Abstract
BackgroundPreoperative assessment of tumor size is important in breast cancer treatment planning, especially in breast conservation surgeries. The use of the Magnetic Resonance Imaging (MRI) is increasing among patients with newly diagnosed breast cancers. However, some pathological features can overestimate the measurement of tumor size by MRI, increasing mastectomy rates. The objective is to evaluate which pathological features may affect the agreement between MRI and pathologic tumor size on invasive breast carcinomas.MethodsEighty seven patients with breast cancer who underwent preoperative breast MRI were retrospectively evaluated. The main tumor size measured by MRI was compared with pathology (gold standard) and concordance was defined as a greater diameter difference of less than 10 mm.ResultsThere was MRI-pathology concordance in 60 cases (69.0%), MRI overestimated tumor size in 21 (24.1%) and underestimated in 6 (6.9%). After multivariate analysis, only associated ductal carcinoma in situ (DCIS) remained significantly related to overestimation of tumor size on MRI (OR: 9.00; 95% IC:1.13-71.87; p = 0.038).ConclusionThere was good correlation between tumor size evaluation on MRI and pathology. The presence of associated DCIS was the only pathological parameter associated with size overestimation on MRI.
Highlights
Preoperative assessment of tumor size is important in breast cancer treatment planning, especially in breast conservation surgeries
Our hypothesis is that breast Magnetic Resonance Imaging (MRI) is a good exam to predict pathologic tumor size, it can be affected by pathological parameters that will cause extent overestimation
After approval of the institution ethics review board, we retrospectively evaluated 87 patients with breast cancer who were submitted MRI for preoperative staging and treatment planning, from August 2012 to August 2014
Summary
Preoperative assessment of tumor size is important in breast cancer treatment planning, especially in breast conservation surgeries. The use of the Magnetic Resonance Imaging (MRI) is increasing among patients with newly diagnosed breast cancers. Some pathological features can overestimate the measurement of tumor size by MRI, increasing mastectomy rates. The objective is to evaluate which pathological features may affect the agreement between MRI and pathologic tumor size on invasive breast carcinomas. Preoperative Magnetic Resonance Imaging (MRI) has been used in patients with newly diagnosed breast cancer for proper evaluation of tumor extent. Some pathological features can lead to an overestimation of tumor size by MRI, which increases rates of mastectomy [1,2,3]. The aim of this study was to evaluate which pathological features may influence the agreement on tumor size assessment of invasive breast cancers between MRI and pathology
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