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Comparing the diagnostic efficacy of optical coherence tomography and frozen section for margin assessment in breast-conserving surgery: a meta-analysis
  1. Shishun Fan,
  2. Huirui Zhang,
  3. Zhenyu Meng,
  4. Ang Li,
  5. Yuqing Luo,
  6. Yueping Liu
  1. Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
  1. Correspondence to Dr Yueping Liu, Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; annama{at}163.com

Abstract

Aims This meta-analysis assessed the relative diagnostic accuracy of optical coherence tomography (OCT) versus frozen section (FS) in evaluating surgical margins during breast-conserving procedures.

Methods PubMed and Embase were searched for relevant studies published up to October 2023. The inclusion criteria encompassed studies evaluating the diagnostic accuracy of OCT or FS in patients undergoing breast-conserving surgery. Sensitivity and specificity were analysed using the DerSimonian and Laird method and subsequently transformed through the Freeman-Tukey double inverse sine method.

Results The meta-analysis encompassed 36 articles, comprising 16 studies on OCT and 20 on FS, involving 10 289 specimens from 8058 patients. The overall sensitivity of OCT was 0.93 (95% CI: 0.90 to 0.96), surpassing that of FS, which was 0.82 (95% CI: 0.71 to 0.92), indicating a significantly higher sensitivity for OCT (p=0.04). Conversely, the overall specificity of OCT was 0.89 (95% CI: 0.83 to 0.94), while FS exhibited a higher specificity at 0.97 (95% CI: 0.95 to 0.99), suggesting a superior specificity for FS (p<0.01).

Conclusions Our meta-analysis reveals that OCT offers superior sensitivity but inferior specificity compared with FS in assessing surgical margins in breast-conserving surgery patients. Further larger well-designed prospective studies are needed, especially those employing a head-to-head comparison design.

PROSPERO registration number CRD42023483751.

  • BREAST CANCER
  • Breast Diseases
  • Breast Neoplasms

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. The original findings discussed in this study can be found within the article. For further inquiries, please contact to the corresponding authors.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. The original findings discussed in this study can be found within the article. For further inquiries, please contact to the corresponding authors.

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Footnotes

  • Handling editor L C Collins.

  • Contributors SF and YL conceived and designed the study. ZM, AL and YL extracted the data. SF and HZ analysed the data, while SF wrote the first version of the manuscript. All authors contributed to the manuscript and approved the final version for submission. YL was the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.