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Understanding Tumor Excision with Frozen Section

A tumor is a lump or mass of tissue in the body that's not normal. Tumor excision is surgery to remove a tumor.

Frozen section is a method that can be used during surgery. It can help the surgeon decide how much of a tumor needs to be removed and show that the margins (edges) don't have cancer cells.

Frozen section is not right for all patients. Be sure you understand how it works. Talk with your healthcare provider about the pros and cons of this procedure.

Why tumor excision with frozen section is done

A tumor can be harmless (benign). Or it can be cancer (malignant). To know which kind of tumor it is, a small piece of it can be taken out during surgery and checked in a lab. This way, the surgeon finds out if the tumor is cancer during the surgery. This helps the surgeon decide how much tissue to remove. Then a second surgery isn't needed.

Tissue is taken out until no cancer cells are seen in the margins (edges) of the tumor. This helps the surgeon remove all the cancer cells in that area. This makes it less likely that the cancer will come back there.

Frozen section can be very useful when removing a skin tumor. It allows the surgeon to remove the changed tissue until it's gone, and leave more healthy tissue in place.

How tumor excision with frozen section is done

  • Small needles might be used to inject numbing medicine (local anesthesia) around the tumor to numb the area. Or you may be given medicine through an IV (general anesthesia) to make you drowsy or asleep. This will keep you from feeling pain during the surgery.

  • The surgeon makes a cut (incision) in the skin over the area so that the tumor can be seen.

  • A tiny piece (sample) of the tumor is taken out. This is called a biopsy.

  • The sample is given to a healthcare provider who specializes in looking at tissues (called a pathologist). The pathologist freezes the sample quickly. It's cut into very thin slices and looked at under a microscope.

  • If another sample is needed, the surgeon may remove more of the tumor.

  • If the tumor isn't cancer (benign), the surgeon will not remove any more tissue. The surgery may end there.

  • If the tumor is cancer, all of it may be taken out. To be sure that all cancer is taken out, a margin of tissue around the tumor may also be removed. It will be checked to be sure there are no cancer cells in it.

The goal is for the pathologist to tell the surgeon whether the tumor is or isn't cancer during the surgery.

In some cases, it may not be possible to find cancer using frozen section. Instead, a different test may need to be done on the sample. This takes longer. Surgery will have to be ended. Then, if the tumor is then found to be cancer, a second surgery may need to be planned.

Risks of tumor excision with frozen section

  • Risks of anesthesia, like allergic reactions, nausea, confusion, and breathing problems

  • General risks of surgery, such as bleeding, infection, scarring, nerve damage, and pain

  • Need for a second surgery to take out more tissue

Online Medical Reviewer: Kimberly Stump-Sutliff RN MSN AOCNS
Online Medical Reviewer: Lu Cunningham RN BSN
Online Medical Reviewer: Michael Lehrer MD
Date Last Reviewed: 8/1/2019
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