Analysis of misdiagnosed cases and standardized quality control in the intraoperative frozen pathological diagnosis of breast disease
10.3760/cma.j.cn115807-20231216-00194
- VernacularTitle:乳腺疾病术中冰冻病理诊断中误诊病例分析和规范化质量控制
- Author:
Juan WU
1
;
Hao WU
1
;
Huihua HE
1
;
Jingping YUAN
1
Author Information
1. 武汉大学人民医院病理科，武汉 430060
- Publication Type:Journal Article
- Keywords:
Breast disease;
Intraoperative frozen pathological technique;
Pathological diagnosis;
Management
- From:
Chinese Journal of Endocrine Surgery
2025;19(5):651-655
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the reasons of misdiagnosed cases in the intraoperative frozen pathological diagnosis of breast disease and explore effective measures and practices for targeted and standardized quality control.Methods:A retrospective analysis was conducted on 2 421 cases of breast intraoperative frozen pathological examination performed at Renmin Hospital of Wuhan University from Apr. 2020 to Dec. 2021. The results of intraoperative frozen pathological examination were compared with postoperative pathological results to calculate the overall concordance rate and misdiagnosis rate. Pathological classification and causative analysis were performed for misdiagnosed cases. Standardized management was implemented to address the identified issues, and an analysis was conducted on 2248 cases from Feb. 2022 to Nov. 2023 to compare the overall concordance rate and misdiagnosis rate before and after management.Results:The comparison between intraoperative rapid frozen pathology diagnosis and postoperative paraffin pathology diagnosis showed that among the 2 421 breast specimens, there were 2 377 cases (98.18%) with concordant results and 44 cases of misdiagnosis, resulting in a misdiagnosis rate of 1.82%. The pathological types of 44 misdiagnosed cases were analyzed, among which 10 cases were lymph node metastatic carcinoma, 5 were lobar tumors, 3 were intraductal papillary tumors, 7 were carcinoma in situ and common hyperplasia each, and 4 were carcinoma in situ, sclerosing adenopathy, and other invasive carcinoma each. Through the analysis of causes, it was found that poor slide quality, the need for immunohistochemistry assistance, careless slide reading, missed critical lesions, and other factors contributed to misdiagnosis, with variations in the causes of misdiagnosis among different pathological types. After implementing standardized management, the overall concordance rate significantly improved (98.93%) and the misdiagnosis rate significantly decreased (1.07%) .Conclusions:Intraoperative frozen pathological diagnosis is of great significance in the treatment of breast diseases. The targeted standardized quality control can help early detection and solve problems, reduce the differences between different doctors and technicians, and improve the accuracy of intraoperative frozen pathological diagnosis.
