title: Application of intraoperative frozen section examination in the management of female breast cancer in China: a nationwide, multicenter 10-year epidemiological study.
abstract: BACKGROUND
  Intraoperative frozen section examination (IFSE) during breast cancer surgery can partly reflect the status of surgical treatment since the surgical method used directly determines the purpose of IFSE use in disease management. This study aims to investigate the application of, changing trends in, and factors influencing IFSE in the management of female breast cancer in China.
  
  
  METHODS
  We collected the sociodemographic and clinical data of 4,211 breast cancer patients between 1999 and 2008 and statistically analyzed these data using χ2 or Fisher's exact tests.
  
  
  RESULTS
  A total of 2,283 (54.22%) patients with breast cancer underwent IFSE. During the 10-year study period, IFSE use was associated with an increase in the number of sentinel lymph node biopsies (SLNB) and breast-conserving surgeries (BS) performed, with significant regional differences noted in this trend (P < 0.05). Patients' education, occupation, age, tumor size estimated by preoperative palpation, and the use of imaging examinations affected the purpose of IFSE use (P < 0.05).
  
  
  CONCLUSIONS
  Our results show that the purpose of IFSE in the surgical treatment of breast cancer in China is gradually approaching that in developed countries. We believe that policymakers must address the differences in breast cancer treatment based on the socioeconomic status of patients. Lastly, the use of IFSE for determining tumor characteristics should be avoided as far as possible, and patient education and breast cancer screening programs tailored to the Chinese population should be established. Our findings may guide the formulation of breast cancer control strategies in China and other low-income countries.
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
authors.forename: Yu
authors.initials: Y
authors.lastname: Ren
authors.forename: Rong
authors.initials: R
authors.lastname: Huang
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: He
authors.forename: Wei-Liang
authors.initials: WL
authors.lastname: Feng
authors.forename: Ya-Nan
authors.initials: YN
authors.lastname: Kong
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.forename: Lin
authors.initials: L
authors.lastname: Zhao
authors.forename: Qing-Kun
authors.initials: QK
authors.lastname: Song
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Bao-Ning
authors.initials: BN
authors.lastname: Zhang
authors.forename: Jin-Hu
authors.initials: JH
authors.lastname: Fan
authors.affiliation: Department of Breast Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East, Guangzhou 510060, P,R, China. xxie1234@126.com.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Xie
authors.forename: Shan
authors.initials: S
authors.lastname: Zheng
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Qiao
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000145:classification / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D002681:China / Q000453:epidemiology; D019468:Disease Management; D016021:Epidemiologic Studies; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D013997:Time Factors