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May 18, 1984

Frozen Sections: Their Use and Abuse

Author Affiliations

From the Monroe Clinic, Monroe, Wis.

JAMA. 1984;251(19):2559-2560. doi:10.1001/jama.1984.03340430057030

THE THEORY behind using the frozen section technique for quick tissue diagnosis is quite simple: while the patient is kept under continual anesthesia, the frozen section can rapidly provide information to the operating surgeon to help "make a therapeutic decision."1

Not always, however, is this procedure used in a proper manner. All too often the frozen section is used merely to satisfy the surgeon's curiosity. In one study,2 42% of the frozen sections performed at one institution were done as an afterthought. Thus, while the frozen sections did not contribute to the care of the patient, they did contribute to the cost of the health care. As succinctly stated by Dehner and Rosai2: "Satisfaction of the surgeon's curiosity will never reasonably justify a request for the frozen section."

Apparently many surgeons do not realize that in the process of freezing the specimen, artifacts may be produced within

Ackerman LV, Ramirez GA:  The indications for and limitations of frozen section diagnosis .  Br J Surg 1959;46:336.Crossref
Dehner LP, Rosai J:  Frozen section examination in surgical pathology .  Minn Med 1977; 60:83-94.
Saltzstein SL, Nahum AM:  Frozen section diagnosis: Accuracy and errors; uses and abuses .  Laryngoscope 1973;83:1128.Crossref
Duray PH, Flannery B:  Tuberculosis infection from preparation of frozen sections .  N Engl J Med 1981;305:167.
Dalai BI, Malik AK, Datta BN, et al:  Frozen section diagnosis: A review of 1,051 cases .  Ind J Cancer 1979;16:59-65.
Dahlin DC:  Seventy-five years' experience with frozen sections at the Mayo Clinic .  Mayo Clin Proc 1980;55:721-723.