- 期刊
Frozen Section Diagnosis of Breast Lesions
乳房病變的病理冰凍切片檢查
摘要
病理冰凍切片檢查，對於乳房病變診斷，不只在乳房手術可快速得知結果，並可在術中做一決定性的手術方法，是乳房手術不可缺少的檢查。本研究針對五年來本院 549 例乳房病理冰凍切片及永久性石蠟病理切片診斷比較，發現在 220 例的良性乳房病變(40.1% ）並未發現任何假陽性的冰凍病理切片診斷，而在 329 例（ 59.9 % ）惡性乳房病變中，其中有三例假陰性包含二例乳房管道原位癌及一例合併良性乳突瘤的浸潤性乳癌，而這三例均屬較小病變及未有腋下淋巴腺轉移。其病理冰凍切片診斷率與石蠟切片診斷率兩者在統計上有非常良好的一致性， K = 0.981 斷正確率為 99.1 % ，特異率為 100 % ，我們的結果顯示病理冰凍切片的診斷對乳房病變是一種可靠的方法，但針對較小的病變尤其小於一公分者，則應避免施行冰凍切片檢查，以避免在準備切片的過程中，喪失過多的腫瘤組織而影響最後的診斷，此類病人建議直接施行保留性乳房腫塊切除並接受詳細的常規石蠟包理切片診斷。
關鍵字
無資料並列摘要
Frozen section diagnosis rendered in 549 consecutive breast biopsies performed in 5 years in a single pathology laboratory was correlated with the final pathological diagnosis. There were no false positive reports among the 220 (40.1%) biopsies interpreted as benign lesions in paraffin sections. Among 329 (59.9%) malignant biopsies on paraffin sections, 3 cases were interpreted as benign lesions on frozen sections. Three false negatives included 2 ductal carcinoma in situ and one infiltrating ductal carcinoma associated with papillomatosis. The tumors were small and confined to the breast without any evidence of metastasis. There was a very good correspondence between the frozen section diagnosis and the paraffin section diagnosis (K= 0.98). The sensitivity of frozen section diagnosis was 99.1% and the clinical diagnostic specificity was 100%. Our results suggest that frozen section diagnosis is a highly reliable procedure, but small lesions (less than 1 cm in diameter, or non-palpable) should not be subjected to frozen section examination to avoid unnecessary loss of neoplastic tissue during the frozen section. The careful investigation of paraffin-embedded tissue is recommended for small breast lesions in breast conserving lumpectomy.