Preoperative staging of breast cancer by palpation, mammography and high‐resolution ultrasound

Madjar, H.; Ladner, H.-A.; Sauerbrei, Willi; Oberstein, A; Prömpeler, H. J.; Pfleiderer, A.

doi:10.1046/j.1469-0705.1993.03030185.x

Cited by 75 publications

(47 citation statements)

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“…Increasing confidence with the needle and increasing resolution of ultrasound machines have expanded the scope of ultrasound to guide diagnostic biopsies more accurately and measure tumors. 8,9 FNAC has a high diagnostic accuracy rate (97%) in the hands of experiencedcytopathologists.…”

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confidence: 99%

Significance of Quadruple assessment of breast lump–A hospital based study

Ghartimagar

Ghosh

et al. 2014

J Pathol Nep

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Background: Approximately 10% of breast masses are breast cancer. It is important for women with a breast lump to receive appropriate evaluation. Mammography has been the "gold standard" in breast cancer detection for >40 years. Ultrasonography is non-invasive easily available, cheaper and accurate tool while Fine needle aspiration cytology has a high diagnostic accuracy rate in hands of experienced cytopathologist. Materials and methods:This was a retrospective and prospective study of 173 women attending radiology department in Manipal Teaching Hospital, Pokhara for mammography during a period of 18 months from January 2011 to June 2012.The age ranged from 20yrs to 75yrs. BIRADS score was given for both mammography and sonomammography. All malignant and suspicious cases had undergone fine needle aspiration cytology. Cytology reports were correlated with imaging study. Results:The most common age group for the breast lump was 40-49 years showing 65(37.57%) cases. Most lumps were seen on the left side 54.3% (94/ 173) cases and were seenin upper outer quadrant of the breast (74 cases). 11 cases each were given the BIRADS score of 4 in both mammography and sonomammography. Sensitivity and specificity of mammography and sonomammography were compared to cytologyreports. The sensitivity for mammogram was 73.7% while specificity was 96.3%. The sensitivity and specificity for sonomammogram was 78.9% and 95% respectively. Conclusion:Quadruple assessment i.e. clinical assessment, mammography, sonomammography and cytologicalstudy are the new "gold standard" in the investigation of breast disease.

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confidence: 99%

Significance of Quadruple assessment of breast lump–A hospital based study

Ghartimagar

Ghosh

et al. 2014

J Pathol Nep

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] These studies indicate that although magnetic resonance imaging is accurate at predicting pathologic tumor size, ultrasonography is more widely available, relatively faster and less expensive. For these reasons, ultrasound appears to be the most useful imaging modality for preoperative tumor assessment.…”

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confidence: 99%

Influence of breast cancer histology on the relationship between ultrasound and pathology tumor size measurements

et al. 2004

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Establishing an accurate primary invasive breast cancer size is crucial for patient management. Although ultrasonographic measurement is reported to correlate reliably with the gold standard pathology measurement, few authors have examined the influence of histologic subtype on ultrasound measurement. The common subtypes of invasive breast carcinoma, ductal and lobular, have different growth patterns, which may influence the ability of ultrasound to predict pathologic size. For this analysis, ultrasound and pathology reports were retrospectively reviewed for 204 women with 210 invasive breast cancers, including 129 ductal, 41 lobular, and 40 mixed pattern ductal and lobular carcinomas. For each tumor, the largest pathology and ultrasound dimensions were compared using Pearson's correlations, linear regression, paired t-tests and Wilcoxon signed ranks tests, stratified by histologic subtype. The Hodges-Lehmann approach was used to obtain 95% confidence intervals (CI) for median difference of the sizes. Ultrasonography consistently underestimated pathologic tumor size; the overall median difference was 3.5 mm (CI: 2.5-4.0 mm) and for subtypes: 2.5 mm (CI: 1.5-3.5 mm) for ductal pattern; 3.0 mm (CI: 1.5-4.5 mm) for mixed pattern; and in contrast, 7.5 mm (CI: 5.0-13.5 mm) for lobular pattern tumors. Significant correlations of similar magnitude, were observed between size measurements for ductal, lobular, and mixed subtypes (r ¼ 0.816, 0.811 and 0.672, respectively; all Po0.001); however, linear regression models differed between subtypes. Although practical and widely available, ultrasonography tends to underestimate pathologic tumor size. The size difference may be large for lobular carcinomas, potentially influencing stage; differences are less pronounced for ductal and mixed subtypes. Pathologic tumor size can be estimated from the ultrasonographic measurement, particularly if the histologic tumor subtype is known. The results of this study underscore the continued benefit of pretreatment tumor histology.

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“…This finding is consistent with prior studies (Table 1). 1,3,6,[12][13][14][15][16][17][18][19][20][21] Tumour size measured by micro-CT correlated better with histopathological invasive tumour size than any of the three pre-operative imaging modalities. This is likely because micro-CT generates higher resolution images, making fine structures, anatomic features and tumour boundaries more clearly visible.…”

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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Preoperative staging of breast cancer by palpation, mammography and high‐resolution ultrasound

Cited by 75 publications

References 0 publications

Significance of Quadruple assessment of breast lump–A hospital based study

Significance of Quadruple assessment of breast lump–A hospital based study

Influence of breast cancer histology on the relationship between ultrasound and pathology tumor size measurements

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

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