Tumor Size of Invasive Breast Cancer on Magnetic Resonance Imaging and Conventional Imaging (Mammogram/Ultrasound): Comparison with Pathological Size and Clinical Implications
| Autor: | Karl-Göran Tranberg, K. S. Ásgeirsson, Þ. Jónsson, K. H. Haraldsdóttir, A. B. Halldórsdóttir |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Clinical Decision-Making Breast Neoplasms 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Breast cancer Preoperative Care medicine Humans Pathological Mastectomy Aged Retrospective Studies Aged 80 and over Chemotherapy medicine.diagnostic_test Tumor size business.industry Ultrasound Carcinoma Ductal Breast Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Tumor Burden Oncoplastic Surgery Carcinoma Lobular 030220 oncology & carcinogenesis Surgery Female Radiology Ultrasonography Mammary business Mammography |
| Zdroj: | Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. 106(1) |
| ISSN: | 1799-7267 |
| Popis: | Background and Aim: In Landspitali University Hospital, magnetic resonance imaging is used non-selectively in addition to mammogram and ultrasound in the preoperative assessment of breast cancer patients. The aim of this study was to assess invasive tumor size on imaging, compare with pathological size and evaluate the impact of magnetic resonance imaging on the type of surgery performed. Material and Methods: All women with invasive breast cancer, diagnosed in Iceland, between 2007 and 2009 were reviewed retrospectively. In all, 438 of 641 (68%) patients diagnosed had preoperative magnetic resonance imaging. Twelve patients treated with neoadjuvant chemotherapy were excluded and 65 patients with multifocal or contralateral disease were assessed separately. Results: Correlations between microscopic and radiologic tumor sizes were relatively weak. All imaging methods were inaccurate especially for large tumors, resulting in an overall underestimation of tumor size for these tumors. Magnetic resonance imaging under- and overestimated pathological tumor size by more than 10 mm in 16/348 (4.6%) and 26/348 patients (7.5%), respectively. In 19 patients (73%), overestimation of size was seen exclusively on magnetic resonance imaging. For tumors under- or overestimated by magnetic resonance imaging, the mastectomy rates were 56% and 65%, respectively, compared to an overall mastectomy rate of 43%. Of 51 patients diagnosed with multifocal disease on pathology, 19 (37%) were diagnosed by mammogram or ultrasound and 40 (78%) by magnetic resonance imaging resulting in a total detection rate of 84% (43 patients). Fourteen (3%) patients were diagnosed preoperatively with contralateral disease. Of those tumors, all were detected on magnetic resonance imaging but seven (50%) were also detected on mammogram or ultrasound or both. Conclusion: Our results suggest that routine use of magnetic resonance imaging may result in both under- and overestimation of tumor size and increase mastectomy rates in a small proportion of patients. Magnetic resonance imaging aids in the diagnosis of contralateral and multifocal disease. |
| Databáze: | OpenAIRE |
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