title: Therapeutic mammaplasties: full local control of breast cancer in one surgical stage with frozen section.
abstract: OBJECTIVE
  To evaluate the effectiveness of therapeutic mammoplasty with frozen section in achieving negative surgical margins in a single-stage surgery for breast cancer.
  
  
  METHODS
  Fifty patients affected by early stage breast cancer treated by therapeutic mammaplasties were retrospectively reviewed in this study. Fifty-two therapeutic mammaplasties were accomplished. After resection the specimen was sent to pathologist for examination with frozen section. Tumour positive margins were defined as presence of cancerous cells at ≤ 2 mm from the edge of the specimen. In case of positive margins a second large re-excision was accomplished intra-operatively. All patients were followed every 4 months for the first 2 years and twice a year subsequently.
  
  
  RESULTS
  Fifty-two procedures were evaluated (median follow-up of 72.6 months). The overall survival rate was 98% we had a single case of local recurrent disease (1.9%) that progressed to metastatic disease and patient's death. Frozen section as a diagnostic tool for identification of positive margins has been tested. In conclusion we report a sensitivity of 0.83 and a specificity of 0.93; the predictive positive value was 0.62 and the negative predictive value was 0.97, for a final accuracy of 0.94.
  
  
  CONCLUSIONS
  Frozen section coupled to oncoplastic resections allows a proper control of local disease and can minimize any second surgical look for margins revision.
authors.affiliation: Department of Surgical Oncology, Humanitas Centro Catanese di Oncologia, Via G. Da Bormida 64, 95100 Catania, Italy. francesco.caruso@ccocatania.it
authors.forename: F
authors.initials: F
authors.lastname: Caruso
authors.forename: M
authors.initials: M
authors.lastname: Ferrara
authors.forename: G
authors.initials: G
authors.lastname: Castiglione
authors.forename: I
authors.initials: I
authors.lastname: Cannata
authors.forename: A
authors.initials: A
authors.lastname: Marziani
authors.forename: C
authors.initials: C
authors.lastname: Polino
authors.forename: M
authors.initials: M
authors.lastname: Caruso
authors.forename: A
authors.initials: A
authors.lastname: Girlando
authors.forename: G
authors.initials: G
authors.lastname: Nuciforo
authors.forename: G
authors.initials: G
authors.lastname: Catanuto
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections / Q000379:methods*; D006801:Humans; D007558:Italy; D016462:Mammaplasty / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome