Skip to main content

Advertisement

SpringerLink
Log in

Assessment of Breast Cancer Tumor Size Depends on Method, Histopathology and Tumor Size Itself*

  • Report
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Summary

Purpose.Mammography (MG), breast (BU) and axillary ultrasound (AU), and clinical examination (CE) are commonly used for clinical staging. These different methods were compared in order to assess the accuracy of clinical tumor staging (cT).

Method.About 503 breast cancer (BC) patients were prospectively measured by MG, ultrasound and clinical examination. Pearson’s correlation to pathological tumor size (pT) was tested and the deviation of MG, BU and CE to pT was analyzed in subgroups defined by pT, grading (G), estrogen receptor (ER), progesteron receptor (PR), proliferation (MIB-1) and HER2/neu. Association of AU to pN was examined by χ2-test. Receiver operating characteristics (ROC) were used to test the prediction of a pT > 2 cm.

Results.Mammography correlated best with pT (r = 0.752). Mammography (mean (MG) = 2.17 cm) overestimated tumors in size (mean (pT) = 2.04 cm) rather than ultrasound (mean (BU) = 1.86 cm) and clinical examination (mean (cT) = 1.70 cm). pT of invasive ductal BC could be estimated significantly better than pT of invasive lobular BC. Smaller tumors were better to assess than larger ones. Tumors with a grading G1 were easier to estimate than tumors with G2/3. Best predictor of a pT > 2 cm was the mammography with an area under the curve of 0.876. The combination of all three modalities by linear regression performed even better with an AUC of 0.906.

Conclusions.The dimension of invasive ductal carcinomas, small and low grading tumors is significantly better to estimate. Concerning treatment decisions, we propose a combination of all three modalities, as the best predictive value was seen for the complementary use of mammography, ultrasound and clinical examination.

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

Similar content being viewed by others

References

  1. MW Beckmann C Nestle-Kraemling MP Lux D Klemt B Schroer TO Goecke D Niederacher PA Fasching (2001) ArticleTitleDas Familiäre Mammakarzinom-Syndrom: prädiktive genetische Testung, Beratung und Betreuung Med Welt 12 385–390

    Google Scholar 

  2. MW Beckmann PA Fasching JM Weiss A Magener O Ortmann (2003) ArticleTitleUpdate primäres Mammakarzinom 2003 Geburtshilfe Frauenheilkd 04 R66–R91

    Google Scholar 

  3. B Fisher J Bryant N Wolmark E Mamounas A Brown ER Fisher DL Wickerham M Begovic A DeCillis A Robidoux RG Margolese AB Cruz SuffixJr. JL Hoehn AW Lees NV Dimitrov HD Bear (1998) ArticleTitleEffect of preoperative chemotherapy on the outcome of women with operable breast cancer J Clin Oncol 16 2672–2685 Occurrence Handle9704717 Occurrence Handle1:CAS:528:DyaK1cXlsFCgurg%3D

    PubMed  CAS  Google Scholar 

  4. G Minckwitz Particlevon SD Costa W Eiermann JU Blohmer AH Tulusan C Jackisch M Kaufmann (1999) ArticleTitleMaximized reduction of primary breast tumor size using preoperative chemotherapy with doxorubicin and docetaxel J Clin Oncol 17 1999–2005 Occurrence Handle10561250

    PubMed  Google Scholar 

  5. G Bonadonna P Valagussa C Brambilla L Ferrari A Moliterni M Terenziani M Zambetti (1998) ArticleTitlePrimary chemotherapy in operable breast cancer: eight-year experience at the Milan Cancer Institute J Clin Oncol 16 93–100 Occurrence Handle9440728 Occurrence Handle1:STN:280:DyaK1c7gtFKkug%3D%3D

    PubMed  CAS  Google Scholar 

  6. B Fisher A Brown E Mamounas S Wieand A Robidoux RG Margolese AB, Cruz SuffixJr. ER Fisher DL Wickerham N Wolmark A DeCillis JL Hoehn AW Lees NV Dimitrov (1997) ArticleTitleEffect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18 J Clin Oncol 15 2483–2493 Occurrence Handle9215816 Occurrence Handle1:CAS:528:DyaK2sXkslymsr8%3D

    PubMed  CAS  Google Scholar 

  7. JA Hage Particlevan der CJ Velde Particlevan de JP Julien M Tubiana-Hulin C Vandervelden L Duchateau (2001) ArticleTitlePreoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902 J Clin Oncol 19 4224–4237 Occurrence Handle11709566

