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Frozen Section Biopsy for Breast Cancer

Overview

Biopsies extract a small portion of the mass where doctors expect tumours after examining it under a microscope. It helps to identify the chances of cancer, infection or any other disease.

So if the oncologist suspects someone of cancer, a piece of tissue is taken or extracted from the patient’s body. A biopsy of the tissue is done to check whether the cancer is malignant or benign. 

In the case of breast cancer, frozen section biopsy is a very common procedure to check whether the tissue is malignant or benign (cancerous OR non-cancerous). It is also called an intra-operative frozen section.

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Everything You Need To Know about Frozen Section Biopsy

How is frozen section biopsy performed?

It is a process in which tissue is removed from the suspected body part and is taken to a laboratory. The pathologist freezes the tissue in a cryostat machine first and then begins the test. The tissue is cut with the help of a microtone and placed at a -25-degree centigrade temperature.

A biopsy of the breast tissues through a frozen section can give accurate results and has advantages.

Why is frozen section biopsy important?

A frozen section biopsy is important because it is trusted by most pathologists and oncologists for determining the extent of cancer. A frozen section biopsy is very quick and saves a lot of time in the procedure. 

  • It saves the need for another operation, as the surgeon can obtain the tissues quickly. This process requires little tissue for a correct diagnosis.

  • Most surgeons rely on this method as the treatment can be done quickly. If the tissue is found cancerous, then the breasts can be removed or treated as per the oncologist.

  • If the tissue is found to be benign (non-cancerous), there is no need to proceed further.

  • A frozen section biopsy takes very little time for the results to come. It takes less than 20 minutes as compared to any other procedure.

  • Frozen section can reduce re- surgery rates in breast conservation procedures done for breast cancer.

Breast core biopsy showing infiltrating ductal carcinoma (frozen section, ×100).

How accurate is frozen section biopsy?

    The frozen section biopsy was introduced in 1905. Since then, there has been enough innovation in the technique. The modern frozen section biopsies are known to produce accurate results. However, there have been enough discussions and debates regarding the accuracy of the biopsies. In the case of the ovary, the tumours that were visible or collected gave accurate results in the frozen section biopsy test. 

    A test conducted among 4436 breast biopsies in the last 5 years shows that these results are accurate. Although there were a few cases of false-negative the majority of cases were accurate. Frozen section cases were accurate in almost 92.7% of the total cases. The remaining 7% of the cases showed incorrect results.

    However, the report also shows that borderline tumours do not get easily caught by the frozen section biopsy. This is indeed a matter of concern as borderline cancer will not be detected.

    However, this is not the only method by which the suspected tissue will be tested. Oncologists with the help of pathologists, apply several other methods also to check the tissue.

    Read Also:- How Much Does It Cost for Breast Cancer Treatment in India

    Does the world still rely upon frozen section biopsy for breast cancer?

    Yes, medical practitioners still rely upon frozen section biopsy to get the best results. When a breast conservation surgery is done the specimen is sent for a frozen section to check the margins. Surgery is successful if the margins of a specimen are free of any cancer cells. 

    Also, for sentinel node biopsy intraoperative frozen section is very important, so as to complete the entire surgery in one go. In some countries where a frozen section is not available, patients need to undergo second surgery once a histopathology report is received after a week.

    Read Also: Breast Biopsy

    Why do doctors choose to go through frozen section biopsy?

    There are a couple of reasons why doctors choose the process of frozen section biopsy. Some of them are as follows:

    • The doctors may find this process suitable for accurate diagnosis as the process helps to get an additional sample to avoid a second operation.
    • The pathologist and the surgeon can work together for the proper treatment of the patient.
    • The process helps to collect an adequate tissue sample for in-depth scientific research. 
    • It helps ensure the doctors that the whole mass, along with safe margin, is removed. 

    Conclusion

    Frozen section biopsy for breast cancer is a great technique to check for the tissues, whether they are benign or malignant. This technique involves no pain or slight pain at times in extracting the tissues.

    About Author
    Dr. Jay Rashmi Anam

    Surgical Oncologists

    15+

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    Dr. Jay Anam is one of the best surgical oncologists in India. With expertise as a breast cancer surgeon, he believes in world-class cancer care for all patients.

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    This post first appeared on Dr. Jay Anam - Breast Cancer Surgeon, please read the originial post: here

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