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Background and objective: The size of the tumor significantly influences the prognosis and treatment approach for breast cancer patients. The aim of this study was to find the most accurate imaging method for estimating pre-treatment tumor size in women with newly diagnosed primary invasive breast cancer by comparing the predicted tumor size obtained from mammography, ultrasonography, and magnetic resonance imaging with the pathologic size obtained from the surgical specimens. Methods: This cross-sectional study included 181 primary invasive breast cancer patients from September 2021 to March 2023. The difference in tumor size was evaluated based on imaging and pathological reports. Variables such as age, breast density, and tumor characteristics like histologic type, grade, location, and side were recorded and analyzed. The American College of Radiology Breast Imaging Reporting and Data System was used for reporting. Data analysis, performed using SPSS Statistics software, included descriptive statistics, Spearman's correlation coefficient, and Lin's index. The statistical significance level was set at P <0.05. Results: The mean tumor size was 29.68, 29.07, 28.37, and 27.7mm by mammography, ultrasonography, magnetic resonance imaging, and pathology, respectively. All diagnostic procedures revealed a statistically significant correlation with pathologic tumor size with the Spearman correlation test, P = 0.000. MRI had the highest Lin’s concordance correlation coefficient (0.93). Conclusion: The study determined that all imaging modalities were accurate in estimating tumor size when compared to the gold standard of pathological specimens and that magnetic resonance imaging outperformed digital mammography and ultrasonography.
Dawood et al. (Wed,) studied this question.