J M Jorns1, S Daignault2, M S Sabel3, J L Myers4, A J Wu4. 1. University of Michigan, Department of Pathology, 1500 East Medical Center Drive 2G332 UH, Ann Arbor, MI 48109, USA. Electronic address: jjorns@med.umich.edu. 2. University of Michigan, Comprehensive Cancer Center, Biostatistics Core, USA. 3. University of Michigan, Department of Surgery, USA. 4. University of Michigan, Department of Pathology, 1500 East Medical Center Drive 2G332 UH, Ann Arbor, MI 48109, USA.
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.
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.
Authors: Jennifer M Racz; Amy E Glasgow; Gary L Keeney; Amy C Degnim; Tina J Hieken; James W Jakub; John C Cheville; Elizabeth B Habermann; Judy C Boughey Journal: Ann Surg Oncol Date: 2020-07-04 Impact factor: 5.344