Effective Test Utilization Recommendations

Do not order a frozen section on a pathology specimen if the result will not affect immediate (i.e., intraoperative or perioperative) patient management

Surgical Pathology
Although the result of an intraoperative frozen section evaluation is often helpful to determine the treatment path of a patient during a surgical procedure, the frozen section analysis may be limited in regards to sampling and technical issues that can hinder interpretation and/or compromise the integrity of the specimen for the final diagnosis. If there is no therapeutic decision to be made for the patient on the day of the surgical procedure based on the results of the frozen section, it is preferable to submit the specimen for routine (or rush, if necessary) histologic processing and permanent section evaluation.

REFERENCES

  1. Prieto VG, Argenyi ZB, Barnhill RL, Duray PH, Elenitsas R, From L, Guitart J, Horenstein MG, Ming ME, Piepkorn MW, Rabkin MS, Reed JA, Selim MA, Trotter MJ, Johnson MM, Shea CR. Are en face frozen sections accurate for diagnosing margin status in melanocytic lesions? Am J Clin Pathol [Internet]. 2003 Aug [cited 2017 Jul 14]; 120:203-208
  2. Taxy JB. Frozen section and the surgical pathologist: a point of view. Arch Pathol Lab Med [Internet]. 2009 July [cited 2017 Jul 14]; 133: 1135-1138
  3. Roy S, Parwani AV, Dhir R, Yousem SA, Kelly SM, Pantanowitz L. Frozen section diagnosis: is there discordance between what pathologists say and what surgeons hear? Am J Clin Pathol [Internet]. 2013 Sept [cited 2017 July 14];140:363-369
  4. Ali R, Hanly AM, Naughton P, Castineira CF, Landers R, Cahill RA, Watson RG. Intraoperative frozen section assessment of sentinel lymph nodes in the operative management of women with symptomatic breast cancer. World Journal of Surgical Oncology [Internet]. 2008 June [cited 2017 July 14]; 6:69-74
  5. Huber GF, Dziegielewski P, Matthews TW, Warshawski SJ, Kmet LM, Faris P, Khalil M, Dort JC. Intraoperative frozen-section analysis for thyroid nodules: a step toward clarity or confusion? Arch Otolaryngol Head Neck Surg [Internet]. 2007 Sept [cited 2017 July 14];133(9):874-881
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