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.
Department of Surgery, The Mayo Clinic Arizona, 5777 East Mayo Blvd., Phoenix, AZ 85054, USA. grimsby.gwen@mayo.edu
Gwen M
GM
Grimsby
Richard
R
Gray
Amylou
A
Dueck
Susanne
S
Carpenter
Chee-Chee
CC
Stucky
Heidi
H
Aspey
Marina E
ME
Giurescu
Barbara
B
Pockaj
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