Clinical, Mammographic, and Ultrasonographic Assessment of Breast Cancer Size

ABSTRACT

PURPOSE: Tumor size is a prognostic factor, as well as an important factor, in staging. Also, tumor size is a major factor in determining if a woman is a suitable candidate for various treatments, including a mastectomy or breast-conserving surgery. Thus, an accurate assessment of breast tumor size is important in making a prognosis and in planning treatment. METHODS: One hundred fifty-two patients presenting with palpable primary breast cancer were studied to evaluate the accuracies of clinical assessment, mammography, and ultrasonography in measuring tumor size. The clinical, mammographic, and ultrasonographic diameters of the tumors were compared to histological diameters. RESULTS: The average histological diameter of the tumors was 27.0+/-12.9 mm. The average diameter of the tumors on clinical assessment was 33.8+/-13.1 mm, and its correlation coefficient to the histological size was 0.73. The average size on mammography was 21.4+/-9.0 mm and its correlation coefficient to the histological size was 0.71. The tumor size on ultrasonography in 22 patients was 22.3+/-10.4 mm. The sonographic measurement demonstrated the highest correlation coefficient (0.83). The clinical assessment overestimated the histological tumor size, but the mammographic and sonographic measurement underestimated it. A combined measurement using both the clinical and the ultrasonographic methods slightly improved the correlation with the histological size (0.86). CONCLUSION: Ultrasonography could be a useful method for estimating tumor size preoperatively, and when it is combined with clinical assessment, it is the most reliable and accurate technique.