Comparative Accuracy of Preoperative Tumor Size Assessment on Mammography, Sonography, and MRI: Is the Accuracy Affected by Breast Density or Cancer Subtype?
Comparative Accuracy of Preoperative Tumor Size Assessment on Mammography, Sonography, and MRI: Is the Accuracy Affected by Breast Density or Cancer Subtype?
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DOI：
10.1002/jcu.22290
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发表时间：
2016-01-01
影响因子：
0.9
通讯作者：
Lewis, Madelene
中科院分区：
文献类型：
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作者：
Leddy, Rebecca;Irshad, Abid;Lewis, Madelene
目的.比较不同乳腺密度和不同肿瘤类型的术前乳腺肿瘤大小测量结果与最终病理检查结果的准确性。方法回顾性分析了2008年至2012年期间接受乳腺癌肿块切除术的患者的记录，其中所有三种成像模式均显示肿瘤，以测量最大肿瘤大小。排除肿瘤切缘阳性和接受过新辅助化疗的患者。在三种成像方式上获得的肿瘤大小测量值与最终病理检查期间获得的准确性进行比较。根据乳腺密度和肿瘤类型分析整个组和亚组的差异。总共纳入了57例患者，其中在没有新辅助化疗的情况下进行了导丝定位肿块切除术;获得了肿瘤的阴性手术切缘，并且在所有三种成像模式上术前均显示了肿瘤。MRI测量的平均（6 SEM）肿瘤大小显著大于病理学测量的肿瘤大小（p < 0.001），而US和MM测量的肿瘤大小与病理学测量的肿瘤大小无统计学显著差异（p = 0.62和p = 0.57）。MRI测量的肿瘤大小大于US和MM测量的肿瘤大小（p = 0.003和p < 0.001）。与病理学测量结果相比，超声测量结果显示出中等程度的一致性（Lin一致性相关系数[CCC]，0.71; 95%置信区间[CI]，0.56-0.82）; MM上获得的尺寸一致性较差（CCC，0.58; 95% CI，0.38-0.72）和MRI（CCC，0.50; 95% CI，0.31-0.65）。在致密和非致密乳腺组织之间，尺寸测量的相对准确性没有差异。MRI高估了导管癌的肿瘤大小（p < 0.001），而略低估了小叶癌。术前MRI明显高估了肿瘤大小。无论乳腺密度如何，在US和MM上获得的测量结果更准确，US测量结果比MM测量结果略准确。(C)2015 Wiley Periodicals，Inc.
Purpose. To compare the accuracy of preoperative breast tumor size measurements obtained on three imaging modalities (mammography [MM], sonography [US], and MRI) with those obtained on final pathologic examination for different breast densities and various tumor types.Methods. Records from patients who underwent breast cancer lumpectomy between 2008 and 2012 and in whom tumor was seen on all three imaging modalities were retrospectively reviewed for maximum tumor size measurements. Patients with positive tumor margins and those who had undergone neoadjuvant chemotherapy were excluded. Tumor size measurements obtained on the three imaging modalities were compared for accuracy with those obtained during the final pathologic examination. Differences were analyzed for the whole group and for subgroups according to breast density and tumor type.Results. In total, 57 patients were included, in whom wire-localization lumpectomy was performed without neoadjuvant chemotherapy; negative surgical margins for tumor were obtained, and tumor was preoperatively visualized on all three imaging modalities. The mean (6 SEM) tumor size measured on MRI was significantly greater than that measured on pathology (p < 0.001), whereas the sizes measured on US and MM were not statistically significantly different from that measured on pathology (p = 0.62 and p = 0.57). Tumor size measured on MRI was greater than that measured on both US and MM (p = 0.003 and p < 0.001). Compared with the measurements obtained on pathology, that obtained on US showed moderate agreement (Lin concordance correlation coefficient [CCC], 0.71; 95% confidence interval [CI], 0.56-0.82); poorer agreement was found for the sizes obtained on MM (CCC, 0.58; 95% CI, 0.38-0.72) and MRI (CCC, 0.50; 95% CI, 0.31-0.65). No difference in comparative accuracy of size measurement was noted between dense and nondense breast tissue. MRI overestimated tumor size in ductal cancers (p < 0.001) and slightly underestimated it in lobular cancers.Conclusions. Preoperative MRI significantly overestimated tumor size. Measurements obtained on US and MM were more accurate irrespective of breast density, with US measurements being slightly more accurate than MM measurements. (C) 2015 Wiley Periodicals, Inc.