The influencing factors and prognosis analysis of positive initial margin in intraoperative frozen section during breast-conserving surgery.

Objectives: A critical measure to reduce the risk of ipsilateral breast tumor recurrence after breast-conserving surgery (BCS) for patients with early invasive breast cancer (BC) is ensuring negative margins through frozen section intraoperative margin assessment (FSIMA).This study aims to evaluate the influencing factors and prognosis associated with positive initial margins in FSIMA.

Methods: The clinical data of 436 BC patients treated with BCS were retrospectively analyzed, and long-term follow-up outcomes were evaluated.

Results: Among the 436 patients, approximately 90.8% (396/436) underwent successful BCS, while 71.8% (313/436) exhibited initial negative margins based on FSIMA. A total of 123 patients (28.2%) had positive initial margins, following additional excisions in some cases, 89 patients achieved negative margins. Univariate and multivariate analyses revealed significant differences between the positive and negative margin groups in tumor diameter, distance from the tumor to the nipple, and axillary lymph node metastasis (P < 0.05). No significant differences were observed in disease-free survival or overall survival between the two groups (P > 0.05).

Conclusions: The findings suggest that tumor diameter, the distance between the tumor and nipple, and axillary lymph node metastasis may influence the determination of positive initial margins in FSIMA. Positive initial margins do not appear to influence disease-free survival (DFS) or overall survival (OS) among BC patients treated with BCS.