Investigating the Health of Resection Margins for Conducting Intra-operative During Breast Conservative Surgery
Nahid Nafissi1,2, Amir Makhdoom1, Mostafa Hoseini1, Mohammad Esmaeil Akbari2, Mohammad Hashemi2,3, Alireza Sarafzadeh4 and Alireza Negahi1*1Department of Surgery , Iran University of Medical Science , Teharn , Iran.
2Cancer Research Center, Shahid Beheshti University of Medical , Science , Teharn , Iran.
3Department of Pathology , Shahid Beheshti University of Medical , Science , Teharn , Iran.
4Department of Pathology, Khatam-Al Anbia Hospital , Shahid Beheshti University of Medical , Science , Teharn , Iran.
*Corresponding author E-mail : arnegahi@gmail.com
Abstract: To conduct radiotherapy during operation in treating the breast cancer through breast conservative surgery method, we must ensure the healthiness of resection margins during the operation. Then, electron ray is flashed to the surrounding tissues in order to reduce the chance of the presence of any microscopic cancer cells. The present research studies the ability of Frozen in diagnosing the health or involvement of margins during the operation and seeks to compare the results of Frozen with the results of gold standard (permanent pathology) diagnostic method in patients suffering from breast cancer who have undergone breast conservative surgery and Intra-operative radiotherapy. In this observational study conducted in the form of a retrospective research, some 496 patients suffering from breast cancer who have undergone breast conservative surgery were selected through the convenience sampling method and the results of breast margin pathologies conducted through Permanent and Frozen methods were compared against one another so that we may find the sensitivities and specifications of the Frozen methods in comparison with the Permanent method. In the Frozen and Permanent methods, the margins had a freedom degree of 83.1% and 98% respectively. The sensitivity and peculiarity of the Frozen method as compared to the Permanent method were 80% and 84% respectively, however the negative predictive value was 99.5%. A significant relationship was observed here based on chi square test. The level of accuracy was 84.3%, and the pseudo negative weas 0.5%. The compliance level of the Permanent and Frozen diagnostic methods was 84.3%. It is therefore concluded that the Frozen method has a good degree of compliance in determining the state of margin of the removed cancerous lump in breast conservative surgeries and false negative reports have been issued for 0.5% of the cases. Thus, it is recommended to use the Frozen method before radiotherapy to determine the freedom of margins.
Keywords: Breast Conservative Surgery and Intra-operative radiotherapy; Frozen Method; Permanent Method Back to TOC