# Frozen Section



## Eliza79 (Jul 23, 2013)

For those of you who had a PT or a TT and a frozen section during surgery, how often was the frozen section pathology confirmed, or disputed, by the final pathology?

I had a PT yesterday and the "follicular neoplasm" on my right lobe, and the lobe itself, removed. My surgeon said pathology is really spot on in most cases and he is confident my nodule will end up being benign. But they won't know for sure until next week. My family is thrilled and wants me to be upbeat but I am a little hesitant about counting my chicks before they hatch, so to speak!

I'm hoping for good results but don't want to be shocked just in case they do find something else. And I know follicular nodules are weird because they have to do a careful study of vascular/capsule invasion before knowing for sure.


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## Octavia (Aug 1, 2011)

My surgeon told me in advance that the frozen section is inaccurate frequently enough that even if it came back positive during the surgery, he would leave my other lobe in, unless the pathology left absolutely no doubt.

That said, my frozen section was negative, but final pathology was positive.

Really, though, odds are in your favor. Keep us posted.


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## KarenB (Jul 19, 2013)

Well you know about my frozen section, and how it turned out, but I thought I would add my surgeon reiterated two things:

1. The chance of the nodule being benign was good, and there was only a 30% chance of it being malignant; and

2. IF it was indeed malignant, the frozen section was notoriously unreliable at showing this during surgery.

I am not going to tell you to try not to worry about the pathology results, because having been through this myself, I know exactly the mental craziness this is causing you right now and nothing I say will help that. HOWEVER, try to take heart that, according to the general advice, you would have to be in the unlucky 30% to have to go through the second surgery.

Hugs to you.


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## Eliza79 (Jul 23, 2013)

Thanks to both of you. Like my husband always says, I move from one worry to the next! I do realize the odds are in my favor that the nodule is benign, ESP since it is less than 2cm, but it is still hard not to dwell on it and anxiously await the final pathology. I read so many studies citing the lack of precision regarding frozen sections in cases of follicular neoplasms and other follicular cases. But my surgeon seemed so confident; he believes the pathologist's prelim report is very accurate in most cases. I hope so!

The surgery wouldn't be so scary to contemplate for the 2 nd time it I hadn't had such an awful experience with nausea, etc. for 24 hours after my procedure. That was utter hell. And they gave me every drug possible to reduce nausea before and after the surgery. Guess I am just unlucky!

Hope others are recovering well and feeling better day by day. I am fortunate my mom is here from out of state to help with the kids for a few days. My husband is happy for the help!


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## Eliza79 (Jul 23, 2013)

It does make me wonder why so many surgeons rely on frozen sections when they are often incorrect. They end up giving their patients a false sense of security...

Were both of you told after surgery 1, " yes, this is benign based on the FS and i'm confident the pathologist is correct" or were your surgeons more hesitant until the final results were in? My surgeon seemed very confident that mine is benign so it will be interesting to see if his hunch is right.


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## Octavia (Aug 1, 2011)

No, my surgeon said the frozen section was negative, but we'd have to wait for the official results, and he reiterated that the frozen section is unreliable.


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## Eliza79 (Jul 23, 2013)

Hmm, well then I guess it just depends on the surgeon's experience with, and faith in, frozen sections. My surgeon has near total confidence in the pathologist he works with but even a star pathologist isn't a miracle worker if he or she only has a small sample to work with in a short period of time!


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## catherinelyn (Jul 17, 2013)

Hi Eliza,

Praying for you that the final pathology is negative like the frozen section. Just wondering how you are doing a few days post op? I'm scheduled for a PT on August 13 and am starting to get really nervous. My surgeon is not doing a frozen section, so I'll have to go through 7-10 days of wating without any hopeful information.


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## Eliza79 (Jul 23, 2013)

Hi Catherine. Thanks for your well wishes. I am doing OK and can definitely say that i am seeing improvement each day. The first 24 hours were hard for me, mainly due to extreme nausea. The throat pain was no fun but the nausea was worse. Once that subsidized I have been able to focus more on letting my body heal. I feel best when I am lying in bed with pillows for neck support, and taking tylenol regularly and a stronger pain med at night has helped me get some sleep, too. I sleep for about an hour or two at a time. Today is day three and I am able to eat and drink normally.

I am sure you will be fine and if you are not cursed with excessive nausea you may find the experience to be better than you expected. And not having a frozen section is probably a good thing because they are often wrong. My husband and mother told everyone that I am cancer free based on their quick conversation with the surgeon about the frozen section. He didn't tell them that the benign report during surgery was essentially provisional. I hope he is right!!


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## KarenB (Jul 19, 2013)

Eliza79 said:


> Were both of you told after surgery 1, " yes, this is benign based on the FS and i'm confident the pathologist is correct" or were your surgeons more hesitant until the final results were in? My surgeon seemed very confident that mine is benign so it will be interesting to see if his hunch is right.


