Resection margins grossly free of tumor: Because of inherent sampling error, the fatty nature of margins, and the number of sections necessary for a thorough study, this evaluation is best performed on permanent sections. If there is a specific area of concern to the surgeon, or if the tumor grossly appears to approach a margin, a frozen section of that particular area may be indicated.
Mammographic calcifications: Frozen sections to check for the presence of mammographic calcifications should be avoided. Many of these lesions are small, and it may not be possible to perform a frozen section and still retain a sufficient amount of lesional tissue for permanent sections. Moreover, artifact resulting from freezing the specimen may make it extremely difficult, if not impossible, to accurately evaluate the permanent sections.
Mammographic density grossly suspicious for carcinoma: If the lesion is large enough, a piece may be submitted for frozen section. The remainder of the lesion is then submitted for permanent sections.
Lesions grossly 1 cm or less in greatest diameter: Frozen section should not be performed, since too much of the specimen will be lost, and freezing artifact may render interpretation of permanent sections difficult or impossible. Touch preps can be performed in this situation.
Re-excision specimens: Frozen sections are not necessary and should be performed only on the rare occasion when a margin of re-excision is grossly suspicious for involvement by malignancy.
Grossly papillary lesions: Frozen sections are not recommended since the frozen sections may be difficult to interpret, and freezing of the specimen may render accurate interpretation of the subsequent permanent sections difficult, if not impossible.