Comparison of histological tumor size with mammography and magnetic resonance imaging in primary breast carcinoma

OBJECTİVE: Tumor size is the main prognostic indicator in breast cancers and is the determining factor for planning surgical treatment. The aim of this study is the correlation between radiological and histological size in tumor size measurement. MATERİALS AND METHOD: In this study; 65 patients who underwent mammography and breast magnetic resonance imaging preoperatively, did not receive preoperative neo-adjuvant chemotherapy treatment and applied to Ankara Atatürk Training and Research Hospital and Ankara Bilkent City Hospital Radiology Clinic were included between January 2014 and Oktober 2020. Patients underwent total or modified radical mastectomy surgery were screened retrospectively. In addition, pathology results of these patients were evaluated through the system. Inadequate examinations, pediatric patients, and without pathology results from the selected population were excluded from our study. The size of malignant mass lesions was measured using mammography and breast magnetic resonance images of patients diagnosed with primary breast cancer. Measurements were made by two independent breast radiologists. Pathological examinations and radiological findings are evaluated independently and dependently. The difference between the size of the mass determined by imaging methods and the size in the pathological specimen, kinetic curve type, cancer subtype, grade, hormone receptor grade, patient age range, mass lesion sizes and metastatic axillary lymph nodes. The findings obtained in the study were analyzed using appropriate statistical program formats with IBM SPSS Statistics 22 (IBM SPSS, Turkey). FINDINGS: The mean age of 65 female patients was 52.01 ± 9.97. The minimum patient age is 31 and the maximum patient age is 75.Breast parenchymal patterns in breast MRI and mammographic examination were ACR type A in 9 patients (13.8%), ACR type B in 21 patients (32.3%), ACR type C in 24 patients (36.9%), and ACR type D in 11 patients (16.9%). In breast MRI examination performed in breast cancer cases, 21 patients were evaluated as BIRADS 4, 37 patients as BIRADS 5 and 7 patients as BIRADS 6. Pathologically, invasive ductal carcinoma in 40 patients (61.5%), invasive lobular carcinoma in 3 patients (4.6%), ductal carcinoma in situ in 5 patients (7.7%), lobular carcinoma in situ in 1 patient (1.5%) in, 12 patients (18.5%) lobular and ductal carcinoma in situ mixed type. XI CONCLUSİON: Dynamic contrast-enhanced breast MRI was found to be more reliable and superior than other imaging modalities in showing pathological invasive breast carcinoma tumor size. Dynamic breast MRI examination was found to be more reliable than other methods in terms of reproducibility. KEY WORDS: DWI, ADC, breast, cancer, subtypes, grading, ER, PR, Ki-67, Her-2, malign, benign, MR