Comparison Of Clinical Assessment, Mammography And Ultrasound In Pre-Operative Estimation Of Primary Breast-Cancer Size: A Practical Approach

Abstract

The stage of breast cancer and prognosis for the patient depend, in part, on the largest diameter of the primary tumour. The measurement modality is not specified in literature but the best estimate of tumour size is accepted to be the histopathological measurement, which is not available until after the initial surgery. Management is therefore planned using the size of the tumour at imaging/clinical palpation. We wished to determine which of the modalities provides the closet estimation of histopathological tumor size. In our study, clinical palpation tended to overestimate tumour size and gave the largest standard deviation of the difference and ultrasound tends to underestimate tumor size. Although there is little difference between the precision of ultrasound and mammography in measuring tumour size, mammography is the most precise method for measuring primary breast tumor size. The wide 95% confidence intervals for any method of pre-operative tumor measurement should be considered when planning patient management.