Accuracy of intraoperative frozen-section analysis of axillary nodes

Background: Intraoperative assessment of axillary lymph node involvement would allow selection of patients who would benefit from axillary lymph node dissection. Methods: Eighty-eight patients undergoing mastectomy or wide excision had four nodes sampled and sent for frozen-section examination. Results: Frozen-section analysis of the nodes was correct in 81 of the 88 patients but: missed seven of the 26 patients who had involved nodes on paraffin section (sensitivity 73 per cent). Conclusion: Frozen-section analysis of axillary lymph nodes as currently practised cannot be recommended for routine use although it may have a role in specific groups of patients.