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Abstract
Purpose
This comparative study analyzed the relationship between the preoperative diagnostic tumor size and the postoperative pathologic tumor size for breast cancer patients and benign breast tumor patients.
Methods
We analyzed the clinicopathological information of 191 breast cancer patients and 187 benign breast tumor patients by conducting a retrospective chart review. The preoperative diagnostic tumor sizes were measured using physical examination, mammography and sonography in the benign breast tumor patients and they were additionally measured by computerized tomography and magnetic resonance imaging in the breast cancer patients. Body mass index (BMI) was defined as the ratio of the body weight in kilograms to the square of height in meters.
Results
The tumor sizes measured by mammography (r=0.66) and physical examination (r=0.87) were highly correlated to the pathologic tumor size in the breast cancer patients and benign the breast tumor patients, respectively. Physical examination and magnetic resonance imaging had a tendency to overestimate the tumor size and sonography underestimated the pathologic tumor size in the breast cancer patients. The correlation coefficient for the physical examination was increased when the patient age was less than 50 years and the BMI was less than 25. Multiple regression analysis revealed that assessing the tumor size according to physical examination, mammography and sonography were effective for determining estimation of pathologic tumor size in the benign breast tumor patients, but assessing the tumor size by physical examination and sonography was not effective for determining the tumor size in breast cancer patients.
Conclusion
Mammography and physical examination can be useful to estimate the pathologic tumor size in breast cancer patients and benign breast tumor patients, respectively. Physical examination can be useful to estimate the size when a breast tumor is palpable, the age of a patient is less than 50, and the BMI is less than 25.
Figures and Tables
Figure 1
A linear regression scatter plot between the pathologic tumor size and tumor sizes measured using physical examination, mammography, sonography and breast magnetic resonance imaging in breast cancer patients. The Pearson correlation coefficients were 0.55, 0.66, 0.43 and 0.58 for the size based on physical examination, mammography, sonography and breast magnetic resonance imaging respectively compared to pathologic tumor size in breast cancer patients.
......=line of linear regression; —=line of equation.
Figure 2
A linear regression scatter plot between the pathologic tumor size and tumor sizes measured using physical examination, mammography and sonography in benign breast tumor patients. The Pearson correlation coefficients were 0.87, 0.72 and 0.79 for the size based on physical examination, mammography and sonography, respectively compared to the pathologic tumor size in benign breast tumor patients.
......=line of linear regression; —=line of equation.
Figure 3
A Normal probability plot of regression standardized residual by linear regression analysis in benign breast tumor patients. The pathologic tumor size can be calculated using the following equation; Pathologic tumor size=0.014+0.049×[tumor size on physical examination]-0.490×[tumor size by mammography]+1.361×[tumor size by sonography].
Table 2
Results of correlation analysis between pathologic tumor size and other tumor sizes measured using physical examination, mammography, ultrasonography, computerized tomography, and magnetic resonance imaging in breast cancer and benign breast tumor patients
Table 3
Resutls of correlation analysis between pathologic tumor size and other tumor sizes measured using physical examination, mammography, sonography, computerized tomography, and magnetic resonance imaging in breast cancer patients (n=191) according to various clinicopathological features
PE=physical examination; MMG=mammography; USG=ultrasonography; CT=computerized tomography; MRI=magnetic resonance imaging; NS= not significant; NA=not applicable; BMI=body mass index; IDC=invasive ductal carcinoma.
*Pearson's coefficient and p-value cannot be calculated because the number of cases is 2.
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