Accuracy of frozen section in intraoperative margin assessment for breast-conserving surgery: A systematic review and meta-analysis

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGARCIA, Mila Trementosa
dc.contributor.authorMOTA, Bruna Salani
dc.contributor.authorCARDOSO, Natalia
dc.contributor.authorMARTIMBIANCO, Ana Luiza Cabrera
dc.contributor.authorRICCI, Marcos Desiderio
dc.contributor.authorCARVALHO, Filomena Marino
dc.contributor.authorGONCALVES, Rodrigo
dc.contributor.authorSOARES JUNIOR, Jose Maria
dc.contributor.authorFILASSI, Jose Roberto
dc.date.accessioned2021-06-17T13:55:58Z
dc.date.available2021-06-17T13:55:58Z
dc.date.issued2021
dc.description.abstractBackground and objectives It is well established that tumor-free margin is an important factor for reducing local recurrence and reoperation rates. This systematic review with meta-analysis of frozen section intraoperative margin assessment aims to evaluate the accuracy, and reoperation and survival rates, and to establish its importance in breast-conserving surgery. Methods A thorough review was conducted in all online publication-databases for the related literature up to March 2020. MeSH terms used: ""Breast Cancer"", ""Segmental Mastectomy"" and ""Frozen Section"". We included the studies that evaluated accuracy of frozen section, reoperation and survival rates. To ensure quality of the included articles, the QUADAS-2 tool (adapted) was employed. The assessment of publication bias by graphical and statistical methods was performed using the funnel plot and the Egger's test. The review protocol was registered in PROSPERO (CRD42019125682). Results Nineteen studies were deemed suitable, with a total of 6,769 cases. The reoperation rate on average was 5.9%. Sensitivity was 0.81, with a Confidence Interval of 0.79-0.83, p = 0.0000, I2 = 95.1%, and specificity was 0.97, with a Confidence Interval of 0.97-0.98, p = 0.0000, I-2 = 90.8%, for 17 studies and 5,615 cases. Accuracy was 0.98. Twelve studies described local recurrence and the highest cumulative recurrence rate in 3 years was 7.5%. The quality of the included studies based on the QUADAS-2 tool showed a low risk of bias. There is no publication bias (p = 0.32) and the funnel plot showed symmetry. Conclusion Frozen section is a reliable procedure with high accuracy, sensitivity and specificity in intraoperative margin assessment of breast-conserving surgery. Therefore, this modality of margin assessment could be useful in reducing reoperation rates.eng
dc.description.indexMEDLINEeng
dc.identifier.citationPLOS ONE, v.16, n.3, article ID e0248768, 15p, 2021
dc.identifier.doi10.1371/journal.pone.0248768
dc.identifier.issn1932-6203
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/40834
dc.language.isoeng
dc.publisherPUBLIC LIBRARY SCIENCEeng
dc.relation.ispartofPlos One
dc.rightsopenAccesseng
dc.rights.holderCopyright PUBLIC LIBRARY SCIENCEeng
dc.subject.other20-year follow-upeng
dc.subject.othersurgical marginseng
dc.subject.otherlumpectomy marginseng
dc.subject.otherlocal recurrenceeng
dc.subject.otherconservation therapyeng
dc.subject.othercancereng
dc.subject.othermastectomyeng
dc.subject.otherreoperationeng
dc.subject.othercarcinomaeng
dc.subject.otherstageeng
dc.subject.wosMultidisciplinary Scienceseng
dc.titleAccuracy of frozen section in intraoperative margin assessment for breast-conserving surgery: A systematic review and meta-analysiseng
dc.typearticleeng
dc.type.categoryrevieweng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalCARDOSO, Natalia:Univ Sao Paulo, Sch Med, Sao Paulo, Brazil
hcfmusp.author.externalMARTIMBIANCO, Ana Luiza Cabrera:Univ Metropolitana Santos UNIMES, Grad Program Hlth & Environm, Santos, SP, Brazil
hcfmusp.citation.scopus20
hcfmusp.contributor.author-fmusphcMILA TREMENTOSA GARCIA
hcfmusp.contributor.author-fmusphcBRUNA SALANI MOTA
hcfmusp.contributor.author-fmusphcMARCOS DESIDERIO RICCI
hcfmusp.contributor.author-fmusphcFILOMENA MARINO CARVALHO
hcfmusp.contributor.author-fmusphcRODRIGO GONCALVES
hcfmusp.contributor.author-fmusphcJOSE MARIA SOARES JUNIOR
hcfmusp.contributor.author-fmusphcJOSE ROBERTO FILASSI
hcfmusp.description.articlenumbere0248768
hcfmusp.description.issue3
hcfmusp.description.volume16
hcfmusp.origemWOS
hcfmusp.origem.pubmed33735315
hcfmusp.origem.scopus2-s2.0-85102730333
hcfmusp.origem.wosWOS:000631029700082
hcfmusp.publisher.citySAN FRANCISCOeng
hcfmusp.publisher.countryUSAeng
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