Background: Frozen section (FS) examination is a widely used intraoperative diagnostic technique that provides rapid histopathological assessment to guide surgical decision-making. However, its diagnostic performance across different tissue types remains an important clinical consideration. This study aimed to evaluate the diagnostic accuracy of FS in thyroid, breast, and ovarian specimens by comparing its results with permanent histopathological diagnoses.
Methods: This analytical cross-sectional study included 199 pathology records of thyroid, breast, and ovarian specimens collected from 2021 to 2024 at Shahid Rahimi Hospital, Khorramabad, Iran. Cases were selected using stratified simple random sampling. Frozen section results were compared with permanent histopathology, which was considered the gold standard. Diagnostic performance indices including sensitivity, specificity, positive predictive value, and negative predictive value were calculated using SPSS version 22.
Results: The mean age of patients was 47.35 ± 12.04 years, and most cases were female (96%). Breast specimens accounted for 67.8%, followed by thyroid (30.7%) and ovarian (1.5%) samples. FS showed complete concordance with permanent histopathology, with no false-positive or false-negative cases identified. Accordingly, sensitivity, specificity, PPV, and NPV were all 100% across all specimen types.
Conclusion: Frozen section examination demonstrated high diagnostic accuracy and complete concordance with permanent histopathology in thyroid, breast, and ovarian specimens. FS remains a reliable intraoperative tool that supports surgical decision-making, although its limitations in specific tumor types highlight the continued importance of permanent section diagnosis.
Implications for Patient Care: Frozen section (FS) examination may support intraoperative decision-making by providing rapid histopathological information, helping guide the extent of surgery and potentially reducing reoperations. FS results should be interpreted with clinical, radiological, and permanent histopathological findings, especially in challenging cases. Overall, FS may enhance surgical efficiency and support individualized patient care.