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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

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

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 < 0.001). Sonography had a concordance rate of 54.3 %, an overestimated rate of 9.8 %, and an underestimated rate of 35.9 %. For MRI, the concordance rate was 44.1 %, the overestimated rate was 52.5 %, and the underestimated rate was 3.4 %. In subgroup analysis, breast MRI had a higher concordance rate in patients with T3 (>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.

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References

  1. Grimsby GM, Gray R, Dueck A, et al. Is there concordance of invasive breast cancer pathologic tumor size with magnetic resonance imaging? Am J Surg. 2009;198:500–4.

    Article  PubMed  Google Scholar 

  2. Gruber IV, Rueckert M, Kagan KO, 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.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Kuroki Y, Nawano S, Hasebe T, et al. Efficacy of MR mammography (MRM) in providing preoperative locoregional information on breast cancer: correlation between MRM and histological findings. Magn Reson Med Sci. 2002;1:73–80.

    Article  PubMed  Google Scholar 

  4. Onesti JK, Mangus BE, Helmer SD, Osland JS. Breast cancer tumor size: correlation between magnetic resonance imaging and pathology measurements. Am J Surg. 2008;196:844–8.

    Article  PubMed  Google Scholar 

  5. Luparia A, Mariscotti G, Durando M, 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;118:1119–36.

    Article  PubMed  Google Scholar 

  6. Wasif N, Garreau J, Terando A, et al. MRI versus ultrasonography and mammography for preoperative assessment of breast cancer. Am Surg. 2009;75:970–5.

    PubMed  Google Scholar 

  7. Bosch AM, Kessels AG, Beets GL, et al. Preoperative estimation of the pathological breast tumour size by physical examination, mammography and ultrasound: a prospective study on 105 invasive tumours. Eur J Radiol. 2003;48:285–92.

    Article  PubMed  Google Scholar 

  8. Goldhirsch A, Wood WC, Coates AS, et al. Strategies for subtypes—dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer, 2011. Ann Oncol. 2011;22:1736–47.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Goldhirsch A, Winer EP, Coates AS, et al. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol. 2013;24:2206–23.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. American College of Radiology. Breast imaging reporting and data system atlas (BI-RADS atlas). 4th edition. Reston VA: American College of Radiology; 2003.

  11. Shen YC, Chang CJ, Hsu C, et al. Significant difference in the trends of female breast cancer incidence between Taiwanese and Caucasian Americans: implications from age-period-cohort analysis. Cancer Epidemiol Biomarkers Prev. 2005;14:1986–90.

    Article  PubMed  Google Scholar 

  12. Lee MM, Chang IY, Horng CF, et al. Breast cancer and dietary factors in Taiwanese women. Cancer Causes Control. 2005;16:929–37.

    Article  PubMed  Google Scholar 

  13. Kuhl CK, Schrading S, Bieling HB, et al. MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet. 2007;370:485–92.

    Article  PubMed  Google Scholar 

  14. Berg WA, Gutierrez L, NessAiver MS, et al. Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology. 2004;233:830–49.

    Article  PubMed  Google Scholar 

  15. Weinstein SP, Orel SG, Heller R, et al. MR imaging of the breast in patients with invasive lobular carcinoma. Am J Roentgenol. 2001;176:399–406.

    Article  CAS  PubMed  Google Scholar 

  16. Hieken TJ, Harrison J, Herreros J, Velasco JM. Correlating sonography, mammography, and pathology in the assessment of breast cancer size. Am J Surg. 2001;182:351–4.

  17. Bae MS, Seo M, Kim KG, et al. Quantitative MRI morphology of invasive breast cancer: correlation with immunohistochemical biomarkers and subtypes. Acta Radiol. 2014. doi:10.1177/0284185114524197.

  18. Kawashima H, Inokuchi M, Furukawa H, et al. Magnetic resonance imaging features of breast cancer according to intrinsic subtypes: correlations with neoadjuvant chemotherapy effects. Springerplus. 2014;3:240.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Nakahara H, Yasuda Y, Machida E, et al. MR and US imaging for breast cancer patients who underwent conservation surgery after neoadjuvant chemotherapy: comparison of triple negative breast cancer and other intrinsic subtypes. Breast Cancer. 2011;18:152–60.

    Article  PubMed  Google Scholar 

  20. Richard R, Thomassin I, Chapellier M, et al. Diffusion-weighted MRI in pretreatment prediction of response to neoadjuvant chemotherapy in patients with breast cancer. Eur Radiol. 2013;23:2420–31.

    Article  PubMed  Google Scholar 

  21. Martincich L, Deantoni V, Bertotto I, et al. Correlations between diffusion-weighted imaging and breast cancer biomarkers. Eur Radiol. 2012;22:1519–28.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Dr. Ping-Yi Lin for her assistance in the statistics of the data.

Conflict of interest

The authors declare no conflict of interest.

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Author notes

    Authors and Affiliations

    1. Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua, Taiwan

      Hung-Wen Lai MD, PhD & Dar-Ren Chen MD

    2. Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan

      Hung-Wen Lai MD, PhD, Dar-Ren Chen MD, Yao-Chung Wu MD, Shou-Jen Kuo MD & Shou-Tung Chen MD

    3. Comprehensive Breast Cancer Center, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan

      Hung-Wen Lai MD, PhD, Dar-Ren Chen MD, Yao-Chung Wu MD, Shou-Jen Kuo MD & Shou-Tung Chen MD

    4. School of Medicine, National Yang Ming University, Taipei, Taiwan

      Hung-Wen Lai MD, PhD

    5. Department of Surgical Pathology, Changhua Christian Hospital, Changhua, Taiwan

      Chih-Jung Chen MD, PhD

    6. School of Medicine, Chung Shan Medical University, Taichung, Taiwan

      Chih-Jung Chen MD, PhD

    7. Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan

      Chih-Jung Chen MD, PhD

    8. Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan

      Chih-Wei Lee MD & Hwa-Koon Wu MD

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    1. Hung-Wen Lai MD, PhD
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    Correspondence to Shou-Tung Chen MD or Hwa-Koon Wu MD.

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    Lai, HW., Chen, DR., Wu, YC. 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 22, 3816–3823 (2015). https://doi.org/10.1245/s10434-015-4424-4

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    • DOI: https://doi.org/10.1245/s10434-015-4424-4

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