Winning Abstracts from the 2008 Medical Student Abstract Competition: Breast Cancer Tumor Size in MRI versus Surgical Pathological Specimen: A Correlative Study.
Author: Andrew D Schwartzman, West Virginia University
Introduction
Although Magnetic Resonance Imaging (MRI) is superior to conventional imaging techniques in breast cancer, its correlation with actual tumor size has not been shown to be impressive. The purpose of our study is to determine the correlation of MRI with pathological findings of breast cancer in patients treated in West Virginia University Hospitals.
Methods
This is a retrospective study analyzing a database of 43 patients with breast cancer who had preoperative MRI. We estimated the correlation between the preoperative largest tumor diameter on MRI and diameter on pathological evaluation after surgery. The size of the surgical specimen is considered the gold standard for tumor measurement. A subset of 15 patients received neoadjuvant chemotherapy, while 28 patients did not. In all patients, MRI diameters were measured preoperatively. All MRI diameters were estimated by ONLY two radiologists in our institution.
Results
The mean age of our patient population was 47.4 years (range: 36-70). The median of the largest preoperative diameter as seen in the MRI was 20 mm, while the median of the diameter at surgery was 15 mm. The difference was significant (Wilcoxon Signed Rank Test, p= 0.0054). The correlation coefficient was 0.47(P-value= 0.0016). Further analysis of the same population based on whether they received neoadjuvant chemotherapy or not showed no difference in the level of correlation.
Conclusion
MRI of the breast tends to overestimate the tumor diameter seen in the pathological specimen of resected masses. However, an evident correlation exists between the MRI estimated diameter and the actual tumor size.
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