@article {Luo188, author = {Daniel Luo and Jennifer Ha and Bruce Latham and David Ingram and Tony Connell and Diana Hastrich and Weng-Chan Yeow and Peter Willsher and Joseph Luo}, title = {The Accuracy of Intraoperative Subareolar Frozen Section in Nipple-Sparing Mastectomies}, volume = {10}, number = {3}, pages = {188--192}, year = {2010}, publisher = {Ochsner Journal}, abstract = {Background: Intraoperative subareolar frozen sections are used to assess the nipple areolar complex{\textquoteright}s suitability for preservation for patients selected for nipple-sparing mastectomy. We aim to investigate the accuracy and value of the frozen section compared to formal histopathologic results.Methods: In our 5-year retrospective study, 52 candidates for nipple-sparing mastectomies had subareolar frozen sections analyzed intraoperatively for malignant or atypical duct changes. Women were considered for nipple-sparing mastectomy if their primary breast malignancy was greater than 3~cm from the nipple-areolar complex and not multifocal in nature. Frozen-section results were compared to the formal histopathologic results, allowing analysis of the sensitivity, specificity, and predictive value. Causes of false negatives (negative frozen-section findings, positive histopathology findings) were then examined.Results: Of 52 frozen sections, 47 (90\%) yielded negative results and 5 (10\%) yielded positive results. Of the 47 negative results, 39 were true negatives while 8 were false negatives. Of the 5 positive results, all were true positives with no false positives. Therefore, the positive predictive value of subareolar frozen section is 100\%, negative predictive value 83\%, sensitivity 38\%, and specificity 100\%. Of the 8 false negatives, 4 (50\%) were due to sampling errors, 3 (37.5\%) were due to interpretation errors, and 1 (12.5\%) was due to diathermy artifact.Conclusion: Intraoperative subareolar frozen section is a specific but nonsensitive test. It is useful in nipple-sparing mastectomy because in 10\% of cases a positive result allows immediate nipple and areolar excision. Its low sensitivity and negative predictive value means that 15\% of patients will need a subsequent nipple and areolar excision. Eighty-five percent of patients can, however, have a single-stage excision.}, issn = {1524-5012}, URL = {https://www.ochsnerjournal.org/content/10/3/188}, eprint = {https://www.ochsnerjournal.org/content/10/3/188.full.pdf}, journal = {Ochsner Journal} }