Chair and Department of Surgical Oncology, Ludwik Rydygier's Collegium Medicum UMK in Bydgoszcz, Prof I. Romanowskiej 2, 85-796, Bydgoszcz, Poland.
Department of Clinical Breast Cancer and Reconstructive Surgery, Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital, Prof I. Romanowskiej 2, 85-796, Bydgoszcz, Poland.
Sci Rep. 2019 Sep 17;9(1):13441. doi: 10.1038/s41598-019-49951-y.
Breast conserving treatment (BCT) is a safe standard therapeutic method in patients with early invasive breast cancer. However, it is associated with an increased risk of residual neoplastic tissues in surgical margins. The aim of this study was to assess the outcome of the use of the intraoperative pathologic analysis by the frozen section (FS) method for evaluation of the extent of the primary lumpectomy. The study concerns a retrospective analysis of a group of 1102 patients who underwent BCT between Jan 2015 and Dec 2016. The assessment focused on the frequency of the intraoperative pathologic analysis of the primary lumpectomy extent (fresh frozen section method). The influence of the BCT specimen analysis method on the free margins width, as well as the rate and the cause of reoperation were evaluated. The intraoperative lumpectomy evaluation was performed in 45.8% (505/1102) of patients (Group I), while in the remaining 54.2% of the cases it was decided to abandon this procedure (Group II). Although in 72 (14.3%) patients the intraoperative analysis gave negative results, the margins contained residual tumor tissue (vs. 16.9% in Group II). In Group I, conversion from the previously planned BCT to mastectomy was necessary in 5.9% (30/505) patients (vs. 9.7% in Group II). The duration of surgery was 48.9 ± 17.3 minutes (Group I) and 42.9 ± 13.6 minutes (Group II). In patients undergoing BCT, the use of the intraoperative pathologic analysis by the FS method resulted in a reduction of the total number of reoperations performed due to residual tumor found in the margins following the primary lumpectomy. However, it statistically significantly extended the duration of the surgery.
保乳治疗（BCT）是早期浸润性乳腺癌患者的安全标准治疗方法。然而，它与手术切缘残留肿瘤组织的风险增加有关。本研究旨在评估术中病理分析（冷冻切片 [FS] 方法）在评估原发性肿瘤切除术范围中的应用效果。本研究回顾性分析了 2015 年 1 月至 2016 年 12 月期间接受 BCT 的 1102 例患者。评估的重点是原发性肿瘤切除术范围的术中病理分析（新鲜冷冻切片方法）的频率。评估了 BCT 标本分析方法对游离切缘宽度的影响，以及再次手术的发生率和原因。在 45.8%（505/1102）的患者（组 I）中进行了术中肿瘤切除术评估，而在其余 54.2%的病例中决定放弃该手术（组 II）。尽管在 72 例（14.3%）患者中术中分析结果为阴性，但切缘仍含有残留肿瘤组织（组 II 中为 16.9%）。在组 I 中，由于术前计划的 BCT 转为乳房切除术，5.9%（30/505）的患者需要进行（组 II 中为 9.7%）。手术时间为 48.9 ± 17.3 分钟（组 I）和 42.9 ± 13.6 分钟（组 II）。在接受 BCT 的患者中，由于原发性肿瘤切除术切缘残留肿瘤，术中病理分析（FS 方法）的使用减少了因肿瘤残留而进行的总再手术次数。然而，它显著延长了手术时间。
