title: Prediction of primary breast cancer size and T-stage using micro-computed tomography in lumpectomy specimens.
abstract: BACKGROUND
  Histopathology is the only accepted method to measure and stage the breast tumor size. However, there is a need to find another method to measure and stage the tumor size when the pathological assessment is not available. Micro-computed tomography. (micro-CT) has the ability to measure tumor in three dimensions in an intact lumpectomy specimen. In this study, we aimed to determine the accuracy of micro-CT to measure and stage the primary tumor size in breast lumpectomy specimens, as compared to the histopathology.
  
  
  METHODS
  Seventy-two women who underwent lumpectomy surgery at the Massachusetts General Hospital Department of Surgery from June 2011 to September 2011, and from August 2013 to December 2013 participated in this study. The lumpectomy specimens were scanned using micro-CT followed by routine pathological processing. The maximum dimension of the invasive breast tumor was obtained from the micro-CT image and was compared to the corresponding pathology report for each subject.
  
  
  RESULTS
  The invasive tumor size measurement by micro-CT was underestimated in 24 cases. (33%), overestimated in 37 cases. (51%), and matched it exactly in 11 cases. (15%) compared to the histopathology measurement for all the cases. However, micro-CT T-stage classification differed from histopathology in only 11. (15.2%) with 6 cases. (8.3%) classified as a higher stage by micro-CT, and 5 cases. (6.9%) classified as lower compared to histopathology. In addition, micro-CT demonstrated a statically significant strong agreement (κ =0.6, P < 0.05) with pathological tumor size and staging for invasive ductal carcinoma. (IDC) group. In contrast, there was no agreement. (κ = -2, P = 0.67) between micro-CT and pathology in estimating and staging tumor size for invasive lobular carcinoma. (ILC) group. This could be explained by a small sample size. (7) for ILC group.
  
  
  CONCLUSIONS
  Micro-CT is a promising modality for measuring and staging the IDC.
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Wafa M
authors.initials: WM
authors.lastname: Sarraj
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Breast Surgery, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya Medical School of Central South University, Changsha 410013, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Tang
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Anas L
authors.initials: AL
authors.lastname: Najjar
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Griffin
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Bui
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Zambeli-Ljepovic
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Mike
authors.initials: M
authors.lastname: Senter-Zapata
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Lewin-Berlin
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Fernandez
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Juliette
authors.initials: J
authors.lastname: Buckley
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Ly
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Brachtel
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Owen
authors.initials: O
authors.lastname: Aftreth
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: John
authors.initials: J
authors.lastname: Gilbertson
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Yukako
authors.initials: Y
authors.lastname: Yagi
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Gadd
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Hughes
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Smith
authors.affiliation: Division of Surgical Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Michaelson
keywords: Breast cancer; breast imaging; gross pathology; micro-computed tomography; tumor size