[Evaluation of frozen sections and cytological diagnosis during surgery]

When a surgeon feels it to be necessary to carry out morphological diagnosis during the operation, the pathologist may assist him or her with rapid cell or tissue diagnosis. This must be a conscious decision to introduce an additional step into the chain of laboratory procedures from the taking of the sample to the reporting of the result. Because this additional phase requires a longer stay in the operating room and additional effort on the part of the laboratory staff, together with an increased risk of misclassification of the disease process, this step should only be taken after careful consideration of the pros en cons. On the one hand, the need for intra-operative diagnosis has decreased because of the availability of better and more accurate pre-operative diagnostic techniques; on the other hand, there are new developments such as the introduction of sentinel-node biopsy, in which one must weigh the advantages of a rapid intra-operative diagnosis against the slower but surer results of a more comprehensive lymph-node investigation. Routine examination of the cut edges during an operation is hardly ever done any longer as a result of changed biological knowledge regarding the margins needed for radical surgery.