Evaluation of Surgical Margins with Intraoperative Frozen Section in Patients Undergoing Breast-Conserving Surgery: Our clinical experience. Importance of IO Surgical Margin Assessment

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Bulent Koca https://orcid.org/0000-0001-7614-392X
Murat Yıldırım https://orcid.org/0000-0003-1089-1380
Ali İhsan Saglam https://orcid.org/0000-0003-3031-7028

Keywords

Breast Carcinoma, Breast-Conserving Surgery, Positive Surgical Margin

Abstract

Background: Breast cancer is the second most common cancer in women. Breast-conserving surgery (BCS) has increasingly been applied to eligible patients. One of the most important points in BCS is to provide clean surgical margins. In this study, it is aimed to share the re-excision results of those having positive surgical margins in intra-operative evaluation among BCS patients, and to discuss the intra-operative evaluation in the light of the literature. 
MATERIALS AND METHODS:The data (patient files, surgery notes and pathology reports) of 203 patients who had undergone BCS for breast cancer between January 2016 and January 2022 and whose excision materials had been evaluated with intra-operative frozen sections in terms of surgical margins, were scanned retrospectively. Absence of ink on tumoral cells (“no ink on tumor”) for invasive ductal carcinoma (IDC), and a margin width of ≥ 2mm for ductal carcinoma in situ (DCIS) were considered as a clean surgical margin.
RESULTS: Median age was 51 years (range, 22-75). There were reportedly 27 with positive surgical margins, five of whom with positive margins in re-excision. Second re-excision specimens of all these 5 cases (18.5%) had been reported to have no positive surgical margins. No patients had been reported to require a second re-excision or mastectomy.
CONCLUSION: Intraoperative surgical margin assessment eliminates the need for repetitive surgery. We recommend routine application of intra-operative surgical margin assessment.

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