Supine versus Prone 3D Abus Accuracy in Breast Tumor Size Evaluation

Area of Science:

• Medical Imaging
• Oncology
• Surgical Oncology

Background:

• Breast-conserving surgery (BCS) relies on accurate tumor size assessment for effective locoregional control.
• Tumor size is a critical factor in breast cancer staging (Tumor-Node-Metastasis or TNM).
• Current imaging modalities may have limitations in precisely measuring tumor dimensions.

Purpose of the Study:

• To compare the accuracy of supine 3D automated breast ultrasound (3D ABUS) versus prone 3D ABUS in evaluating breast tumor size.
• To assess the utility of supine 3D ABUS in patients considered for BCS.
• To determine if supine 3D ABUS offers improved accuracy over hand-held ultrasound (HHUS).

Main Methods:

• Prospective two-center study enrolling 88 patients with biopsy-proven early-stage breast cancer.
• Patients underwent hand-held ultrasound (HHUS), contrast-enhanced MRI (CE-MRI), and 3D ABUS (supine in Group 1, prone in Group 2).
• Histopathological examination (HE) served as the reference standard; Bland-Altman analysis was employed.

Main Results:

• Supine 3D ABUS demonstrated better agreement with histopathology compared to prone 3D ABUS.
• A slight tendency towards underestimation of tumor size was observed with supine 3D ABUS (mean difference -2 mm).
• Supine 3D ABUS showed greater accuracy than HHUS for breast cancer staging.

Conclusions:

• Supine 3D ABUS is a valuable tool for accurate breast tumor size evaluation.
• This technique offers improved accuracy over traditional HHUS in the context of BCS candidacy.
• Precise tumor measurement using supine 3D ABUS can enhance breast cancer staging and surgical planning.