    PubMed  Google Scholar 

  8. SM Scholl A Fourquet B Asselain JY Pierga JR Vilcoq JC Durand T Dorval T Palangie M Jouve P Beuzeboc et al. (1994) ArticleTitleNeoadjuvant versus adjuvant chemotherapy in premenopausal patients with tumours considered too large for breast conserving surgery: preliminary results of a randomised trial: S6 Eur J Cancer 30A 645–652 Occurrence Handle10.1016/0959-8049(94)90537-1 Occurrence Handle8080680 Occurrence Handle1:STN:280:DyaK2czmtFyltw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  9. M Kaufmann G Minckwitz Particlevon R Smith V Valero L Gianni W Eiermann A Howell SD Costa P Beuzeboc M Untch JU Blohmer HP Sinn R Sittek R Souchon AH Tulusan T Volm HJ Senn (2003) ArticleTitleInternational expert panel on the use of primary (preoperative) systemic treatment of operable breast cancer: review and recommendations J Clin Oncol 21 2600–2608 Occurrence Handle10.1200/JCO.2003.01.136 Occurrence Handle12829681

    Article  PubMed  Google Scholar 

  10. TJ Hieken J Harrison J Herreros JM Velasco (2001) ArticleTitleCorrelating sonography, mammography, and pathology in the assessment of breast cancer size Am J Surg 182 351–354 Occurrence Handle10.1016/S0002-9610(01)00726-7 Occurrence Handle11720669 Occurrence Handle1:STN:280:DC%2BD3MnnsVOitw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  11. JD Snelling N Abdullah G Brown DM King E Moskovic GP Gui (2004) ArticleTitleMeasurement of tumour size in case selection for breast cancer therapy by clinical assessment and ultrasound Eur J Surg Oncol 30 5–9 Occurrence Handle10.1016/j.ejso.2003.10.003 Occurrence Handle14736515 Occurrence Handle1:STN:280:DC%2BD2c%2Fjslajuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  12. WF Zeggelink EE Deurloo H Bartelink EJ Rutgers KG Gilhuijs (2003) ArticleTitleReproducibility of the assessment of tumor extent in the breast using multiple image modalities Med Phys 30 2919–2926 Occurrence Handle10.1118/1.1621136 Occurrence Handle14655939

    Article  PubMed  Google Scholar 

  13. I Fredriksson G Liljegren M Palm-Sjovall LG Arnesson SO Emdin T Fornander A Lindgren H Nordgren I Idvall M Holmqvist L Holmberg J Frisell (2003) ArticleTitleRisk factors for local recurrence after breast-conserving surgery Br J Surg 90 1093–1102 Occurrence Handle10.1002/bjs.4206 Occurrence Handle12945077 Occurrence Handle1:STN:280:DC%2BD3svgsFenug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  14. U Veronesi B Salvadori A Luini M Greco R Saccozzi M Vecchio Particledel L Mariani S Zurrida F Rilke (1995) ArticleTitleBreast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1,973 patients Eur J Cancer 31A 1574–1579 Occurrence Handle10.1016/0959-8049(95)00271-J Occurrence Handle7488404 Occurrence Handle1:STN:280:DyaK28%2Fps1WltQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  15. A Goldhirsch WC Wood RD Gelber AS Coates B Thurlimann HJ Senn (2003) ArticleTitleMeeting highlights: updated international expert consensus on the primary therapy of early breast cancer J Clin Oncol 21 3357–3365 Occurrence Handle10.1200/JCO.2003.04.576 Occurrence Handle12847142

    Article  PubMed  Google Scholar 

  16. BD Fornage O Toubas M Morel (1987) ArticleTitleClinical, mammographic, and sonographic determination of preoperative breast cancer size Cancer 60 765–771 Occurrence Handle3297295 Occurrence Handle1:STN:280:DyaL2s3ktl2ntg%3D%3D

    PubMed  CAS  Google Scholar 

  17. F Tresserra J Feu PJ Grases B Navarro X Alegret A Fernandez-Cid (1999) ArticleTitleAssessment of breast cancer size: sonographic and pathologic correlation J Clin Ultrasound 27 485–491 Occurrence Handle10.1002/(SICI)1097-0096(199911/12)27:9<485::AID-JCU1>3.0.CO;2-C Occurrence Handle10525209 Occurrence Handle1:STN:280:DyaK1MvlsVyqtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  18. P Forouhi JS Walsh TJ Anderson U Chetty (1994) ArticleTitleUltrasonography as a method of measuring breast tumour size and monitoring response to primary systemic treatment Br J Surg 81 223–225 Occurrence Handle8156342 Occurrence Handle1:STN:280:DyaK2c3gslOgug%3D%3D

