Is there concordance of invasive breast cancer pathologic tumor size with magnetic resonance imaging?
BACKGROUND
In the era of breast conservation therapy, preoperative imaging is imperative in planning a single definitive surgical treatment.


METHODS
We performed a retrospective review of a prospectively collected database of patients treated at a single institution for invasive breast cancer over 5 years. Clinical and pathologic variables were analyzed with respect to magnetic resonance imaging (MRI) and pathologic tumor size using analysis of variance F tests and chi-square tests.


RESULTS
Of 190 patients, 53% had concordance of MRI and pathologic cancer size within .5 cm. MRI overestimated 33% and underestimated 15% of tumors. Neoadjuvant chemotherapy and lymph node status were associated with discordance. Among tumors overestimated by MRI, 65% had additional significant findings in the breast tissue around the main lesion: satellite lesions, ductal carcinoma in situ, and/or lymphovascular invasion.


CONCLUSIONS
Breast MRI is concordant with pathologic tumor size within .5 cm among 53% of patients. Most patients with tumors overestimated by MRI have significant findings in the surrounding breast tissue, the excision of which would be expected to benefit the patient.
Grimsby
Gwen M
GM
Department of Surgery, The Mayo Clinic Arizona, 5777 East Mayo Blvd., Phoenix, AZ 85054, USA. grimsby.gwen@mayo.edu
Gray
Richard
R
Dueck
Amylou
A
Carpenter
Susanne
S
Stucky
Chee-Chee
CC
Aspey
Heidi
H
Giurescu
Marina E
ME
Pockaj
Barbara
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D055815:Young Adult