Comparative Study between Intraoperative Ultrasound and Frozen Section in the Assessment of Margins in Conservative Breast Surgery

Document Type : Original Article

Authors

1 Department of General Surgery, Mansoura General Hospital, Ministry of Health, Mansoura, Egypt

2 Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

3 Department of Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

4 Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Frozen sections [FS] analysis is the most often used intraoperative method for analyzing excisions of breast tumors. However, ultrasound may play a pivotal role and avoids the invasiveness.
Aim of the Study: The work's objective was to compare the use of FS versus intraoperative ultrasound [IOUS] in determining an appropriate negative margin for conservative breast surgery
Patients and Methods: With the same inclusion and exclusion criteria, we included 30 patients who were divided into two equal groups, the first for FS and marked as [Group-A], and the second group for IOUS and marked as [Group-B]. Results of FZ and IOUS were compared to the results of histopathology. In addition, the operative time, volumetric resection and short-term recurrence were document.
Results: The FZ group had a significantly larger mean value of safety margins than the IOUS group, while the pathological group had the lowest mean value. The FZ had a sensitivity of 80%, specificity of 100%, accuracy of 86.7%, positive predictive value [PPV] of 100%, negative predictive value [NPV] of 71.4%, and Kappa agreement of 0.727 [0.389-1.00], with a p-value < 0.05 indicating statistical significance. Moreover, the IOUS group's sensitivity, specificity, accuracy, PPV, and NPV were all 100%. Their Kappa agreement was 1.00 [1.00-1.00], and their p-value [p<0.05] indicated statistical significance.
Conclusion: When evaluating safety margins in conservative breast surgery, intraoperative ultrasound performs better than frozen sections.

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