Affiliations: [a] Department of Surgery, St. Vincent’s Medical Center, Toledo, OH, USA | [b] Department of Surgery, Mercy Health St. Vincent Medical Center, Toledo, OH, USA | [c] Department of Diagnostic Radiology, St. Vincent Medical Center, Toledo, OH, USA | [d] Department of Graduate Medical Education, Mercy Health St. Vincent Medical Center, Toledo, OH, USA | [e] Buderer Drug Co, Perrysburg, OH, USA
Correspondence:
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Corresponding author: Olutayo Sogunro, D.O., M.S., Department of Surgery, Hartford HealthCare: St. Vincent’s Medical Center, 2800 Main Street, Bridgeport, CT 06606, USA. Tel.: +1 475 210 5436; Fax: +1 203 581 6512; E-mail: olutayosogunro@yahoo.com
Abstract: BACKGROUND:Of the most common imaging modalities for breast cancer diagnosis – mammogram (MAM), ultrasound (US), magnetic resonance imaging (MRI) – it has not been well established which of these most accurately corresponds to the histological tumor size. OBJECTIVE:To determine which imaging modality (MAM, US, MRI) is most accurate for determining the histological tumor size of breast lesions. METHODS:A retrospective study of 76 breast cancers found in 73 female patients who received MAM, US, and/or MRI was performed. 239 charts were reviewed and 73 patients met inclusion criteria. Analysis was performed using signed rank tests comparing the reported tumor size on the imaging modality to the tumor size on pathology report. RESULTS:Mammography and ultrasonography underestimated tumor size by 3.5 mm and 4 mm (p-values < 0.002), respectively. MRI tends to overestimate tumor size by 3 mm (p-value = 0.0570). Mammogram was equivalent to pathological size within 1 mm 24% of the time and within 2 mm 35% of the time. CONCLUSIONS:No one single modality is the most accurate for detecting tumor size. When interpreting the size reported on breast imaging modalities, the amount of underestimation and overestimation in tumor size should be considered for both clinical staging and surgical decision-making.
Keywords: Breast cancer, tumor, size, accurate, imaging, mammogram, ultrasound, MRI
DOI: 10.3233/BD-201021
Journal: Breast Disease, vol. 40, no. 3, pp. 177-182, 2021
