Background: This study aimed to evaluate the relationship of tumor size and ultrasound (US) Breast Imaging Reporting and Data System (BI-RADS), and further analyze if tumor size can impact the evaluation for US features in patients with breast cancer. Materials and Methods: In this retrospective study, preoperative US features and postoperative pathological results were collected from 498 patients with breast cancer. The association of BI-RADS classification with tumor size was analyzed, and the US features related to tumor size were determined. Results: A significant association was found between tumor size and BI-RADS category, and tumor with small size was classified into the low BI-RADS category (p < 0.05). Some US features including shape, growth orientation, microcalcification and color Doppler flow imaging (CDFI) were influenced by tumor size (p<0.001). Conclusion: Tumor size can influence the diagnosis performance for US BI-RADS category in patients with breast cancer.
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