Intra-Operative Frozen Section with Histopathological Diagnosis in Surgical Biopsies

This chapter aimed to evaluate the performance and limitations of frozen sections in the intraoperative evaluation of thyroid, breast, gastric, ovarian, central nervous system and lower extremities biopsies. Frozen section is a specimen of tissue that has been quick-frozen, cut by microtome, and stained immediately for rapid diagnosis of possible malignant lesions. A specimen processed in this manner is not satisfactory for detailed study of the cells, but it is valuable because it is quick and gives the surgeon immediate information regarding the malignancy of a piece of tissue. Frozen section plays an important role in the management of surgical patients yet it must be used prudently to avoid the indiscriminate usage of this important technique.

A cross-sectional study of frozen sections was done over a period of one and half year. All Intraoperative frozen sections of breast, thyroid, and gastric, ovarian, central nervous system tumours performed at Asram medical college, Eluru over a period of one and half years from 2013 to 2014 were studied. Fine needle aspiration cytology, frozen and biopsy performed for various tumours in thyroid, breast, gastric, ovary, CNS and lower limb were studied.

Out of 21 cases, 19 cases of frozen sections coincided with histopathological diagnosis and 20 cases of fine needle aspiration cytology coincided with histopathological diagnosis. In our study diagnostic accuracy for breast specimens was 50%.False negative result in frozen section in our study was that of intraductal/in situ carcinoma of breast.

Frozen section aides the surgeon to choose the best therapeutic approach and in rapid diagnosis of a pathological process. Newer techniques like MRI scan, CT scan, optical imaging, intra-operative cytology, and immunohistochemistry techniques are also helpful in diagnosing cancers.