BACKGROUND: There has been no published study estimating the proportion of positive surgical margins that is missed when serial transverse cross-sectioning (bread-loafing) is used to histologically evaluate the surgical margins. OBJECTIVE: Our purpose was to estimate the accuracy of serial transverse cross-sectioning (bread-loafing) at 4-mm intervals in detecting the presence of @entity41 at the margins of well-defined @entity1491 excised as an @entity7085 with 2-mm surgical margins. METHODS: Forty-two small (<1 cm), well-defined, primary, nonmorpheaform @entity1491 that had been excised as an @entity7085 with 2-mm margins and that had positive surgical margins utilizing en-face Mohs sections were included. After longitudinal bisection of each @entity7085 , frozen sections were prepared encompassing the entire surgical margin. Transparencies with parallel lines spaced at 4-mm intervals were superimposed on the histologic slides with the lines perpendicular to the epidermal surface. Areas in which the lines intersected @entity5 at the surgical margin were noted. The percentage of @entity5 that would be detected by serial cross sections was calculated on the basis of the percentage of these parallel lines that intersected @entity5 . RESULTS: The 42 @entity5 had a total of 50 positive surgical margins. Overall, the cross-sectional lines intersected @entity5 44% of the time (95% confidence interval, 37%-51%). Only 5 (10%) of the @entity41 at the surgical margins exceeded 4 mm in their longitudinal dimension. In the 9 sections containing @entity5 in the deep margin, @entity5 intersected the lines 39% of the time. CONCLUSION: Bread-loafing at 4-mm intervals of elliptical excision specimens from @entity1491 excised with 2-mm surgical margins is only 44% sensitive in detecting @entity41 at the surgical margins. We recommend complete histologic margin control by using en face tissue orientation (Mohs technique) to identify @entity41 and reduce the risk of @entity5 recurrence after elliptical excision of @entity1491 .

Accuracy of serial transverse cross-sections in detecting XXXX at the surgical margins of an elliptical excision specimen.

@entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity7085 :: ('301928', 'Species') :: ['ellipse'] @entity41 :: ('MESH:D018365', 'Disease') :: ['residual tumors', 'residual tumor'] @entity1491 :: ('MESH:D002280', 'Disease') :: ['facial basal cell carcinomas']
@entity1491 :: (MESH:D002280,Disease) :: ['residual basal cell carcinoma']
