Accurate Estimation of Breast Tumor Size: A Comparison Between Ultrasonography, Mammography, Magnetic Resonance Imaging, and Associated Contributing Factors

Abstract

Breast cancer is the second most common cause of cancer-related mortality in women worldwide, with a lifetime risk of approximately 12% (1). Tumor size is one of the main prognostic factors in breast cancer and is reported to correlate with lymph node involvement, tumor grade, and overall survival rate (2). Tumor size is also a factor assessed to determine treatment plans: breast conservation, mastectomy, or neoadjuvant chemotherapy (3). Accordingly, precise estimation of tumor size is of utmost importance for planning a therapeutic strategy, and the main imaging modalities are mammogram (MGM), ultrasound (US), and magnetic resonance imaging (MRI). Each of these modalities has certain strengths and weaknesses in breast tumor evaluation. For instance, MGM is superior in identifying malignant calcifications; however, the obscurity of the margins and magnification variability limits the accuracy of measurements by this method (4). The sensitivity of MGM to detect malignant lesions in younger patients with dense breast tissue is also reported to be poor (5, 6). As for US, its ability to measure tumors in multiple planes is a great strength that enables a skilled operator to make measurements of its largest dimension (7). However, one main limitation of US is that it is highly operator dependent (8). MRI also offers the merit of multiplanar imaging along with a higher accuracy in assessing multicentric and multifocal lesions (9, 10); however, MRI has been reported to overestimate tumor size (9, 11), and the extent of background parenchymal enhancement (BPE) affects its accuracy (12).In this regard, studies have assessed the accuracy of tumor size estimation by MGM and US (11,[13][14][15], and compared their measurements with those by MRI (10,16,17). In comparing US and MGM, some studies have reported that US has a higher accuracy than MGM (7, 11,

Machine Learning to Predict the Need for Postmastectomy Radiotherapy after Immediate Breast Reconstruction

“…Maximal tumor dimension from any imaging modality was used in the model given that mammogram, ultrasound, and MRI differ in their accuracy of tumor size estimation. 63 Interestingly, ultrasound as an initial diagnostic modality was most predictive when compared with other modalities, which may be explained by the underestimation of size with mammogram and overestimation of size with MRI. 63,64…”

“…63 Interestingly, ultrasound as an initial diagnostic modality was most predictive when compared with other modalities, which may be explained by the underestimation of size with mammogram and overestimation of size with MRI. 63,64…”

Ultrasound classification of non-mass breast lesions following BI-RADS presents high positive predictive value

“…The size of breast carcinomas is an important variable for clinical management, metastasis, and prognosis, and inadequate measurement may be misleading [ 14 ]. Because taking an accurate measurement in breast NMLs is difficult, no size measurement was performed in our study.…”

Nanoparticle-Based Techniques for Bladder Cancer Imaging: A Review

“…In recent years, the availability of increasing magnetic field intensity significantly improved image quality. Moreover, the 3D measure of tumor volume makes it possible to stage the cancer or monitor the response in terms of mass reduction following therapeutic treatments [ 39 , 40 , 41 , 42 ]. Many NPs have been developed to be used in MRI as contrast agents or diagnostic biosensors, for hyperthermia therapy, or for targeted drug or gene delivery [ 43 , 44 , 45 , 46 ].…”