[Evaluation of efficacy of stereoscopic location and whole serial sections of margin status in breast conservation therapy specimens].
OBJECTIVE
To evaluate the efficacy of different methods in pathologic assessment of margin status in breast conservation therapy specimens.


METHODS
Assessment of margin status in breast conservation therapy specimens by stereoscopic location and whole serial sections (SLWS) and selective margin sections (SMS) was compared. The margin status was evaluated with intraoperative frozen sections either by SLWS (145 cases) or SMS (79 cases). On the other hand, with formalin-fixed specimens, the margin status of 84 cases was assessed by SLWS and that of another 226 cases by SMS. Follow-up data of all patients were analyzed.


RESULTS
The rate of detection of positive margin by SLWS (24.1%, 35/145) was significantly higher than that by SMS (6.3%, 5/79) during frozen section setting. Similarly, the rate of detection of positive margin by SLWS (34.5%, 29/84) was also higher than that by SMS (12.0%, 27/226) when applied in formalin-fixed specimens. The duration of follow-up ranged from 2 to 46 months. None of the patients with margin status assessed by SLWS developed local recurrence. This was in contrast to 3 cases with tumor recurrence (6 months, 15 months and 28 months after the operation respectively) in SMS group.


CONCLUSIONS
Assessment of margin status by SLWS in breast conservation therapy specimens can reduce the chance of missing underlying minute foci of margin involvement and help to localize the exact site of positive margin. It thus reduces the overall risk of local recurrence and the need of a second operation.
Lang
Rong-gang
RG
Department of Breast Pathology and Research, Tianjin Medical University Cancer Hospital, Tianjin 300060, China.
Fan
Yu
Y
Chen
Ling
L
Wang
Ying
Y
Guo
Xiao-jing
XJ
Fu
Li
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections / Q000379:methods*; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012306:Risk; D055815:Young Adult