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  • Title: Immediate latissimus dorsi miniflap volume replacement for partial mastectomy: use of intra-operative frozen sections to confirm negative margins.
    Author: Rusby JE, Paramanathan N, Laws SA, Rainsbury RM.
    Journal: Am J Surg; 2008 Oct; 196(4):512-8. PubMed ID: 18809053.
    Abstract:
    BACKGROUND: Latissimus dorsi (LD) miniflap volume replacement is used for immediate reconstruction after partial mastectomy. This prospectively collected series was analyzed to evaluate the accuracy of intraoperative frozen sections. METHODS: After partial mastectomy, "bed biopsies" were submitted for intraoperative frozen-section analysis. If disease free, volume replacement was undertaken; if involved, targeted re-excisions were taken. Demographic, pathological, and outcome data were recorded. The proportion of breast excised was calculated. Local recurrences were recorded. RESULTS: One hundred ten partial mastectomies with LD miniflap volume replacement were completed. The median proportion of breast excised was 28% (maximum 72%); median weight 207 g. Frozen sections were positive in 33% of patients with a sensitivity of 83% and accuracy of 96% when compared with paraffin sections. Local recurrence occurred in one case. The median follow-up was 41.4 months. CONCLUSIONS: LD miniflap volume replacement extends the role of breast-conserving surgery. Frozen-section analysis of bed biopsies facilitates a single-stage procedure.
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