Ikeda T, Enomoto K, Wada K, Takeshima K, Yoneyama K, Furukawa J, Watanabe Y, Mukai M, Kitajima M
Department of Surgery, Keio University, School of Medicine, Tokyo, Japan.
Surg Today. 1997;27(3):207-12. doi: 10.1007/BF00941646.
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.
本研究旨在回顾性分析54例乳腺癌患者56个乳房行扇形切除术的结果。腺体切除时，两侧及远端切缘距肿瘤2 cm无瘤，乳头侧切缘距肿瘤超过3 cm无瘤。癌细胞切缘阳性率在乳头侧为7/56（12.5%），在两侧为12/46（26.1%），总体阳性率为15/56（26.8%）。4/46例患者（9%）乳头侧和两侧切缘均有癌细胞阳性。假设可疑切缘癌细胞阳性，56例手术中有51例（91.1%）通过冰冻切片检查做出准确诊断。根据冰冻切片诊断，对所有20例癌细胞切缘阳性的病例均进行了切缘追加切除。此后，13例（65%）切缘转为阴性，但7例（35%）仍为阳性。这些结果表明，对手术切缘进行冰冻切片诊断是充分切除肿瘤的有效指导。
