title: Breast cancer characteristics-comparison of preoperative and postoperative values.
abstract: Breast cancer characteristics obtained at the time of diagnosis are important for setting the basic strategy of the treatment. Reliability of preoperative investigation differs for various features of the disease. The aim of this study was to ascertain the agreements and differences between preoperative and postoperative values. This retrospective study analyzed the results of 617 women with primary surgery of the breast and axilla. Cohen's kappa coefficient has been employed to measure the degree of agreement between preoperative and postoperative values. Substantial or "almost perfect" agreement has been documented for the histological type of the tumors, their histopathological grade, proliferation index Ki67, as well as for estrogen, progesterone, and HER-2/neu receptors. Substantial differences exist between preoperative and postoperative diagnoses of invasiveness of the tumor, determination of the size of the tumors, and the number of tumor foci. Preoperative imaging and clinical examination of lymph nodes exhibited unacceptably high false negative rates. Heterogeneity of breast cancer cell population, methodology of histology examinations, and insufficient imaging of lymph nodes are the major limitations precluding satisfactory accuracy of preoperative diagnosis. Preoperatively diagnosed in situ carcinomas, as well as multifocal lesions, were the most often sources of diagnostic failures.
authors.affiliation: First Faculty of Medicine, Charles University in Prague, Czech Republic. kolarikd@centrum.cz
authors.forename: Dusan
authors.initials: D
authors.lastname: Kolarik
authors.forename: Vaclav
authors.initials: V
authors.lastname: Pecha
authors.forename: Miroslava
authors.initials: M
authors.lastname: Skovajsova
authors.forename: Jozef
authors.initials: J
authors.lastname: Zahumensky
authors.forename: Marketa
authors.initials: M
authors.lastname: Trnkova
authors.forename: Lubos
authors.initials: L
authors.lastname: Petruzelka
authors.forename: Michael
authors.initials: M
authors.lastname: Halaska
authors.forename: Oldrich
authors.initials: O
authors.lastname: Sottner
authors.forename: Michal
authors.initials: M
authors.lastname: Otcenasek
authors.forename: Hana
authors.initials: H
authors.lastname: Kolarova
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D002277:Carcinoma / Q000378:metabolism / Q000556:secondary / Q000601:surgery*; D002278:Carcinoma in Situ / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D049109:Cell Proliferation; D018153:Czech Republic; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: Biopsy; Breast cancer; Characteristics; Postoperative diagnosis; Preoperative diagnosis