Frozen Sections in Decision-Making Regarding the Axillary Procedures in Breast Conserving Surgery for Intraductal Carcinoma at Preoperative Diagnosis

Background@#Axillary evaluation is unnecessary for pure ductal carcinoma in situ (DCIS);however, it is performed because of the risk of upstaging to invasive cancer. We assessed the role of intraoperative frozen section (IOF) biopsy in reducing invasive cancer upstaging and axillary evaluation in preoperative DCIS patients. @*Methods@#We reviewed patients with preoperative DCIS who underwent breast-conserving surgery (BCS) with IOF biopsy. Positive IOF biopsy findings were defined as the presence of invasive or micro-invasive cancer. The IOF biopsy and permanent pathology findings were compared. @*Results@#Seventy-eight patients underwent BCS with IOF biopsy. Six patients showed positive IOF biopsy findings; five of these patients showed concordant permanent pathology findings.Sentinel lymph node biopsy (SLNB) was positive in one patient. Thirteen patients with invasive breast cancer were missed by IOF biopsy; they underwent SLNB during the second surgery. None of them had metastatic lymph nodes. The sensitivity and specificity of IOF biopsy were 27.7% and 98.3%, respectively, with 82.1% accuracy. None of the other factors showed statistically significant relationships with the permanent pathology findings, except for the IOF biopsy findings. @*Conclusion@#IOF evaluation can aid in detecting the invasiveness of tumors in patients with preoperative DCIS.

Influence of pediatric disease severity on parental report of children admitted in a tertiary care center PICU

The objective of this study was to assess influence of the severity of diseases on parental assessment of their child's health care issues. A cross-sectional study. Pediatric ward [PW]/ Pediatric Intensive Care Unit [PICU] at a 1000 plus bed University affiliated hospital. During the study period of 45 days, we offered the parents/guardians of all children who had been hospitalized for 5 to 10 days to participate and provide responses to 37 items that were divided in five categories. The participants [n=99] comprised of two groups: PICU [n=35] and PW [n=64]. Responses were analyzed using SPSS statistical software; differences were considered significant at P