Three-dimensional pathological size assessment in primary breast carcinoma

Area of Science:

• Oncology
• Pathology
• Radiology

Background:

• Maximal tumor diameter (MD) is a traditional prognostic factor in breast cancer.
• The predictive value of a single 1D measurement for a 3D tumor is questionable.

Purpose of the Study:

• To compare the prognostic accuracy of 1D and 3D tumor measurements for predicting axillary lymph node involvement (ALNI).
• To evaluate tumor volume (TV) and tumor surface area (TSA) as prognostic indicators in invasive breast carcinomas.

Main Methods:

• Calculated MD, two perpendicular diameters (PDs), eccentricity (EF), TV, and TSA for 395 invasive breast carcinomas (10-40 mm).
• Assessed ALNI as the dependent prognostic variable.
• Performed univariate and multivariate analyses to determine the predictive accuracy of each parameter.

Main Results:

• MD, TV, and TSA were all significant predictors of ALNI.
• Univariate analyses showed P-values of 0.0003 for MD, 0.0009 for TV, and <0.0001 for TSA.
• Multivariate analyses yielded P-values of 0.0018 for MD, 0.0109 for TV, and 0.0009 for TSA.
• Pseudo R-squared values were 0.42 for MD, 0.39 for TV, and 0.39 for TSA.
• Despite variations in tumor shape, 3D measurements (TV/TSA) did not demonstrate superior prognostic precision compared to 1D MD.

Conclusions:

• While MD, TV, and TSA are significant predictors of ALNI, 3D measurements do not offer improved prognostic accuracy over the traditional 1D MD.
• The study questions the sole reliance on 1D measurements for assessing breast cancer prognosis.