Reliability of the frozen section in sharp knife cone biopsy of the cervix

Eight patient records were reviewed following cold knife conization in which frozen section diagnosis was utilized to aid the surgeon in formulating appropriate therapy after conization. Two patients were diagnosed as having microinvasive squamous cell carcinoma on final pathology when frozen sections were read as showing no invasion. Furthermore, in the 51 instances in which a degree of cervical dysplasia was determined from frozen sections, 14 discrepancies were noted on final pathology (27%). Such discrepancies may lead to unnecessary hysterectomies performed for cervical dysplasia that is easily treated with outpatient office procedures, especially when cold knife conization and frozen section diagnosis are performed without prior colposcopy and biopsy.