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Int J Clin Exp Pathol 2010;3(3):303-309
Original Article
Does size matter? Comparison study between MRI, gross, and microscopic tumor sizes
in breast cancer in lumpectomy specimens
Bita Behjatnia, Julie Sim, Lawrence W. Bassett, Neda A. Moatamed, Sophia K. Apple
Department of Pathology, 3405 E Hammond Cir Unit F Orange, CA, USA; Department of Radiology, Torrance memorial hosp. 3330 Lomita Blvd
Torrance, CA, 12530 Indianapolis St Los Angeles, CA, USA; Radiologic Sciences, University of California in Los Angeles, Box 951721, BL-428
CHS, Los Angeles, CA, USA; Department of Pathology & Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles,
California, USA.
Received February 3, 2010, accepted February 18, 2010, available online: February 22, 2010
Abstract: Size of breast cancer is essential in staging cancer to determine type and extent of patient management. This study was conducted
to assess accuracy in estimating tumor size by MRI and gross using microscopy as gold standard. A retrospective study was done on 33
patients, 30-75 years, who underwent MRI of breasts with subsequent lumpectomy, 2002-2006, for invasive breast cancer. Size of lesion(s) on
MRI and gross were compared with histological size. Of 37 lesions, 27 (73%) were invasive ductal (IDC) and 10 (27%) invasive lobular
carcinoma (ILC). Tumor size by MRI matched histological size in 3%, underestimated 27%, and overestimated 70% of cases. Tumor
size by gross matched histological size in 22%, underestimated 57%, and overestimated 22% of cases. MRI as an imaging modality and gross
pathology both have significant limitations in measuring tumor size particularly in cases of invasive breast carcinoma. Random sectioning of
lumpectomy specimen in invasive breast carcinoma may result in inaccurate staging of tumor by leading to false impression of tumor size and
multi-focality and/or multi-centricity of tumor particularly in cases of ILC. Microscopic measurements of tumor size are necessary for accurate
T-staging and recommended for appropriate patient management. (IJCEP1002001).
Key words: Breast cancer, MRI, microscopic pathology, gross pathology, tumor size
Full text PDF
Address all correspondence to:
Sophia K. Apple, MD
Department of Pathology & Laboratory Medicine,
David Geffen School of Medicine at UCLA
Los Angeles, California, USA
Tel: 310-825-9288, Fax: 310-267-2058
E-mail: sapple@mednet.ucla.edu
Original Article
Does size matter? Comparison study between MRI, gross, and microscopic tumor sizes
in breast cancer in lumpectomy specimens
Bita Behjatnia, Julie Sim, Lawrence W. Bassett, Neda A. Moatamed, Sophia K. Apple
Department of Pathology, 3405 E Hammond Cir Unit F Orange, CA, USA; Department of Radiology, Torrance memorial hosp. 3330 Lomita Blvd
Torrance, CA, 12530 Indianapolis St Los Angeles, CA, USA; Radiologic Sciences, University of California in Los Angeles, Box 951721, BL-428
CHS, Los Angeles, CA, USA; Department of Pathology & Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles,
California, USA.
Received February 3, 2010, accepted February 18, 2010, available online: February 22, 2010
Abstract: Size of breast cancer is essential in staging cancer to determine type and extent of patient management. This study was conducted
to assess accuracy in estimating tumor size by MRI and gross using microscopy as gold standard. A retrospective study was done on 33
patients, 30-75 years, who underwent MRI of breasts with subsequent lumpectomy, 2002-2006, for invasive breast cancer. Size of lesion(s) on
MRI and gross were compared with histological size. Of 37 lesions, 27 (73%) were invasive ductal (IDC) and 10 (27%) invasive lobular
carcinoma (ILC). Tumor size by MRI matched histological size in 3%, underestimated 27%, and overestimated 70% of cases. Tumor
size by gross matched histological size in 22%, underestimated 57%, and overestimated 22% of cases. MRI as an imaging modality and gross
pathology both have significant limitations in measuring tumor size particularly in cases of invasive breast carcinoma. Random sectioning of
lumpectomy specimen in invasive breast carcinoma may result in inaccurate staging of tumor by leading to false impression of tumor size and
multi-focality and/or multi-centricity of tumor particularly in cases of ILC. Microscopic measurements of tumor size are necessary for accurate
T-staging and recommended for appropriate patient management. (IJCEP1002001).
Key words: Breast cancer, MRI, microscopic pathology, gross pathology, tumor size
Full text PDF
Address all correspondence to:
Sophia K. Apple, MD
Department of Pathology & Laboratory Medicine,
David Geffen School of Medicine at UCLA
Los Angeles, California, USA
Tel: 310-825-9288, Fax: 310-267-2058
E-mail: sapple@mednet.ucla.edu
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