title: Accuracy of frozen sections for breast cancer sentinel lymph node biopsies within a peripheral New Zealand hospital.
abstract: OBJECTIVE
  Intra-operative frozen section is a commonly-used technique for evaluating sentinel lymph node biopsies in breast cancer to determine the need for an axillary node dissection (AND). Frozen section does have drawbacks, including cost and uncertainty around operating time. In addition, recent studies have questioned the benefit of AND in certain cases. The aim of this study was therefore to evaluate the accuracy of frozen section at our institution.
  
  
  METHODS
  All patients who had a sentinel node biopsy for breast cancer in the Hawke's Bay District Health Board region over a 1-year period were included in the study. Results of intra-operative frozen section were compared to routine paraffin histological analysis.
  
  
  RESULTS
  Eighty patients were eligible. Eighteen had a positive frozen section. There were two false negatives. The sensitivity of frozen section for metastases was 90%, specificity was 100%, and the false negative rate was 2.5%.
  
  
  CONCLUSIONS
  The accuracy of frozen section section for sentinel lymph node biopsies in breast cancer at Hawke's Bay District Health Board is acceptable by international standards. However, as further evidence against axillary node dissections in those with sentinel node positive disease mounts, their use in the future may be limited.
authors.affiliation: Department of General Surgery, Level 2, Hawke's Bay Hospital, 398 Omahu Road, Frimley, Hastings 4120, New Zealand. James.Tan@hawkesbaydhb.govt.nz.
authors.forename: James
authors.initials: J
authors.lastname: Tan
authors.forename: Lesley
authors.initials: L
authors.lastname: Joblin
authors.forename: Emily
authors.initials: E
authors.lastname: Davenport
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D005629:Frozen Sections; D016304:Hospitals, Private; D006779:Hospitals, Public; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009520:New Zealand; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy