Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2018 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Factors affecting the concordance of radiologic and pathologic tumor size in breast carcinoma.
2018 ASCO Annual Meeting
J Clin Oncol 36, 2018 (suppl; abstr e12568)
Author(s): Ameer Hamza, Ramen Sakhi, Sidrah Khawar, Shelby Miller, Ahmed Alrajjal, Warda Ibrar, Sajad Salehi, Jacob Edens, Uqba Khan, Daniel Ockner; St. John Hospital & Medical Center, Detroit, MI, US; St. John Hospital and Medical Center, Detroit, MI
Background: Radiologic assessment of tumor size is an essential work up for breast carcinoma. Concordance between radiologic and pathologic tumor size helps surgical decision. A variety of factors affect this concordance. Methods: This study is a retrospective review of surgical pathology breast specimens. Data were collected for 470 cases. Concordance was defined as a size difference within ± 2mm. Results: The difference between radiologic and pathologic tumor size was within ±2mm in 39.8% cases. The mean radiologic size was 1.74±1.07cm. The mean pathologic size was 1.83±1.33cm. A paired t-test showed a significant difference between radiologic and pathologic sizes (p = 0.016). Despite the size difference, stage classification was same in 59.6% cases. Radiologic size overestimated stage in 14.5% cases and underestimated stage in 25.9% cases. The concordance was significantly higher for tumors less than or equal to 2cm as compared to those greater than 2cm (50.2 % vs. 19.7%, p < 0.0001). A significantly higher proportion of lumpectomy specimens (46.6%) were concordant compared to mastectomy specimens (29.5%) (p < 0.0001). Invasive ductal carcinoma had better concordance compared to other tumors (p = 0.007). 44% cases without neoadjuvant therapy were concordant as compared to only 9.5% cases with neoadjuvant therapy (p < 0.0001). Cases with a time gap of no more than two months between imaging and surgery had better concordance as compared to those where the time gap was more than two months (43.1% vs. 29.4%, p = 0.02). Tumor site (quadrant of breast), radiologic characteristics of the tumor (circumscription, homogeneity versus heterogeneity and presence of calcifications), specimen weight and formalin fixation time had no significant effect on the concordance. Conclusions: We found a significant mean difference between radiology and pathology measurements. Radiology and pathology tumor measurements were concordant in about 60% of cases. A high level of concordance between radiology and pathology measurements is essential in determining the correct surgical plan for the patient. Knowledge of factors influencing this concordance can be useful in regards to surgical planning.
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