Pitfalls in frozen section interpretation: A retrospective study of palpable breast tumors

Research output: Contribution to journalArticle

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Abstract

Aims and background: The use of frozen sections for purposes of diagnosis is recognized to involve a degree of uncertainty. A retrospective study of breast specimen frozen section diagnoses was undertaken in order to analyse the major pitfalls. Methods: Hard copy files from our archives relating to symptomatic (palpable) breast specimens obtained between 1983 and 1996 were reviewed. Results: The review revealed 23 errors among the diagnoses on 2110 frozen specimens. Twenty-two of them were false-negative and 1 (a case of multiple intraductal papillomatosis with atypical ductal hyperplasia) was false-positive for malignancy. The factors contributing to the pitfalls were: 1) misinterpretation; 2) poor quality of the frozen sections (artifacts making the diagnosis difficult); 3) sampling errors during sectioning; 4) ignorance of the macroscopic features; 5) lesions difficult to interpret; 6) ductal carcinoma in situ as the only lesion in the specimen; and 7) sections not deep enough. Several of the factors sometimes occurred simultaneously. Conclusions: Although the number of errors is relatively low, more stress should be placed on the preoperative diagnoses of breast lesions. Breast surgery frozen section should be used as rarely as possible for diagnostic purposes, despite the generally good diagnostic accuracy. However, it is reasonable to use frozen sections widely until the given preoperative diagnostic tools allow an appropriate preoperative workup, because it is the only way to keep histopathologists trained to interpret frozen sections.

Original languageEnglish
Pages (from-to)15-18
Number of pages4
JournalTumori
Volume85
Issue number1
Publication statusPublished - Jan 1999

Fingerprint

Frozen Sections
Retrospective Studies
Breast Neoplasms
Breast
Carcinoma, Intraductal, Noninfiltrating
Selection Bias
Papilloma
Artifacts
Uncertainty
Neoplasms

Keywords

  • Breast
  • Frozen section
  • Intraoperative
  • Pitfalls

ASJC Scopus subject areas

  • Cancer Research

Cite this

Pitfalls in frozen section interpretation : A retrospective study of palpable breast tumors. / Cserni, Gábor.

In: Tumori, Vol. 85, No. 1, 01.1999, p. 15-18.

Research output: Contribution to journalArticle

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