title: Frozen sections in patients undergoing breast conserving surgery at a single ambulatory surgical center: 5 year experience.
abstract: OBJECTIVE
  To evaluate outcomes of our breast frozen section (FS) practice in its first 5 years, including our specialized FS of margins (FSM) procedure for breast conserving therapy (BCT) patients.
  
  
  METHODS
  One thousand two hundred and forty eight patients undergoing 1303 breast FSM and/or sentinel lymph node (SLN) FS were included. Clinicopathologic features were assessed by chart review.
  
  
  RESULTS
  Use of SLN FS declined, from 43.5% of FS cases before to 19.2% of FS cases after 2012. FSM patients had a decline in overall reexcision to 12.3% in 2013-2014 (p = 0.063). There was also decline in reexcision for focally close margins (p < 0.0001) but no change in reexcision for extensively close margins. Reexcision was significantly associated with lobular subtype, multifocality and larger (≥T2) size. False negative FSM cases were most often influenced by extensively close or positive final (reexcised) margins sent for permanent section only (96/148; 64.9%).
  
  
  CONCLUSIONS
  Despite changing surgical practices, FSM remains a valuable service that reduces reexcision in BCT patients.
authors.affiliation: University of Michigan, Department of Pathology, 1500 East Medical Center Drive 2G332 UH, Ann Arbor, MI 48109, USA. Electronic address: jjorns@med.umich.edu.
authors.forename: J M
authors.initials: JM
authors.lastname: Jorns
authors.affiliation: University of Michigan, Comprehensive Cancer Center, Biostatistics Core, USA.
authors.forename: S
authors.initials: S
authors.lastname: Daignault
authors.affiliation: University of Michigan, Department of Surgery, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Sabel
authors.affiliation: University of Michigan, Department of Pathology, 1500 East Medical Center Drive 2G332 UH, Ann Arbor, MI 48109, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Myers
authors.affiliation: University of Michigan, Department of Pathology, 1500 East Medical Center Drive 2G332 UH, Ann Arbor, MI 48109, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018567:Breast Neoplasms, Male / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000473:pathology* / Q000601:surgery; D005260:Female; D005629:Frozen Sections / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D000072662:Margins of Excision; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D012086:Reoperation; D000071036:Sentinel Lymph Node / Q000473:pathology; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D013531:Surgicenters; D047368:Tumor Burden; D055815:Young Adult
keywords: Breast cancer; Breast conserving therapy; Frozen section; Intraoperative