Prediction of Postoperative Tumor Size in Breast Cancer Patients by Clinical Assessment, Mammography and Ultrasonography

Background: Aim of study was to determine which is the most optimal and accurate preoperative modality (physical assessment, ultrasonography or mammography) to predict the histopathological size in breast cancer patients treated with breast conserving surgery (BCS) or modified radical mastectomy (MRM). Material and Methods: Between February 1988 and August 2008, 112 confirmed breast cancer patients referred to our tertiary care center underwent thorough physical examination, mammography and ultrasonography before surgery. Findings of physical assessment, mammography and ultrasonography were compared with post-surgical tumor size. The correlation between different tumor size findings was calculated using the Pearson correlative coefficients Results: Mean age of cohort was 47.0 years {range: 23-76; standard deviation (SD) 10.3. According to menopausal status, 93 patients (83.0%) were premenopausal and 19 patients (17.0%) were postmenopausal. Mean histopathological tumor size was 3.63 cm (range: 0.7-9). Preoperative ultrasonography findings were close to histopathological tumor size (R: 0.91, R2: 0.83, p 0.03), whereas both physical examination and mammography overestimated the tumor size (R: 0.53, R2:0.28, p 0.0001) and (R: 0.43, R2: 1.89, p0.001) respectively. Conclusion: Postoperative tumor size assessment was better with ultrasonography and findings of our studies suggest the use of ultrasonography to determine the postoperative tumor size in premenopausal women with breast cancer.