The accuracy of frozen pathology at time of hysterectomy in patients with complex atypical hyperplasia on preoperative biopsy

Objective The purpose of this work was to estimate the accuracy of frozen pathologic analysis, compared with final pathological diagnosis in patients with a preoperative diagnosis of endometrial complex atypical hyperplasia (CAH). Study Design We performed a retrospective review of frozen and final pathology in patients with a preoperative diagnosis of CAH from January 1987 through August 2004. Clinical and pathological information was obtained from patient charts. Results We identified 23 of 41 patients with diagnosis of CAH who had a frozen section. Nine of the frozen pathology results (39.1%) correlated with the final pathological diagnosis. In 14 of 23 of the cases (60.8%), the frozen and final pathology reports disagreed. Eight of 14 patients initially diagnosed with CAH by frozen section (57%) were diagnosed with endometrial adenocarcinoma on final pathology. Conclusion Our data suggest that intraoperative frozen analysis of the endometrium is not a reliable indicator of final pathology in patients with a preoperative diagnosis of CAH.