Improved Rate of Negative Margins for Inflammatory Breast Cancer Using Intraoperative Frozen Section Analysis.

Area of Science:

• Oncology
• Surgical Pathology

Background:

• Inflammatory breast cancer (IBC) is a rare, aggressive malignancy with low survival rates.
• Achieving negative margins via modified radical mastectomy (MRM) is crucial for patient outcomes.
• Intraoperative frozen section analysis (FSA) is being investigated to enhance margin status during surgery.

Purpose of the Study:

• To evaluate the efficacy of intraoperative frozen section analysis (FSA) in achieving disease-free margins during MRM for IBC.
• To assess the impact of FSA on reducing positive margins in IBC patients.

Main Methods:

• A prospective, monocentric study involving 19 patients undergoing MRM for IBC.
• A 2 mm continuous skin edge was analyzed intraoperatively using FSA to guide surgical resection.
• Rates of tumor-free margins and concordance between FSA and permanent pathology were analyzed.

Main Results:

• 15 out of 19 patients (79%) achieved negative margins with the assistance of FSA.
• Four patients who would have had positive margins achieved negative margins due to FSA guidance.
• A strong agreement was observed between FSA and permanent pathological results (Kappa = 0.83, p < 0.0001).

Conclusions:

• Intraoperative FSA significantly decreases positive margins in IBC patients undergoing MRM.
• This technique may reduce re-operations, allow immediate wound closure, and prevent delays in adjuvant radiation therapy.
• Further extensive trials are recommended to establish intraoperative FSA as a standard in IBC treatment.