Estudo conduzido com o objetivo de avaliar a confiabilidade, acurácia e dificuldades do exame de congelação, utilizando-se pequenos fragmentos de tumores mamários obtidos com a biópsia histológica por agulha grossa (bioptycut). Durante 13 meses, 37 pacientes foram submetidas ao Bioptycut (pistola BIP 2.2 ou Promag 1.2, agulhas l4G), sendo que, de cada uma delas, foram retirados no mínimo dois fragmentos, um a fresco para congelação e outro submerso em formol para inclusão posterior em parafina. O estudo de congelação constituiu-se de exame citológico do "imprimir" da peça e de exame histológico usando cortes através de congelação. Os cortes foram feitos usando criostato e micrótomo, com cortes de 8µ. O tamanho do tumor puncionado variou de 1cm a 12cm (média 4,8cm). A congelação foi conclusiva em 33 casos (89%), sendo trinta carcinomas e três benignos, e inconclusiva em quatro casos (11%). A obtenção deste dia:nóstico se deu pelo "imprint" e corte em 29 casos (78%), só pelo "imprint" em quatro casos (11 %), em dois casos tanto o corte quanto o "imprint" foram inadequados e dois não foram descritos. Posteriormente foram obtidas peças por exérese da lesão (até a análise) em 28 casos, dos quais 25 carcinomas e três tumores benignos (11 %). Houve um caso de congelação conclusiva de benignidade, em que a exérese posterior revelou se tratar de carcinoma (falso-negativo). Não houve falsos-positivos. A sensibilidade foi de 96% e a especificidade de 100%. Assim, conclui-se que o exame por congelação, usando-se peças obtidas com bioptycut se mostrou confiável, evitando biópsias abertas em 81 % dos casos, garantindo rapidez e melhor preparo das pacientes para terapêutica definitiva.
A prospective study was carried out to evaluate the reliability, accuracy and difficulties of froozen section, by using small fragments of breast tumors obtained through core needle biopsy. During 13 months, 37 patients with breast lumps underwent core needle biopsy (bioptycut), using two types of guns of 2.2 and 1.2, with 14G needles. At least two specimens were taken from each of these patients: one was kept fresh, for froozen section, and the other was immersed in formal saline to be later imbedded in paraffin. The froozen section constitutes in a cytological examination of the imprinting of the sample and of a histological examination using cuts made by freezing. The 8-m cuts were made with cryostat and microtome. The tumor size ranged from 1 to 12cm (average 4.8cm). Froozen section was conclusive in 33 cases (89%): thirty were carcinomas and three benign tumors. In four cases (11 %) this test was not conclusive. This diagnosis was achieved by imprint and cut in 29 cases (78%), only by imprint in four cases (11%). In two cases both the cut and the imprint were inadequate. Two cases were not described. Later, 28 samples were obtained through exeresis of the lesions (until analysis). Twenty-five were found to be carcinomas, while three were benign tumors (11 %). There was a conclusive case of benign diagnosis through the froozen section which the later exeresis proved that it was a carcinoma (false negative). There were no false positive cases. Sensitivity was of 96% and specificity was of 1 00%. It is concluded that the froozen section, using small samples obtained through bioptycut was shown to be reliable, and in 81 % of the cases open biopsies were avoided. This ensured a faster definite therapy and better patient preparation.