Skip to main content

Advertisement

SpringerLink
Log in

Assessment of breast cancer tumour size using six different methods

  • Breast
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Tumour size estimates using mammography (MG), conventional ultrasound (US), compound imaging (CI) and real-time elastography (RTE) were compared with histopathological specimen sizes.

Methods

The largest diameters of 97 malignant breast lesions were measured. Two US and CI measurements were made: US1/CI1 (hypoechoic nucleus only) and US2/CI2 (hypoechoic nucleus plus hyperechoic halo). Measurements were compared with histopathological tumour sizes using linear regression and Bland–Altman plots.

Results

Size prediction was best with ultrasound (US/CI/RTE: R 2 0.31–0.36); mammography was poorer (R 2 = 0.19). The most accurate method was US2, while US1 and CI1 were poorest. Bland–Altman plots showed better size estimation with US2, CI2 and RTE, with low variation, while mammography showed greatest variability. Smaller tumours were better assessed than larger ones. CI2 and US2 performed best for ductal tumours and RTE for lobular cancers. Tumour size prediction accuracy did not correlate significantly with breast density, but on MG tumours were more difficult to detect in high-density tissue.

Conclusions

The size of ductal tumours is best predicted with US2 and CI2, while for lobular cancers RTE is best. Hyperechoic tumour surroundings should be included in US and CI measurements and RTE used as an additional technique in the clinical staging process.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kaufmann M, von Minckwitz G, Smith R et al (2003) International expert panel on the use of primary (preoperative) systemic treatment of operable breast cancer: review and recommendations. J Clin Oncol 21:2600–2608

    Article  PubMed  Google Scholar 

  2. Goldhirsch A, Ingle JN, Gelber RD, Coates AS, Thürlimann B, Senn HJ, panel members (2009) Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009. Ann Oncol 20:1319–1329

    Article  PubMed  CAS  Google Scholar 

  3. Fredriksson I, Liljegren G, Palm-Sjovall M et al (2003) Risk factors for local recurrence after breast-conserving surgery. Br J Surg 90:1093–1102

    Article  PubMed  CAS  Google Scholar 

  4. Fisher B, Bryant J, Wolmark N et al (1998) Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol 16:2672–2685

    PubMed  CAS  Google Scholar 

  5. Goldhirsch A, Wood WC, Gelber RD, Coates AS, Thurlimann B, Senn HJ (2003) Meeting highlights: updated international expert consensus on the primary therapy of early breast cancer. J Clin Oncol 21:3357–3365

    Article  PubMed  Google Scholar 

  6. Hieken TJ, Harrison J, Herreros J, Velasco JM (2001) Correlating sonography, mammography, and pathology in the assessment of breast cancer size. Am J Surg 182:351–354

    Article  PubMed  CAS  Google Scholar 

  7. Snelling JD, Abdullah N, Brown G, King DM, Moskovic E, Gui GP (2004) Measurement of tumour size in case selection for breast cancer therapy by clinical assessment and ultrasound. Eur J Surg Oncol 30:5–9

    Article  PubMed  CAS  Google Scholar 

  8. Heusinger K, Löhberg C, Lux MP, Papadopoulos T, Imhoff K, Schulz-Wendtland R, Beckmann MW, Fasching PA (2005) Assessment of breast cancer tumor size depends on method, histopathology and tumor size itself. Breast Cancer Res Treat 94:17–23

    Article  PubMed  CAS  Google Scholar 

  9. Siegmann KC, Xydeas T, Sinkus R, Kraemer B, Vogel U, Claussen CD (2010) Diagnostic value of MR elastography in addition to contrast-enhanced MR imaging of the breast-initial clinical results. Eur Radiol 20:318–25

    Article  PubMed  Google Scholar 

  10. Yang WT, Lam WW, Cheung H, Suen M, King WW, Metreweli C (1997) Sonographic, magnetic resonance imaging, and mammographic assessments of preoperative size of breast cancer. J Ultrasound Med 16:791–797

    PubMed  CAS  Google Scholar 

  11. Fornage BD, Toubas O, Morel M (1987) Clinical, mammographic, and sonographic determination of preoperative breast cancer size. Cancer 60:765–771

    Article  PubMed  CAS  Google Scholar 

  12. Tresserra F, Feu J, Grases PJ, Navarro B, Alegret X, Fernandez-Cid A (1999) Assessment of breast cancer size: sonographic and pathologic correlation. J Clin Ultrasound 27:485–491

    Article  PubMed  CAS  Google Scholar 

  13. Forouhi P, Walsh JS, Anderson TJ, Chetty U (1994) Ultrasonography as a method of measuring breast tumour size and monitoring response to primary systemic treatment. Br J Surg 81:223–225

    Article  PubMed  CAS  Google Scholar 

  14. Davis PL, Staiger MJ, Harris KB, Ganott MA, Klementaviciene J, McCarty KS Jr, Tobon H (1996) Breast cancer measurements with magnetic resonance imaging, ultrasonography, and mammography. Breast Cancer Res Treat 37:1–9

