Comparison of Ultrasound and Mammography With Pathologic Examination in Determining the Size of Malignant Breast Masses
Estimation of breast tumor size is one of the most important diagnostic measures in determining the appropriate treatment. Mammography and ultrasound are the main methods for determining the size of breast tumors. The aim of this study was to compare the correlation between tumor size calculated by breast ultrasound and mammography with the results of pathologic measurements in malignant breast masses. Patients diagnosed with breast cancer by pathologic examination underwent mammography and ultrasound to determine the size of the tumor. The largest observed diameter in ultrasound and mammography was recorded as the tumor size. The mean (SD) tumor size measured by ultrasound (23.58±9.38 mm) was significantly less than the actual size based on histopathologic examination (28.87±11.17 mm) (P=0.008). However, there was no significant difference between the measurements performed between mammography (26.54±10.46 mm) and histopathology (P=0.18). The correlation coefficient between mammography and pathologic examination (r=0.61) was higher than the correlation coefficient between ultrasonography and pathology (r=0.5). Mammography, compared to breast ultrasound, had better accuracy in determining the size of malignant breast masses.
2. Meuwly JY. [Ultrasound for Breast Cancer Screening: an Effective Tool in a Personalized Screening]. Praxis (Bern 1994) 2015;104(25):1399-404.
3. Yu KD, Jiang YZ, Chen S, Cao ZG, Wu J, Shen ZZ, et al. Effect of large tumor size on cancer-specific mortality in node-negative breast cancer. Mayo Clin Proc 2012;87(12):1171-80.
4. Narod SA. Tumour size predicts long-term survival among women with lymph node-positive breast cancer. Curr Oncol 2012;19(5):249-53.
5. Baek SH, Choi WJ, Cha JH, Kim HH, Shin HJ, Chae EY. Comparison of mammography, ultrasound, and MRI in size assessment of ductal carcinoma in situ with histopathologic correlation. Acta Radiol 2017;58(12):1434-1441.
6. Wang JT, Chang LM, Song X, Zhao LX, Li JT, Zhang WG, et al. Comparison of primary breast cancer size by mammography and sonography. Asian Pac J Cancer Prev 2014;15(22):9759-61.
7. Scoggins ME, Fox PS, Kuerer HM, Rauch GM, Benveniste AP, Park YM, et al. Correlation between sonographic findings and clinicopathologic and biologic features of pure ductal carcinoma in situ in 691 patients. AJR Am J Roentgenol 2015;204(4):878-88.
8. Eichler C, Abrar S, Puppe J, Arndt M, Ohlinger R, Hahn M, et al. Detection of Ductal Carcinoma In Situ by Ultrasound and Mammography: Size-dependent Inaccuracy. Anticancer Res 2017;37(9):5065-5070.
9. Gruber IV, Rueckert M, Kagan KO, Staebler A, Siegmann KC, Hartkopf A, et al. Measurement of tumour size with mammography, sonography and magnetic resonance imaging as compared to histological tumour size in primary breast cancer. BMC Cancer 2013;13:328.
10. Daniel OK, Lim SM, Kim JH, Park HS, Park S, Kim SI. Preoperative prediction of the size of pure ductal carcinoma in situ using three imaging modalities as compared to histopathological size: does magnetic resonance imaging add value? Breast Cancer Res Treat 2017;164(2):437-444.
11. Luparia A, Mariscotti G, Durando M, Ciatto S, Bosco D, Campanino PP, et al. Accuracy of tumour size assessment in the preoperative staging of breast cancer: comparison of digital mammography, tomosynthesis, ultrasound and MRI. Radiol Med 2013;118(7):1119-36.
12. Haraldsdottir KH, Jonsson T, Halldorsdottir AB, Tranberg KG, Asgeirsson KS. Tumor Size of Invasive Breast Cancer on Magnetic Resonance Imaging and Conventional Imaging (Mammogram/Ultrasound): Comparison with Pathological Size and Clinical Implications. Scand J Surg 2017;106(1):68-73.
13. Leddy R, Irshad A, Metcalfe A, Mabalam P, Abid A, Ackerman S, et al. Comparative accuracy of preoperative tumor size assessment on mammography, sonography, and MRI: Is the accuracy affected by breast density or cancer subtype? J Clin Ultrasound 2016;44(1):17-25.
14. Lai HW, Chen DR, Wu YC, Chen CJ, Lee CW, Kuo SJ, et al. Comparison of the Diagnostic Accuracy of Magnetic Resonance Imaging with Sonography in the Prediction of Breast Cancer Tumor Size: A Concordance Analysis with Histopathologically Determined Tumor Size. Ann Surg Oncol 2015;22(12):3816-23.
15. Dummin LJ, Cox M, Plant L. Prediction of breast tumor size by mammography and sonography--A breast screen experience. Breast 2007;16(1):38-46.
16. Wasif N, Garreau J, Terando A, Kirsch D, Mund DF, Giuliano AE. MRI versus ultrasonography and mammography for preoperative assessment of breast cancer. Am Surg 2009;75(10):970-5.
17. Ramirez SI, Scholle M, Buckmaster J, Paley RH, Kowdley GC. Breast cancer tumor size assessment with mammography, ultrasonography, and magnetic resonance imaging at a community based multidisciplinary breast center. Am Surg 2012;78(4):440-6.
18. Cortadellas T, Argacha P, Acosta J, Rabasa J, Peiro R, Gomez M, et al. Estimation of tumor size in breast cancer comparing clinical examination, mammography, ultrasound and MRI-correlation with the pathological analysis of the surgical specimen. Gland Surg 2017;6(4):330-335.
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