Breast - nonmalignant
Procedures
Open biopsy with frozen section

Author: Hind Nassar, M.D. (see Authors page)

Revised: 25 July 2017, last major update May 2010

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Breast open biopsy with frozen section

Cite this page: Open biopsy with frozen section. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastopenbiopsy.html. Accessed October 23rd, 2017.
Open biopsy - general
Frozen section - general
  • Historically, open biopsy with positive frozen section led to mastectomy
  • Currently, even if frozen section is positive, there is a delay after biopsy to give the patient time to evaluate options
  • First priority of open biopsy or frozen section is accurate histologic diagnosis; sufficient tissue must be obtained for permanent sections
  • If frozen section is suspicious for DCIS, use all remaining tissue for permanent sections
  • Dont do frozen section if mass is 1 cm or less or if calcifications only / no mass (Cancer 1997;80:75) because the frozen block may contain artifacts and no tissue will be left for permanent sections without artifacts
  • Note: this topic excludes frozen section analysis of core biopsies
Uses of frozen section
Limitations of frozen section
  • False positives with frozen section: sclerosing lesions (radial scar, sclerosing adenosis, ductal adenoma), ductal hyperplasia, papillary lesions and fat necrosis; often cannot exclude invasion in DCIS
  • False negatives with frozen section: postchemotherapy tumor, well differentiated papillary carcinoma and lobular carcinoma, tubular carcinoma (Chin Med J (Engl) 2007;120:630); reduced with preoperative core biopsy
  • Note: stereotactic and ultrasonography guided core needle biopsies seem to be almost as accurate as open surgical biopsy, with lower complication rates (Ann Intern Med 2010;152:238)