Diagnostic accuracy and challenges of intraoperative frozen section evaluation for axillary sentinel lymph node biopsy and breast margins

IOE-FSLN and IOE-FSM showed high reliability in guiding intraoperative decisions for axillary lymph node dissection and achieving free surgical margins in one-stage surgeries. However, limitations include challenges in distinguishing metastatic carcinoma from benign mimics in FSLN and diagnosing certain features such as IBC with post-treatment changes, invasive lobular carcinoma in FSLN and FSM; IBC rich in tumour-infiltrating lymphocytes, low-grade (DCIS/IBC in FSM) without immunohistochemical studies.