Intraoperative imprint and exfoliative cytology (IEC) or frozen section (FS) are margin assessment techniques to reduce reoperation risk. These techniques reduce the rate of positive margin on permanent section (PS) after breast conservation surgery (BCS), which lead to reduction of reoperation. The rate of positive margin using these techniques are reported accounts for 6–19% of BCS. However, previous studies reported only the single use of each method. The purpose of this study was to elucidate the efficacy of using IEC followed by FS as intraoperative margin assessment (IMA) in BCS regarding the positive margin rate of PS.
Four hundred and fifty-one women who were admitted to our institution and underwent BCS between January 2013 and November 2018, and participated in this study. At first, IEC was performed as IMA. When the margin was likely to be positive by IEC result, FS was added. Additional excision was performed in patients with positive margin FS. We have analyzed the rate of positive margin on PS based on our margin assessment techniques.
Of 451 patients, 121 (26.8%) patients were IEC-positive and 330 (73.2%) patients were IEC-negative. Among these 121 patients who were added FS, 87 (71.9%) patients were FS-positive. Also, 10 (3.0%) of 330 patients with IEC-negative had positive margin with PS. Of 34 patients with FS-negative, no PS-positive patients were found. Though 87 patients with FS-positive received additional excision, only 3 patients resulted in PS-positive. Overall positive margin rate on final pathology according to PS was 2.9% (13 of 451 patients).
Technique of IMA using IEC followed by FS improved positive margin rate of PS compared to that in the previous studies. Our techniques should contribute to reducing reoperation risk.
The authors.
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All authors have declared no conflicts of interest.