Preoperative measurement of breast cancer overestimates tumor size compared to pathological measurement

PLoS One. 2014 Jan 29;9(1):e86676. doi: 10.1371/journal.pone.0086676. eCollection 2014.

Abstract

Background: Tumor size is one of the most important factors in making clinical and pathological assessment of breast cancer. In the present study, we aimed to determine whether the preoperative measurement of tumor size, by imaging modalities, deviate from the postoperative pathological measurement in breast cancer.

Patients and methods: 1296 patients diagnosed with invasive ductal breast carcinoma (IDC) during 2007 and 2009 were involved. Pre- and postoperative measurements of tumor size were compared using paired t-test and Chi-square test.

Results: The mean maximum diameters of tumors by imaging modalities and pathology were 27.9 mm and 22.4 mm, respectively. There was a statistically significant difference of 5.5 mm (95% CI: 4.7-6.2, p<0.001) between them. The discordance between pre- and post-surgical measurements of tumor size had significant effect on choosing surgery type, causing less application of breast conserving therapy (p<0.0001).

Conclusion: Compared to pathological size, preoperative measurement by imaging modalities tends to overestimate tumor size. These differences could have implications in the treatment of patients with breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breast / pathology*
  • Carcinoma, Ductal, Breast / diagnosis
  • Carcinoma, Ductal, Breast / diagnostic imaging
  • Carcinoma, Ductal, Breast / mortality
  • Carcinoma, Ductal, Breast / pathology*
  • Female
  • Humans
  • Mammography
  • Middle Aged
  • Neoplasm Grading
  • Preoperative Period
  • Retrospective Studies
  • Survival Analysis
  • Tumor Burden

Grants and funding

This research was supported by grants from the National Natural Science Foundation of China (81001169), the Shanghai United Developing Technology Project of Municipal Hospitals (SHDC12010116), the Shanghai Key Laboratory of Breast Cancer (12DZ2260100), and the Zhuo-Xue Project of Fudan University (For Y.K.D.). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.