The value of chest CT for prediction of breast tumor size: comparison with pathology measurement

Ahn, Su Joa; Kim, Young Saing; Kim, Eun Young; Park, Heung Kyu; Cho, Eun Kyung; Kim, Yoon Kyung; Sung, Yon Mi; Choi, Hye-Young

doi:10.1186/1477-7819-11-130

Cited by 16 publications

(16 citation statements)

References 21 publications

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“…Like Ahn et al, 13 we found that smaller tumors ( 2 cm/pT1) had a higher concordance rate as compared to larger tumors (>2 cm/! pT2).…”

Section: Discussionsupporting

confidence: 82%

“…[3][4][5][6][7][8][9] Few studies compared pathologic tumor size to radiologic size using different radiologic modalities. [11][12][13][14][15][16][17][18] In a recent study, Yoo et al 11 studied the correlation of MRI and pathologic size in breast carcinomas. However, not every breast carcinoma patient gets an MRI.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9] Some authors looked into tumor size concordance with respect to different imaging modalities, but many of these studies were limited, either by small sample size; because only a specific type of tumor was considered based on the exclusion criteria; or because only highly specialized techniques such as magnetic resonance imaging (MRI) was used, which is not as widely available or used as ultrasonography (USG) in the assessment of the breast carcinomas. [10][11][12][13][14][15][16][17][18][19][20][21] Moreover, most studies considered a size difference of AE5 mm to be concordant, 11,13 which is significant enough to result in a change of stage classification in a considerable number of cases. We compared pathologic tumor size with ultra-sonographic (USG) size.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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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.

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“…Like Ahn et al, 13 we found that smaller tumors ( 2 cm/pT1) had a higher concordance rate as compared to larger tumors (>2 cm/! pT2).…”

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…Concordance between MRI and pathologic diameter was defined as a tumor size difference of 0.5 cm. This is because limits within which measurements on MRI are considered concordant with measurements at pathology vary and are in the range of 0-2 cm (3,7,(11)(12)(13)(14)(15)(16); however, the majority of previous studies that classified concordance defined a diameter difference of 0.5 cm as concordant. Disease was considered to be overestimated if the size of the tumor on MRI was > 0.5 cm larger than the pathologic tumor size.…”

Section: Image Analysismentioning

confidence: 99%

Agreement between MRI and pathologic analyses for determination of tumor size and correlation with immunohistochemical factors of invasive breast carcinoma

et al. 2017

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Background There may be discordance between tumor size determined by magnetic resonance imaging (MRI) and that observed during pathologic analyses. Purpose To evaluate MRI-pathology concordance of tumor size in patients with invasive breast carcinoma. Material and Methods Data from 307 invasive breast carcinomas were analyzed retrospectively. Preoperative breast MRI was reviewed for size, lesion type, morphology, and dynamic contrast-enhanced tumor kinetics. MRI tumor size was compared with tumor size measurements from the pathologic analysis. Concordance was defined as a difference in diameter of ≤ 0.5 cm. MRI-pathology concordance was compared according to clinical and histopathologic features. Results The mean tumor size on MRI was 2.48 ± 1.41 cm. Tumor measurements determined by MRI were not significantly different from those recorded in the pathologic reports (2.56 ± 1.61 cm, P = 0.199). MRI-pathology concordance was found in 229/307 (74.6%) cases; the size was overestimated in 36 (11.7%) tumors and underestimated in 42 (13.7%). On univariate analysis, MRI-pathology discordance was associated with larger tumor size ( P < 0.001), estrogen receptor (ER) negativity ( P = 0.006), and lymphovascular invasion ( P = 0.003). Human epidermal growth factor receptor 2 positive molecular subtype showed worse correlation between the tumor size measured by MRI and pathology compared with luminal A and luminal B subtypes ( P = 0.008 and 0.007). On multivariate analysis, tumor size and ER status significantly influenced MRI-pathology concordance ( P < 0.05). Conclusion ER negativity and larger tumor size were strongly associated with MRI-pathology discordance in invasive breast carcinomas. Awareness of these factors might improve surgical planning.

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“…Micro-CT is a new imaging modality with a remarkable spatial resolution of 50-1 mm. While a prior study has shown the efficacy of chest CT in determining primary tumour size in breast cancer, 28 micro-CT had not been previously assessed for its accuracy in measuring primary tumour size. This study aimed to assess the accuracy of intraoperative micro-CT in measuring primary breast tumour size within lumpectomy specimens.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative micro-computed tomography (micro-CT): a novel method for determination of primary tumour dimensions in breast cancer specimens

Tang

Saksena

Coopey

et al. 2016

BJR

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Objectives: Micro-CT is a promising modality to determine breast tumour size in three dimensions in intact lumpectomy specimens. We compared the accuracy of tumour size measurements using specimen micro-CT with measurements using multimodality pre-operative imaging. Methods: A tabletop micro-CT was used to image breast lumpectomy specimens. The largest tumour dimension on three-dimensional reconstructed micro-CT images of the specimen was compared with the measurements determined by pre-operative mammography, ultrasound and MRI. The largest dimension of pathologic invasive cancer size was used as the gold standard reference to assess the accuracy of imaging assessments. Results: 50 invasive breast cancer specimens in 50 patients had micro-CT imaging. 42 were invasive ductal carcinoma, 6 were invasive lobular carcinoma and 2 were other invasive cancer. Median patient age was 63 years (range 33-82 years). When compared with the largest pathologic tumour dimension, micro-CT measurements had the best correlation coefficient (r 5 0.82, p , 0.001) followed by MRI (r 5 0.78, p , 0.001), ultrasound (r 5 0.61, p , 0.001) and mammography (r 5 0.40, p , 0.01). When compared with preoperative modalities, micro-CT had the best correlation coefficient (r 5 0.86, p , 0.001) with MRI, followed by ultrasound (r 5 0.60, p , 0.001) and mammography (r 5 0.54, p , 0.001). Overall, mammography and ultrasound tended to underestimate the largest tumour dimension, while MRI and micro-CT overestimated the largest tumour dimension more frequently. Conclusion: Micro-CT is a potentially useful tool for accurate assessment of tumour dimensions within a lumpectomy specimen. Future studies need to be carried out to see if this technology could have a role in margin assessment. Advances in knowledge: Micro-CT is a promising new technique which could potentially be used for rapid assessment of breast cancer dimensions in an intact lumpectomy specimen in order to guide surgical excision.

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The value of chest CT for prediction of breast tumor size: comparison with pathology measurement

Cited by 16 publications

References 21 publications

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

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

Agreement between MRI and pathologic analyses for determination of tumor size and correlation with immunohistochemical factors of invasive breast carcinoma

Intraoperative micro-computed tomography (micro-CT): a novel method for determination of primary tumour dimensions in breast cancer specimens

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