Background Breast carcinoma is the most common malignancy in women worldwide. Intraoperative frozen section of SLNs can detect metastatic disease, allowing immediate axillary dissection and avoiding the need for reoperation, at the same time it avoids unnecessary dissection of uninvolved LNs.

Aim of the study
1. To evaluate the current role of frozen section in identifying patients who could benefit from it.
2. To verify the accuracy of intraoperative frozen section examination for SLNs.

Materials and methods In this combined retrospective and prospective study, we reviewed the outcome for 33 female patients with breast cancer who underwent intraoperative SLN biopsy, at (Al-Shariqa laboratory) and (Ghazi Al-Hariri Hospital, Medical City) Baghdad, Iraq. and compared it with the permanent H&E sections, covering the period between Jan.2019 and Jan.2021

Results: The patients age was ranging from 32 to 79 years with a mean of 50.7 years and the highest proportion was ≥ 40 years (90%).
Only 10 patients (30.3%) of the total cases were diagnosed as having POSITIVE SLNs by intraoperative frozen section examination, while 23 patients (69.7%) had NEGATIVE SLNs. Nine of them (90%) were of ductal type, while only 1 case (10%) was of lobular type. all 10 cases (100%), the primary tumor size measured >2cm, (i.e: pT2). Validity of frozen section examination in comparison with permanent sections showed a sensitivity and specificity of 100%.

Conclusions: Intraoperative frozen section evaluation of SLN biopsy is a reliable method, it offers a high sensitivity, specificity and diagnostic accuracy when compared with permanent section