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    Unifocal Invasive Lobular Carcinoma: Tumor Size Concordance Between Preoperative Ultrasound Imaging and Postoperative Pathology

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    Authors
    Vijayaraghavan, Gopal
    Vedantham, Srinivasan
    Santos-Nunez, Gabriela
    Hultman, Rebecca
    UMass Chan Affiliations
    Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2018-07-27
    Keywords
    Breast
    Cancer
    ILC
    Pathologic examination
    Ultrasound examination
    Neoplasms
    Pathology
    Radiology
    
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    Link to Full Text
    https://doi.org/10.1016/j.clbc.2018.07.017
    Abstract
    BACKGROUND: We systematically analyzed the extent of disease in unifocal invasive lobular carcinoma (ILC) using ultrasonography, with the histopathologic findings as the reference standard. PATIENTS AND METHODS: In the present single-institution retrospective study, 128 cases of ILC were identified during a 5-year period. After exclusions, the analyzed cohort included 66 cases. Ultrasound measurements of the tumor extent along 3 axes were obtained. The tumor size was determined as the largest extent among the 3 axes and the tumor volume by ellipsoidal approximation. Pathology review provided the tumor size and volume. Correlation and regression analyses of tumor size and volume from the ultrasound and pathologic examinations were performed. The tumor stage from the ultrasound and pathologic examinations were used for the concordance analyses. RESULTS: The median and quartiles (Q1, Q3) of tumor size from ultrasonography and pathology were 12.5 mm (Q1, 9 mm; Q3, 19 mm) and 17 mm (Q1, 12 mm; Q3, 25 mm), respectively. The corresponding data for tumor volume were 0.52 cm(3) (Q1, 0.18 cm(3); Q3, 1.92 cm(3)) and 1.04 cm(3) (Q1, 0.45 cm(3); Q3, 2.49 cm(3)). The ultrasound measurements correlated with the pathology-reported tumor size (Spearman rho = 0.678; P < .0001) and volume (Spearman rho = 0.699; P < .0001). The ultrasound-measured size and volume differed from the pathology-reported size and volume (P < .0001; Wilcoxon signed ranks test). Concordance between the clinical tumor size stage from ultrasound (cT) and pathology tumor size stage (pT) varied with the pT stage (P = .0003, Fisher's exact test), with the greatest concordance rate of 95.7% (95% confidence limit, 85.2%-99.5%) observed for pT1 tumors. CONCLUSION: Ultrasonography underestimates the tumor size and volume, with the underestimation increasing for larger tumors. Hence, the concordance rate in tumor size stage between ultrasonography and pathology is tumor size dependent, with the greatest concordance rate observed for pT1 tumors.
    Source

    Clin Breast Cancer. 2018 Jul 27. pii: S1526-8209(18)30425-7. doi: 10.1016/j.clbc.2018.07.017. [Epub ahead of print]. Link to article on publisher's site

    DOI
    10.1016/j.clbc.2018.07.017
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48311
    PubMed ID
    30131246
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1016/j.clbc.2018.07.017
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