Ultrasonography as a method of measuring breast tumour size and monitoring response to primary systemic treatment

Abstract

Accurate measurement of change in tumour size is a prerequisite for the use of response-based regimens of primary systemic therapy for breast cancer. This study evaluated the accuracy of clinical assessment, mammography and ultrasonography in measuring tumour size and in monitoring response to treatment. Size was determined during the week preceding surgery and actual size measured from resected specimens. Sequential measurements were performed in 35 patients undergoing primary systemic treatment. There was moderate correlation between pathological and clinical size (n = 51, r2 = 0.68, P < 0.0001). Close correlation with pathological tumour size was observed for mammographic (n = 45, r2 = 0.84, P < 0.0001) and ultrasonographic (n = 52, r2 = 0.89, P < 0.0001) tumour size. Response was correctly evaluated by clinical assessment in 31 of 35 patients, by mammography in 20 of 35 and by ultrasonography in 31 of 35. Actual tumour size can be measured accurately by available imaging techniques but ultrasonography is the most practical and accurate method for monitoring response.

Dietary supplementation with L-arginine in patients with breast cancer (> 4 cm) receiving multimodality treatment: report of a feasibility study

“…Previous studies comparing clinical, mammographic or ultrasound assessment with maximal histological diameter of the tumour have demonstrated no difference between the modalities (Pain et al, 1992), although others have shown ultrasound to be better (Fornage et al, 1987;Forouhi et al, 1992). In our study, ultrasound and mammography gave substantially lower response rates than did clinical examination.…”

Proliferation, steroid receptors and clinical/pathological response in breast cancer treated with letrozole

“…Serial measurements of the primary tumours were taken before, at 6 weeks and at 3 months by calliper and ultrasound as described previously (Forouhi et al, 1994;Dixon, 2001). The tumour was also imaged mammographically before and at 3 months.…”

“…Tumour volumes were determined from ulstrasound measurements as described by Forouhi et al (1994). Reduction in volume over a 3 month period 450% was regarded as clinical response; this includes both complete and partial responders.…”

Oestrogen receptor β and neoadjuvant therapy with tamoxifen: prediction of response and effects of treatment

“…Ultrasound measurement of three orthogonal tumour diameters produced an estimate of tumour volume. Reduction in tumour volumes 425% was regarded as evidence of tumour response; those 450% were categorised as major response (Forouhi et al, 1994).…”