    PubMed  CAS  Google Scholar 

  19. PL Davis MJ Staiger KB Harris MA Ganott J Klementaviciene KS McCarty SuffixJr. H Tobon (1996) ArticleTitleBreast cancer measurements with magnetic resonance imaging, ultrasonography, and mammography Breast Cancer Res Treat 37 1–9 Occurrence Handle10.1007/BF01806626 Occurrence Handle1:STN:280:DyaK28zmt1Ghug%3D%3D Occurrence Handle8750522

    Article  CAS  PubMed  Google Scholar 

  20. P Skaane F Skjorten (1999) ArticleTitleUltrasonographic evaluation of invasive lobular carcinoma Acta Radiol 40 369–375 Occurrence Handle10394863 Occurrence Handle1:STN:280:DyaK1MzitVOrtA%3D%3D

    PubMed  CAS  Google Scholar 

  21. BJ McNeil E Keller SJ Adelstein (1975) ArticleTitlePrimer on certain elements of medical decision making N Engl J Med 293 211–215 Occurrence Handle806804 Occurrence Handle1:STN:280:DyaE2M7psVeksg%3D%3D Occurrence Handle10.1056/NEJM197507312930501

    Article  PubMed  CAS  Google Scholar 

  22. WT Yang WW Lam H Cheung M Suen WW King C Metreweli (1997) ArticleTitleSonographic, magnetic resonance imaging, and mammographic assessments of preoperative size of breast cancer J Ultrasound Med 16 791–797 Occurrence Handle9401992 Occurrence Handle1:STN:280:DyaK1c%2FmsFGmtg%3D%3D

    PubMed  CAS  Google Scholar 

  23. CA Finlayson TA MacDermott (2000) ArticleTitleUltrasound can estimate the pathologic size of infiltrating ductal carcinoma Arch Surg 135 158–9 Occurrence Handle10.1001/archsurg.135.2.158 Occurrence Handle10668873 Occurrence Handle1:STN:280:DC%2BD3c7jt1emtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  24. J Herrada RB Iyer EN Atkinson N Sneige AU Buzdar GN Hortobagyi (1997) ArticleTitleRelative value of physical examination, mammography, and breast sonography in evaluating the size of the primary tumor and regional lymph node metastases in women receiving neoadjuvant chemotherapy for locally advanced breast carcinoma Clin Cancer Res 3 1565–1569 Occurrence Handle9815844 Occurrence Handle1:STN:280:DyaK1M7htFSqsQ%3D%3D

    PubMed  CAS  Google Scholar 

  25. P Skaane EM Sager JB Olsen M Abdelnoor A Berger PA Wolff G Kullmann (1999) ArticleTitleDiagnostic value of ultrasonography in patients with palpable mammographically noncalcified breast tumors Acta Radiol 40 163–168 Occurrence Handle10080728 Occurrence Handle1:STN:280:DyaK1M7nvVyisQ%3D%3D Occurrence Handle10.3109/02841859909177732

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany

    K. Heusinger, C. Löhberg, M. P. Lux, M. W. Beckmann & P. A. Fasching

  2. Department of Pathology, University of Erlangen, Erlangen, Germany

    T. Papadopoulos & K. Imhoff

  3. Institute of Diagnostic Radiology, University of Erlangen, Erlangen, Germany

    R. Schulz-Wendtland

Authors
  1. K. Heusinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Löhberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. P. Lux
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Papadopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Imhoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R. Schulz-Wendtland
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. W. Beckmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. P. A. Fasching
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. A. Fasching.

Additional information

Presentation as a poster at the Congress of the German Cancer Society 2004 in Berlin: Heusinger K, Fasching PA, Imhoff K et al.: Impact of mammography, ultrasound of the breast and axilla on the decision of treatment strategy. J Cancer Res Res Clin Oncol 130 Suppl: S47, 2004

Rights and permissions

Reprints and permissions

About this article

Cite this article

Heusinger, K., Löhberg, C., Lux, M.P. et al. Assessment of Breast Cancer Tumor Size Depends on Method, Histopathology and Tumor Size Itself*. Breast Cancer Res Treat 94, 17–23 (2005). https://doi.org/10.1007/s10549-005-6653-x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-005-6653-x

Key words

Search

Navigation