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- Title
Factors affecting the concordance of radiologic and pathologic tumor size in breast carcinoma.
- Authors
Hamza, Ameer; Khawar, Sidrah; Sakhi, Ramen; Alrajjal, Ahmed; Miller, Shelby; Ibrar, Warda; Edens, Jacob; Salehi, Sajad; Ockner, Daniel
- Abstract
Background Radiologic assessment of tumor size is an integral part of the work-up for breast carcinoma. With improved radiologic equipment, surgical decision relies profoundly upon radiologic/clinical stage. We wanted to see the concordance between radiologic and pathologic tumor size to infer how accurate radiologic/clinical staging is. Materials and methods The surgical pathology and ultrasonography reports of patients with breast carcinoma were reviewed. Data were collected for 406 cases. Concordance was defined as a size difference within ±2 mm. Results The difference between radiologic and pathologic tumor size was within ±2 mm in 40.4% cases. The mean radiologic size was 1.73 ± 1.06 cm. The mean pathologic size was 1.84 ± 1.24 cm. A paired t-test showed a significant mean difference between radiologic and pathologic measurements (0.12 ± 1.03 cm, p = 0.03). Despite the size difference, stage classification was the same in 59.9% of cases. Radiologic size overestimated stage in 14.5% of cases and underestimated stage in 25.6% of cases. The concordance rate was significantly higher for tumors ≤2 cm (pT1) (51.1%) as compared to those greater than 2 cm (≥pT2) (19.7%) (p < 0.0001). Significantly more lumpectomy specimens (47.5%) had concordance when compared to mastectomy specimens (29.8%) (p < 0.0001). Invasive ductal carcinoma had better concordance compared to other tumors (p = 0.02). Conclusion Mean pathologic tumor size was significantly different from mean radiologic tumor size. Concordance was in just over 40% of cases and the stage classification was the same in about 60% of cases only. Therefore, surgical decision of lumpectomy versus mastectomy based on radiologic tumor size may not always be accurate.
- Subjects
BREAST tumor diagnosis; COLLECTION &; preservation of biological specimens; BREAST cancer; BREAST tumors; CANCER patients; DIAGNOSTIC imaging; MASTECTOMY; REFERENCE values; T-test (Statistics); TUMOR classification; ULTRASONIC imaging; LUMPECTOMY; DUCTAL carcinoma
- Publication
Ultrasound, 2019, Vol 27, Issue 1, p45
- ISSN
1742-271X
- Publication type
Article
- DOI
10.1177/1742271X18804278