a decline in overall reexcision to 12.3% in 2013-2014 (p = 0.063). There was also decline in reexcision for focally close margins (p < 0.0001) but no change in reexcision for extensively close margins. Reexcision was significantly associated with lobular subtype, multifocality and larger (≥T2) size. False negative FSM cases were most often influenced by extensively close or positive final (reexcised) margins sent for permanent section only (96/148; 64.9%).

CONCLUSIONS

Despite changing surgical practices, FSM remains a valuable service that reduces reexcision in BCT patients.

摘要

目的

评估我们乳腺冰冻切片（FS）业务开展头5年的结果，包括我们为保乳治疗（BCT）患者采用的切缘冰冻切片（FSM）专门程序。

方法

纳入1248例接受1303次乳腺FSM和/或前哨淋巴结（SLN）FS的患者。通过查阅病历评估临床病理特征。

结果

SLN FS的使用有所下降，从之前FS病例的43.5%降至2012年后FS病例的19.2%。FSM患者的总体再次切除率在2013 - 2014年降至12.3%（p = 0.063）。切缘局灶性接近的再次切除率也有所下降（p < 0.0001），但切缘广泛接近的再次切除率没有变化。再次切除与小叶型、多灶性和较大（≥T2）尺寸显著相关。FSM假阴性病例最常受仅送检永久切片的广泛接近或阳性最终（再次切除）切缘影响（96/148；64.9%）。