Frozen Section versus Paraffin Section in Diagnosis of Breast Lesions: A Comparative Study

Abstract

Background: Frozen section (FS) examination has a number of indications such as identification of tissue type, benign versus malignant nature of the tissue, type of malignancy, determination of surgical margins, positivity of lymph nodes, and presence of malignant implants and/or metastasis in other tissues. Contraindications to the use of FS exist such as small lesions that could be destroyed by the freezing and sectioning and leaving no tissue for a definitive diagnosis. Therefore, this prospective study was planned to compare the accuracy of FSs versus paraffin sections in diagnosis of breast lesions. Subjects and Methods: The present prospective study was conducted from December 2008 to September 2010 in the Department of Pathology, GSVM. Medical College, Kanpur. A total of 115 cases were studied including benign and malignant breast lesions. Results were compared between FS diagnosis, and gold standard paraffin section diagnosis was evaluated, following Hematoxylin and Eosin staining and analyzed for accuracy in terms of false positivity and false negativity. Results: Out of 115 cases in our study, concordance was found in 109 cases. In our study, concordance for malignant breast lesion was 100%, whereas for benign lesions, it was 95.9%. Four cases (3.5%) were deferred to paraffin section diagnosis and two cases (1.8%) were misdiagnosed on FS. Conclusions: Diagnosis by FS is accurate to 100% in case of malignancy and confirming up to 96% for benign lesions. Its use, thus during breast surgery, is advocated for better clinical management of patients.