Frozen Sections in Decision-Making Regarding the Axillary Procedures in Breast Conserving Surgery for Intraductal Carcinoma at Preoperative Diagnosis.
Breast Neoplasms
Diagnosis
Frozen Sections
Journal
Journal of Korean medical science
ISSN: 1598-6357
Titre abrégé: J Korean Med Sci
Pays: Korea (South)
ID NLM: 8703518
Informations de publication
Date de publication:
31 Jul 2023
31 Jul 2023
Historique:
received:
30
12
2022
accepted:
30
03
2023
medline:
3
8
2023
pubmed:
2
8
2023
entrez:
1
8
2023
Statut:
epublish
Résumé
Axillary evaluation is unnecessary for pure ductal carcinoma in situ (DCIS); however, it is performed because of the risk of upstaging to invasive cancer. We assessed the role of intraoperative frozen section (IOF) biopsy in reducing invasive cancer upstaging and axillary evaluation in preoperative DCIS patients. We reviewed patients with preoperative DCIS who underwent breast-conserving surgery (BCS) with IOF biopsy. Positive IOF biopsy findings were defined as the presence of invasive or micro-invasive cancer. The IOF biopsy and permanent pathology findings were compared. Seventy-eight patients underwent BCS with IOF biopsy. Six patients showed positive IOF biopsy findings; five of these patients showed concordant permanent pathology findings. Sentinel lymph node biopsy (SLNB) was positive in one patient. Thirteen patients with invasive breast cancer were missed by IOF biopsy; they underwent SLNB during the second surgery. None of them had metastatic lymph nodes. The sensitivity and specificity of IOF biopsy were 27.7% and 98.3%, respectively, with 82.1% accuracy. None of the other factors showed statistically significant relationships with the permanent pathology findings, except for the IOF biopsy findings. IOF evaluation can aid in detecting the invasiveness of tumors in patients with preoperative DCIS.
Sections du résumé
BACKGROUND
BACKGROUND
Axillary evaluation is unnecessary for pure ductal carcinoma in situ (DCIS); however, it is performed because of the risk of upstaging to invasive cancer. We assessed the role of intraoperative frozen section (IOF) biopsy in reducing invasive cancer upstaging and axillary evaluation in preoperative DCIS patients.
METHODS
METHODS
We reviewed patients with preoperative DCIS who underwent breast-conserving surgery (BCS) with IOF biopsy. Positive IOF biopsy findings were defined as the presence of invasive or micro-invasive cancer. The IOF biopsy and permanent pathology findings were compared.
RESULTS
RESULTS
Seventy-eight patients underwent BCS with IOF biopsy. Six patients showed positive IOF biopsy findings; five of these patients showed concordant permanent pathology findings. Sentinel lymph node biopsy (SLNB) was positive in one patient. Thirteen patients with invasive breast cancer were missed by IOF biopsy; they underwent SLNB during the second surgery. None of them had metastatic lymph nodes. The sensitivity and specificity of IOF biopsy were 27.7% and 98.3%, respectively, with 82.1% accuracy. None of the other factors showed statistically significant relationships with the permanent pathology findings, except for the IOF biopsy findings.
CONCLUSION
CONCLUSIONS
IOF evaluation can aid in detecting the invasiveness of tumors in patients with preoperative DCIS.
Identifiants
pubmed: 37527907
pii: 38.e224
doi: 10.3346/jkms.2023.38.e224
pmc: PMC10396433
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e224Subventions
Organisme : National Research Foundation of Korea
ID : 2022R1C1C1010441
Pays : Korea
Organisme : Yonsei University College of Medicine
ID : 6-2021-0239
Pays : Korea
Informations de copyright
© 2023 The Korean Academy of Medical Sciences.
Déclaration de conflit d'intérêts
The authors have no potential conflicts of interest to disclose.
Références
Breast. 2013 Oct;22(5):869-73
pubmed: 23601760
Ann Surg. 2008 Feb;247(2):315-9
pubmed: 18216539
Arch Surg. 2010 Nov;145(11):1098-104
pubmed: 21079099
Breast. 2015 Jun;24(3):197-200
pubmed: 25681861
J Surg Oncol. 2013 Mar;107(4):388-92
pubmed: 23007901
Am Surg. 2018 Apr 1;84(4):537-542
pubmed: 29712602
BMJ Open. 2019 Mar 12;9(3):e026797
pubmed: 30862637
Br J Radiol. 2012 Aug;85(1016):e349-56
pubmed: 22422382
JAMA Oncol. 2015 Oct;1(7):888-96
pubmed: 26291673
BMC Surg. 2017 Feb 7;17(1):12
pubmed: 28173790
Ann Surg Oncol. 2017 Oct;24(10):2915-2924
pubmed: 28766196
Radiology. 2011 Jul;260(1):119-28
pubmed: 21493791
Int Sch Res Notices. 2014 Oct 29;2014:624185
pubmed: 27379334
Ann Surg Oncol. 2016 Dec;23(13):4253-4261
pubmed: 27766556
Breast. 2012 Oct;21(5):678-81
pubmed: 22835916
J Natl Compr Canc Netw. 2018 May;16(5S):605-610
pubmed: 29784737
Asian Pac J Cancer Prev. 2016;17(9):4463-4467
pubmed: 27797262
Br J Surg. 2014 Apr;101(5):488-94
pubmed: 24493058
Yonsei Med J. 2019 Nov;60(11):1028-1035
pubmed: 31637884
J Natl Cancer Inst. 2002 Oct 16;94(20):1546-54
pubmed: 12381707
Indian J Cancer. 2016 Apr-Jun;53(2):235-238
pubmed: 28071617
Breast Cancer Res Treat. 2016 Apr;156(3):517-525
pubmed: 27083179
Lancet Oncol. 2016 Oct;17(10):e430-e441
pubmed: 27733269
Br J Surg. 2016 May;103(6):644-655
pubmed: 26990850