The role and limitations of frozen section and needle aspiration biopsy in breast cancer diagnosis.

Frozen section of breast biopsy specimens, and cytologic smears of breast mass aspirates, are both acceptable methods in the initial evaluation of palpable breast masses. The latter method is an outpatient procedure without significant morbidity. Interpretation may be made immediately; however, the diagnostic information obtained is limited to "malignant" or "negative." Frozen section may be applied to open biopsy or needle core biopsy specimens. In either case, the false-negative rate is less than that experienced with needle aspiration, and additional information is obtained regarding the histologic characteristic of the neoplasm. Although open biopsy is an operating room procedure, needle core biopsy may be performed in the office; however, local anesthetic is required and the patients do experience more pain than with fine-needle aspiration. The selection of the proper procedure must be individualized, depending on the clinical situation and the amount of diagnostic information required. It is essential to remember that although a positive result may be considered diagnostic, a negative report is always tenuous and should not lead to definitive therapy.