Correlating sonography, mammography, and pathology in the assessment of breast cancer size

Background: With the increasing use of neoadjuvant and minimally invasive therapy, the accuracy of preoperative determination of breast tumor size becomes important. Therefore, we under-took this study to compare mammography and ultrasonography (US). Methods: A total of 180 invasive breast cancer patients were prospectively examined by mammography and US; 146 eligible patients had tumors visualized by both modalities. Results: In 69% of cases, US was better than or equivalent to mammography in determining tumor size. Both underestimated tumor size; mean (median) underestimation was 3.8 +/- 0.7 nim (1.7 mm) by US and 3.5 +/- 0.9 mm (2 mm) by mammogram. Maximal tumor dimension Was accurate within 5 mm in 65% of cases by mammography and 75% of cases by US. For mammographically determined size (versus pathologic size) correlation, r, was 0.4 and for US it was 0.63 and improved for only TI and T2 tumors. Conclusions: These data suggest that US is more accurate than mammography in assessing breast cancer size. (C) 2001 Excerpta Medica, Inc. All rights reserved.