Predicting Breast Tumor Size for Pre-operative Planning: Which Imaging Modality is Best?

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Accurate breast tumor size estimation is crucial for treatment planning and prognosis.
• Discrepancies between imaging-predicted and pathologic tumor size can impact clinical decisions.

Purpose of the Study:

• To compare the accuracy of different imaging modalities in predicting breast tumor size against final pathologic measurements.
• To determine the optimal imaging modality for estimating tumor dimensions in invasive ductal (IDC) and invasive lobular (ILC) carcinomas.

Main Methods:

• Retrospective analysis of 261 patients with biopsy-proven IDC and/or ILC.
• Correlation of imaging-predicted tumor dimensions (ultrasound, MRI, mammography, clinical breast exam) with final pathologic size.
• Statistical analysis using Spearman correlations, Zou's method, and McNemar's test.

Main Results:

• Magnetic resonance imaging (MRI) and ultrasound showed strong correlations with pathologic tumor size (r=0.76 and r=0.71, respectively).
• Correlations for MRI and ultrasound were significantly stronger than for mammography or clinical breast exam (p < 0.05).
• No significant difference in correlation was found between MRI and ultrasound.

Conclusions:

• MRI and ultrasound are superior to mammography and clinical breast exam for accurately estimating breast tumor size.
• Both MRI and ultrasound demonstrate strong correlations with pathologic size across different tumor grades and types (IDC/ILC).
• These findings support the use of MRI and ultrasound for more precise tumor size assessment in breast cancer management.