Frozen section diagnosis: an audit

Area of Science:

• Pathology
• Surgical Pathology

Background:

• Frozen section analysis is a critical intraoperative diagnostic tool.
• Rapid pathological assessment impacts surgical decisions.

Purpose of the Study:

• To evaluate the accuracy and error rates of operative frozen section diagnoses.
• To identify factors contributing to diagnostic errors and deferred diagnoses.

Main Methods:

• Retrospective review of 1000 consecutive operative frozen section diagnoses.
• Analysis of cases with incorrect or deferred diagnoses to determine causative factors.

Main Results:

• 96.5% of frozen section diagnoses were correct.
• Clinically relevant errors occurred in 1.3%, with 0.9% unimportant errors.
• 1.3% of diagnoses were deferred; all were conservative false negatives, with no false positive malignancy diagnoses.

Conclusions:

• Pathological misinterpretation was the primary cause of avoidable errors.
• Unavoidable factors contributed to approximately 2% of diagnostic failures.
• Current methods achieve a low, irreducible minimum of diagnostic errors in frozen section analysis.