My surgeon sounded hesitant from the outset, when he gave me the news they didn't find anything during surgery. He clearly said he left me on the table longer than he normally would, and had the pathologist look for a solid 45 minutes. And he said 'I wasn't sure, but we'd only discussed taking half, so I took half'. He reiterated at least twice that the frozen section was never conclusive.

I had exactly the same problem with my husband and mum - as soon as they heard they didn't find anything, they started telling the whole world it was benign. But I said to my husband I felt like that might not be it - he told me I should be more positive 

When are you expecting your results, Eliza?


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## Eliza79 (Jul 23, 2013)

Yes, KarenB, I think our families believe we are being overly negative when we tell them to be cautious before having a no cancer celebration. And I suppose if we hadn't spent time researching thyroid issues and frozen sections, and talking to people here, we'd probably be very optimistic after surgery, too.

Although it sounds as though your surgeon had a bad feeling, as though based on the size, etc of the nodule he was expecting bad news and was surprised not to find it. That would have made me worry some. But, honestly, I worry regardless! My surgeon said he thinks everything is fine and there won't be any surprises and I am still anxious...should find out by tomorrow.

How are you feeling, by the way? Is your recovery after the 2nd surgery going well? I hope you are receiving a lot of love and support from your family. Today is day 5 for me and I slept through the night for the first time last night so that is good.


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## Velcro (Jul 26, 2013)

Glad you Ladies are feeling better. I almost think (hearing all these stories) that it would be better if the surgeons would start using different words with the families. I know they want to be reassuring but I think that causes more stress on the patients because then the family's see them as such pessimists.


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## KarenB (Jul 19, 2013)

I think he did have a bad feeling this wouldn't be it. Your surgeon sounds so confident, I'm sure you'll be fine!! I have fingers, toes and eyes crossed for you.

I am twelve days out from the second surgery now, and I'm doing okay! I have a horrible cold, so I'm pretty sure the headaches etc I've had the last 2 days are because of that. The muscle twitches etc have eased up a bit, but I'm still not sleeping well - it takes me a good two hours to get to sleep, and then I have broken sleep most of the night. I wake up very anxious - I'm hoping this will work itself out.

Today was my first full day back at work and it was pretty tiring. We had a full case work meeting at 3 and I was almost falling asleep by the end! I can't wait until this cold is done so I can work out properly how I'm feeling.

My swallowing is SO much better - it mechanically still feels 'interesting' but I have no problems and I'm eating totally normally. My neck movement is pretty much back to normal.

Endo appointment tomorrow to talk about monitoring levels and RAI treatment . I will post a proper update then!

I'm really glad to see from your posts you're doing well Eliza. I'm sure once you get your pathology results this will all be a mere speed bump!!


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## Eliza79 (Jul 23, 2013)

Was told last week that my surgeon would have the pathology report by Tuesday and definitely get in touch by Wednesday either way. Was also told I could get results by calling his nurse.

So I called over 2 hrs ago and was told the nurse would return my call but so far nothing. Hope she calls soon! I didn't feel that anxious about it until now.


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## Eliza79 (Jul 23, 2013)

Hooray, benign! I am lucky and relieved and hope others have similar results!

Going to take a nap now. I worked myself up today and actually cried when I received the good news. I was just so relieved...


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## catherinelyn (Jul 17, 2013)

Ohh, I so love to hear good news! I'm so happy for you--have a nice long peaceful nap so you can arty0006:arty0006:later!


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## joplin1975 (Jul 21, 2011)

YAYAYAYAYAYAY!!!!

Congrats! :-D


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## Eliza79 (Jul 23, 2013)

Thank you!! Waiting for results has been the hardest part of recovery. Waiting for the unknown is never fun...


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## Velcro (Jul 26, 2013)

Woot! Woot!


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## Octavia (Aug 1, 2011)

I'm so happy for you!!!! Congrats!!!

:hugs:


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## KarenB (Jul 19, 2013)

Eliza, I saw this before I went to work today, and it absolutely made my morning.

I am SO HAPPY for you. You can really just concentrate on getting properly well now


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## Eliza79 (Jul 23, 2013)

Thanks, Karen, you are sweet.  I was mentally prepared for the 2nd surgery, etc but obviously relieved when I found out all was well. I have two small children and have to start teaching in 10 days and so was doubly anxious about having to delay recovery. Honestly, though, I do feel lucky, even though I know the odds were technically in my favor, it sure didn't feel like it. And I am so sorry for all the others here who did have to go through thyroid cancer. You are all in my thoughts.


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## KarenB (Jul 19, 2013)

I can't even imagine doing this with kids - I think you're all amazing. I only have a husband and a very surly cat to take care of, and they're a pretty low maintenance bunch haha. Hopefully you're getting some help from the right places!


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