Guidelines for practical utilization of intraoperative frozen sections
M. U. Prey, T. Vitale and S. A. Martin
Department of Pathology, St. Louis University.
We reviewed 4057 intraoperative frozen sections from 1980 through 1984 to
assess the accuracy, strengths, and weaknesses of this technique. Breast,
lymph node, and skin comprised half of the sites evaluated. Frozen-section
and final diagnoses agreed in 91.5% and disagreed in 6.8% of the cases;
1.7% of the cases were deferred. False-negative frozen-section diagnoses
were due to pathologist sampling or judgment errors and surgeon sampling
errors. There were eight (0.15%) false-positive diagnoses, none of which
altered patient treatment. We recommend that lymph nodes for
lymphoproliferative disorders and breast tissue for which a malignant
diagnosis will not result in an immediate mastectomy not be submitted for
frozen-section diagnosis. Appropriate studies of these tissues can be
carried out without an intraoperative diagnosis; such a policy will
increase the cost-effectiveness of frozen sections without compromising
patient care.
