Abstract
BackgroundIntraoperative 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.MethodsWe 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.ResultsA 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).ConclusionsOur 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.
Highlights
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
The number and percentages of IFSEs performed for identifying the type of primary tumor declined gradually, while the corresponding figures for assessment of metastasis to sentinel lymph node (SLN) or identification of the resection margin increased gradually (P
Overall, during the study period, 94.61% (2,160/ 2,283) of IFSEs were used to identify the type of primary tumor, 2.98% (68/2,283) for sentinel lymph node biopsy (SLNB), and 9.46% (216/2,283) for breast-conserving surgeries (BS)
Summary
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. This method permits the rapid diagnosis of tumors during method used directly determines the purpose for which IFSE is used [6]. The current study is part of a series of studies concerning the application and temporal tendencies of and regional differences in IFSE use in the diagnosis and treatment of female breast cancer in China during the period 1999–2008. We examined factors affecting the purpose for which IFSE is used in breast cancer management
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