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The Value of Intraoperative Frozen Section Analysis for Margin Status in Breast Conservation Surgery in a Nontertiary Institution

机译:非大专院校保乳手术中术中冰冻切片分析对保证金状况的价值

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摘要

Introduction. Breast conservation treatment (BCT) for early-stage breast malignancies requires negative margins and good cosmesis. Reoperations may be needed to achieve negative margins, which can have an adverse impact on outcomes. This study was performed to evaluate the efficacy of intraoperative frozen section analysis (IFSA) for margin assessment to reduce excision rates. Methods. All patients treated at the authors' private healthcare facility between 2009 and 2011 for breast cancer were included in the study. Those for whom BCT was intended underwent wide excision with IFSA. Six margins of the excised tissue, and the sentinel lymph node (SLN), where appropriate, were submitted for IFSA. Patient demographics, tumour characteristics, number of operations performed, and outcomes were analysed. Results. Of the 161 patients analysed, 138 (85.7%) had successful breast conservation. Four patients required a reoperation for incomplete surgical extirpation. One had a false negative SLN assessment on IFSA, and was returned to the operating room for an axillary dissection. Three patients required reoperations for inadvertently missed multicentric disease. None had false negative margin evaluation with IFSA necessitating reexcision. Conclusion. The use of IFSA allows low rates of reoperation with BCT. Further research is needed to establish consistency in low reexcision rates for cost-effectiveness and optimum resource allocation.
机译:介绍。早期乳腺恶性肿瘤的保乳治疗(BCT)需要负切缘和良好的美容性。可能需要进行重新手术以实现负利润,这可能会对结果产生不利影响。进行这项研究以评估术中冰冻切片分析(IFSA)进行边缘评估以降低切除率的功效。方法。研究纳入了2009年至2011年间在作者的私人医疗保健机构接受治疗的所有患者。打算使用BCT的人与IFSA进行了广泛的切除。 IFSA提交了切除的组织的六个边缘以及前哨淋巴结(SLN)(如果适用)。分析患者的人口统计资料,肿瘤特征,执行的手术次数和结果。结果。在分析的161位患者中,有138位(85.7%)成功完成了乳房保护。四名患者因不完全手术摘除而需要再次手术。其中一名患者对IFSA的SLN评估结果为假阴性,然后被送回手术室进行腋窝解剖。三名患者因无意中错过了多中心疾病而需要再次手术。没有一家公司因IFSA的虚假负利润评估而不得不重新执行。结论。 IFSA的使用可降低BCT的再手术率。需要进行进一步的研究以建立低重复率的一致性,以实现成本效益和最佳资源分配。

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