    Article  PubMed  CAS  Google Scholar 

  15. Skaane P, Skjorten F (1999) Ultrasonographic evaluation of invasive lobular carcinoma. Acta Radiol 40:369–375

    Article  PubMed  CAS  Google Scholar 

  16. Dummin LJ, Cox M, Plant L (2007) Prediction of breast tumor size by mammography and sonography—a breast screen experience. Breast 16:38–46

    Article  PubMed  CAS  Google Scholar 

  17. Cho N, Moon WK, Park JS (2009) Real-time US elastography in the differentiation of suspicious microcalcifications on mammography. Eur Radiol 19:1621–8

    Article  PubMed  Google Scholar 

  18. Fleury EF, Rinaldi JF, Piato S, Fleury JC, Roveda Junior D (2009) Appearance of breast masses on sonoelastography with special focus on the diagnosis of fibroadenomas. Eur Radiol 19:1337–46

    Article  PubMed  Google Scholar 

  19. Scaperrotta G, Ferranti C, Costa C, Mariani L, Marchesini M, Suman L, Folini C, Bergonzi S (2008) Role of sonoelastography in non-palpable breast lesions. Eur Radiol 18:2381–9

    Article  PubMed  Google Scholar 

  20. Mesurolle B, Helou T, El-Khoury M, Edwardes M, Sutton EJ, Kao E (2007) Tissue harmonic imaging, frequency compound imaging, and conventional imaging: use and benefit in breast sonography. J Ultrasound Med 26:1041–1051

    PubMed  Google Scholar 

  21. Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X (1991) Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 13:111–134

    Article  PubMed  CAS  Google Scholar 

  22. Garra BS, Cespedes EI, Ophir J, Spratt SR, Zuurbier RA, Magnant CM, Pennanen MF (1997) Elastography of breast lesions: initial clinical results. Radiology 202:79–86

    PubMed  CAS  Google Scholar 

  23. Huber S, Wagner M, Medl M, Czembirek H (2002) Real-time spatial compound imaging in breast ultrasound. Ultrasound Med Biol 28:155–163

    Article  PubMed  Google Scholar 

  24. Cha JH, Moon WK, Cho N et al (2005) Differentiation of benign from malignant solid breast masses: conventional US versus spatial compound imaging. Radiology 237:841–846

    Article  PubMed  Google Scholar 

  25. Bland JM, Altman DG (1995) Comparing methods of measurements: why plotting difference against method is misleading. Lancet 346:1085–1087

    Article  PubMed  CAS  Google Scholar 

  26. Fasching PA, Heusinger K, Loehberg CR et al (2006) Influence of mammographic density on the diagnostic accuracy of tumor size assessment and association with breast cancer tumor characteristics. Eur J Radiol 60:398–404

    Article  PubMed  Google Scholar 

  27. Osako T, Iwase T, Takahashi K et al (2007) Diagnostic mammography and ultrasonography for palpable and nonpalpable breast cancer in women aged 30 to 39 years. Breast Cancer 14:255–259

    Article  PubMed  Google Scholar 

  28. Stavros AT (2004) Breast ultrasound. Lippincott Williams & Wilkins, Philadelphia, pp vii, 125–126, 465, 470

  29. Fornage BD, Sneige N, Faroux MJ, Andry E (1990) Sonographic appearance and ultrasound-guided fine-needle aspiration biopsy of breast carcinomas smaller than 1 cm3. J Ultrasound Med 9:559–568

    PubMed  CAS  Google Scholar 

  30. Bird RE, Wallace TW, Yankaskas BC (1992) Analysis of cancers missed at screening mammography. Radiology 184:613–617

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Diagnostic Radiology, Erlangen University Hospital, Erlangen, Germany

    Martina Meier-Meitinger, Michael Uder, Rüdiger Schulz-Wendtland & Boris Adamietz

  2. Department of Gynecology and Obstetrics, Erlangen University Hospital, University Breast Center, Erlangen, Germany

    Lothar Häberle, Peter A. Fasching, Mayada R. Bani, Katharina Heusinger & Matthias W. Beckmann

  3. Institute of Pathology, Erlangen University Hospital, Erlangen, Germany

    David Wachter

Authors
  1. Martina Meier-Meitinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lothar Häberle
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter A. Fasching
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mayada R. Bani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Katharina Heusinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David Wachter
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Matthias W. Beckmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michael Uder
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Rüdiger Schulz-Wendtland
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Boris Adamietz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martina Meier-Meitinger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meier-Meitinger, M., Häberle, L., Fasching, P.A. et al. Assessment of breast cancer tumour size using six different methods. Eur Radiol 21, 1180–1187 (2011). https://doi.org/10.1007/s00330-010-2016-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-010-2016-z

Keywords

Search

Navigation