Factors affecting the concordance of radiologic and pathologic tumor size in breast carcinoma

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 AE2 mm. Results: The difference between radiologic and pathologic tumor size was within AE2 mm in 40.4% cases. The mean radiologic size was 1.73 AE 1.06 cm. The mean pathologic size was 1.84 AE 1.24 cm. A paired t-test showed a significant mean difference between radiologic and pathologic measurements (0.12 AE 1.03 cm, p ¼ 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 ¼ 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.

The Accuracy of Breast Cancer Diagnostic Tools

“…Hence, it is important to identify the imaging method that most accurately approximates the tumor size. Maintaining high concordance between radiological and pathological parameters is crucial for making precise management decisions [ 10 ].…”

“…Maintaining high concordance between radiological and pathological parameters is crucial for making precise management decisions [10].…”

Association of Epithelial Mesenchymal Transition, Stemness and Inflammation in Colorectal Carcinoma. Doctoral Thesis

“…The methods for tumour volume assessment mostly involve radiographic image analysis with measurements of the x-, y-, and z-axes of a tumour(Tirumani et al, 2016). However, there could be significant differences between radiographic and pathological volumes, as shown previously in breast cancer(Hamza et al, 2018) and other tumours(Cortadellas et al, 2017;Jeffery, Douek, Guo, & Patel, 2011). Considering that the radiographic tumour size data were not available in the current study, pathological assessment was performed and the tumour volume was calculated based on a previously described method(Tirumani et al, 2016).There was a significant difference in the tumour volume depending on its location: leftsided tumours were smaller than right-sided tumours] cm 3 vs. 29.CI 23.0-35.9] cm 3 , respectively).…”