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

• Published in: Annals of surgical oncology 2015-11, Vol.22 (12), p.3816-3823
• Main Authors: Lai, Hung-Wen, Chen, Dar-Ren, Wu, Yao-Chung, Chen, Chih-Jung, Lee, Chih-Wei, Kuo, Shou-Jen, Chen, Shou-Tung, Wu, Hwa-Koon
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Breast Neoplasms - diagnosis; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breast Neoplasms, Male - diagnosis; Breast Neoplasms, Male - diagnostic imaging; Breast Neoplasms, Male - pathology; Breast Neoplasms, Male - surgery; Breast Oncology; Carcinoma, Ductal, Breast - diagnosis; Carcinoma, Ductal, Breast - diagnostic imaging; Carcinoma, Ductal, Breast - pathology; Carcinoma, Ductal, Breast - surgery; Carcinoma, Intraductal, Noninfiltrating - diagnosis; Carcinoma, Intraductal, Noninfiltrating - pathology; Carcinoma, Intraductal, Noninfiltrating - surgery; Carcinoma, Intraductal, Noninfiltrating - ultrastructure; Carcinoma, Lobular - diagnosis; Carcinoma, Lobular - diagnostic imaging; Carcinoma, Lobular - pathology; Carcinoma, Lobular - surgery; Female; Humans; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Retrospective Studies; Surgery; Surgical Oncology; Tumor Burden; Ultrasonography; Young Adult
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-015-4424-4

Background In order to effectively treat patients with breast cancer, it is important to know the precise tumor size. We compared the rates of concordance of magnetic resonance imaging (MRI)-derived and sonography-derived breast cancer tumor size with histopathologically determined tumor size. Methods Accuracy of MRI and sonography in establishing tumor size was evaluated by comparing preoperative images with postoperative pathologic findings. The accuracy of MRI and sonography was graded as concordance, underestimation, or overestimation and was compared in different subgroups. Results A total of 682 patients comprised the study cohort. Mean tumor size was 3.64 ± 1.8 cm via MRI, 2.12 ± 1.0 cm via sonography, and 2.78 ± 1.7 cm via pathologic examination. The difference between breast sonography and MRI to pathologic tumor field size was −0.68 ± 1.4, and 0.85 ± 1.25 cm, respectively ( P  5 cm) lesions. When the results of MRI and sonography were considered together, the concordance rate increased from 54.3 to 62.2 %. Conclusion MRI tends to overestimate the actual tumor size, while sonography frequently underestimates it. Combined sonography and MRI increases the accuracy of tumor size prediction.