Does frozen section margin evaluation reduce re-excision rates after breast conservation therapy?

摘要

Conservative treatment of breast cancer represents one of the therapeutic solutions of this pathology, especially in early stage cases, since after the introduction of screening protocols the frequency of diagnosis of breast cancer in this stage has increased. This differs from our country, where lack of a national protocol facing this pathology makes patient selection difficult due to the progressive stage at which it is diagnosed. Although the survival rate is similar to that of a radical mastectomy, this type of treatment is still viewed with skepticism by the patients and also by the physicians because of the risk of local relapse. Among responsible factors, invasive surgical margin, represents one of the most frequently incriminated (16). The rate of occurrence on the final examination and re-intervention varies in papers between 20% and 70% (3,11,12), which is why the technique for resection has suffered many changes according to the clinics specialized in this area. This varies from further excisions of the surgical margins up to different methods to evaluate these, in order to obtain free margins. But none of these methods has been employed as standard technique. In the present study we proposed the evaluation feasibility of intra operative frozen section of 98 patients and also the effect on the rate of re-excision, as a result of the conservative treatment of breast cancer. In this group we obtained a sensibility of 93,15%, a specificity of 99,78% by evaluating mammary tumors and we observed a 41% decrease of re-intervention rate. The result obtained strengthened our beliefs that the excision margins after conservative treatment must be evaluated by more methods.