{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T19:13:19Z","timestamp":1788462799492,"version":"build-2803163510"},"reference-count":52,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Our study aims to audit and evaluate the accuracy and pitfalls of intraoperative evaluation of frozen sentinel lymph nodes (IOE\u2010FSLN) and resection margins (IOE\u2010FSM) compared to final findings in paraffin sections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 264 cases underwent intraoperative evaluation, encompassing 688 sentinel lymph nodes (SLNs) and 1186 surgical margins. Frozen section (FS) diagnoses were compared with corresponding permanent sections of FS (PFS). Sensitivity, specificity, false\u2010negative rate, false\u2010positive rate, and concordance rates were assessed. Cases with discrepancies underwent a detailed histological review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study predominantly comprised cases of invasive breast carcinoma (IBC) (74%). For FSLN reporting, sensitivity was 88.1%, specificity 100%, and FS\u2010PFS concordance 99.0%. FSM reporting showed sensitivity of 85.0%, specificity 99.9%, and concordance 98.4%. Sampling errors accounted for 86% (FSLN) and 88% (FSM) of discrepancies, with interpretive errors present in 1\/7 FSLN and in 2\/17 FSM cases. The shave margin method demonstrated a higher false\u2010negative rate in FSM reporting. The rate of final positive margins was reduced from 21.3% to 11.4% when IOE\u2010FSM was utilized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IOE\u2010FSLN and IOE\u2010FSM showed high reliability in guiding intraoperative decisions for axillary lymph node dissection and achieving free surgical margins in one\u2010stage surgeries. However, limitations include challenges in distinguishing metastatic carcinoma from benign mimics in FSLN and diagnosing certain features such as IBC with post\u2010treatment changes, invasive lobular carcinoma in FSLN and FSM; IBC rich in tumour\u2010infiltrating lymphocytes, low\u2010grade (DCIS\/IBC in FSM) without immunohistochemical studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.15418","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T04:55:11Z","timestamp":1739336111000},"page":"1121-1136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Diagnostic accuracy and challenges of intraoperative frozen section evaluation for axillary sentinel lymph node biopsy and breast margins"],"prefix":"10.1111","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0206-7570","authenticated-orcid":false,"given":"Natthawadee","family":"Laokulrath","sequence":"first","affiliation":[{"name":"Department of Pathology, Siriraj Hospital Mahidol University  Bangkok Thailand"},{"name":"Department of Pathology and Laboratory Medicine KK Women's and Children's Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2719-1449","authenticated-orcid":false,"given":"Nur Diyana Md","family":"Nasir","sequence":"additional","affiliation":[{"name":"Singapore Breast Surgery Center  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8078-1630","authenticated-orcid":false,"given":"Mihir","family":"Gudi","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine KK Women's and Children's Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1405-2878","authenticated-orcid":false,"given":"Puay Hoon","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine KK Women's and Children's Hospital  Singapore Singapore"},{"name":"Luma Medical Centre  Singapore Singapore"},{"name":"Parkway Laboratory Services Ltd  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2020-0411-OA"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-021-02288-1"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2023.04.017"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5446-2"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-3480-5"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.03.025"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-08785-z"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11356-022-20569-4"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248768"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqw078"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12829"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001897"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2024.103749"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1066896909332114"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-015-0827-2"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-014-3161-x"},{"key":"e_1_2_12_18_1","unstructured":"KrishnamurtiUG AllisonKH FitzgibbonsPL ConnollyJL.Protocol for the examination of specimens from patients with invasive carcinoma of the breast. 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