Tumor size assessment with three breast imaging modalities: Finding which is best?

Abstract

Background and Objectives: Diagnostic accuracy of breast MR is higher than the routinely used sonomammography and digital mammography. There are mixed reports regarding usefulness of breast MR imaging regarding the tumor size estimation. The objective of this study was to determine which modality can assess the exact tumor dimension in comparison with corresponding tumor dimension at pathologic examinations. Materials and Methods: In a prospective study, 68 patients who came for screening diagnostic mammogram and who had breast lesions of Breast Imaging Reporting and Data System (BIRADS) category 3 and more were evaluated. All patients underwent bilateral digital mammography and targeted high-frequency sonography of the primary lesion. Those patients who were thought to possibly have breast cancer and to be candidates for surgical management were offered bilateral contrast-enhanced breast MRI. Tumor size was evaluated by digital mammography, sonomammography, contrast-enhanced mammography, and compared with histopathology reports. Results: Size of the lesions as measured by DM or SM correlated well with the size determined through breast MR (r = 0.975, P < 0.01). There was a statistically significant difference between the measured sizes of lesions between breast MR and HPE (P = 0.76). Breast MR imaging, true size was overestimated in 28 breasts with range of 0–0.6 cm and underestimated in 25 breasts with range of 0–0.9 cm. Conclusion: Breast MR imaging depicts more accurate dimensions of the tumor and its extensions than digital and sonomammography.