title: Comparison of the Diagnostic Accuracy of Magnetic Resonance Imaging with Sonography in the Prediction of Breast Cancer Tumor Size: A Concordance Analysis with Histopathologically Determined Tumor Size.
abstract: BACKGROUND
  In order to effectively treat patients with breast cancer, it is important to know the precise tumor size. We compared the rates of concordance of magnetic resonance imaging (MRI)-derived and sonography-derived breast cancer tumor size with histopathologically determined tumor size.
  
  
  METHODS
  Accuracy of MRI and sonography in establishing tumor size was evaluated by comparing preoperative images with postoperative pathologic findings. The accuracy of MRI and sonography was graded as concordance, underestimation, or overestimation and was compared in different subgroups.
  
  
  RESULTS
  A total of 682 patients comprised the study cohort. Mean tumor size was 3.64 ± 1.8 cm via MRI, 2.12 ± 1.0 cm via sonography, and 2.78 ± 1.7 cm via pathologic examination. The difference between breast sonography and MRI to pathologic tumor field size was -0.68 ± 1.4, and 0.85 ± 1.25 cm, respectively (P < 0.001). Sonography had a concordance rate of 54.3 %, an overestimated rate of 9.8 %, and an underestimated rate of 35.9 %. For MRI, the concordance rate was 44.1 %, the overestimated rate was 52.5 %, and the underestimated rate was 3.4 %. In subgroup analysis, breast MRI had a higher concordance rate in patients with T3 (>5 cm) lesions. When the results of MRI and sonography were considered together, the concordance rate increased from 54.3 to 62.2 %.
  
  
  CONCLUSIONS
  MRI tends to overestimate the actual tumor size, while sonography frequently underestimates it. Combined sonography and MRI increases the accuracy of tumor size prediction.
authors.affiliation: Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua, Taiwan.|Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan.|Comprehensive Breast Cancer Center, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.|School of Medicine, National Yang Ming University, Taipei, Taiwan.
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Lai
authors.affiliation: Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua, Taiwan.|Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan.|Comprehensive Breast Cancer Center, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Dar-Ren
authors.initials: DR
authors.lastname: Chen
authors.affiliation: Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan.|Comprehensive Breast Cancer Center, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Yao-Chung
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Department of Surgical Pathology, Changhua Christian Hospital, Changhua, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.|Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
authors.forename: Chih-Jung
authors.initials: CJ
authors.lastname: Chen
authors.affiliation: Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan.|Comprehensive Breast Cancer Center, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Shou-Jen
authors.initials: SJ
authors.lastname: Kuo
authors.affiliation: Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan. 1886@cch.org.tw.|Comprehensive Breast Cancer Center, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan. 1886@cch.org.tw.
authors.forename: Shou-Tung
authors.initials: ST
authors.lastname: Chen
authors.affiliation: Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan. 17597@cch.org.tw.
authors.forename: Hwa-Koon
authors.initials: HK
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018567:Breast Neoplasms, Male / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery / Q000648:ultrastructure; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D047368:Tumor Burden; D014463:Ultrasonography; D055815:Young Adult