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Differences between the clinical and histopathological tumor stages in breast cancer diagnosed using vacuum-assisted breast biopsy.

Park HL, Hong JS, Chang SY, Huh JY, Shin JE, Kim JY, Shim JY, Noh S - Oncol Lett (2015)

Bottom Line: The present study aimed to determine the difference between the clinical tumor stage (T stage) based on pre-operative ultrasound and the histopathological T stage subsequent to surgery in vacuum-assisted breast biopsy (VABB)-diagnosed breast cancer.The histopathological tumor size was found to be smaller compared with the USG-determined size in 92.3% of pT1a, 75.5% of pT1b, 44.2% of pT1c, 47.7% of pT2 and 0% of pT3 cases.The smaller the primary tumor at the time of diagnosis by VABB, the higher the likelihood of pathological underestimation on post-operative histopathological assessment compared to pre-operative USG.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kangnam CHA Hospital, CHA University College of Medicine, Seoul 135-080, Republic of Korea.

ABSTRACT

The present study aimed to determine the difference between the clinical tumor stage (T stage) based on pre-operative ultrasound and the histopathological T stage subsequent to surgery in vacuum-assisted breast biopsy (VABB)-diagnosed breast cancer. Tumor sizes measured ultrasonography (USG) and histologically were retrospectively calculated and analyzed using paired t-tests in 209 patients diagnosed with breast cancer using VABB. The patients were classified into two groups, consisting of breast imaging reporting and data system (BI-RADS) category 4a or below, who underwent complete resection by VABB, and BI-RADS category 4b or above, who underwent incisional biopsy by VABB. The histopathological tumor size was found to be smaller compared with the USG-determined size in 92.3% of pT1a, 75.5% of pT1b, 44.2% of pT1c, 47.7% of pT2 and 0% of pT3 cases. Furthermore, the histopathological tumor size was smaller compared with the USG-determined size in 62.8% of cases classified as BI-RADS category 3-4a and in 53.7% of cases classified as BI-RADS category 4b-5. The smaller the primary tumor at the time of diagnosis by VABB, the higher the likelihood of pathological underestimation on post-operative histopathological assessment compared to pre-operative USG.

No MeSH data available.


Related in: MedlinePlus

Bivariate correlation analysis of the post-operative final pathological size and the initial ultrasonography-determined size in US category 4b-5 lesions [correlation coefficient (r)=0.502; P<0.01; r2=0.252]. US, ultrasound.
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f2-ol-09-04-1662: Bivariate correlation analysis of the post-operative final pathological size and the initial ultrasonography-determined size in US category 4b-5 lesions [correlation coefficient (r)=0.502; P<0.01; r2=0.252]. US, ultrasound.

Mentions: Analysis on ultrasound BI-RADS categorization revealed that in 27 of 43 category 3–4a cases (62.8%), in which complete excision by VABB, the pathological tumor size was smaller than the USG-determined size, while only 10 cases (23.3%) revealed the opposite result (Table III). An analysis of the aforementioned results by T staging also demonstrated that the pathological tumor size was smaller than the USG-determined size in 100% of pT1a cases, 77.8% of pT1b cases, 33.3% of pT1c cases, 66.7% of pT2 cases and 0% of pT3 cases, again indicating that the bigger the pathological tumor size, the less likely it is that histological underestimation occurs. However, 88 out of 164 cases (53.7%) in category 4b-5, where an incisional biopsy by VABB was performed, revealed that the pathological tumor size was smaller than the USG-determined size (Table IV). Further analysis of the category 4b-5 results by tumor-node-metastasis (TNM) staging showed that the pathological tumor size was smaller than the USG-determined size in 88.9% of pT1a cases, 82.8% of pT1b cases, 46.8% of pT1c cases, 45.8% of pT2 cases and 0.0% of pT3 cases, confirming that the larger the pathological tumor size, the less likely it is that histological underestimation takes place. Simple correlation analysis on the category 3–4a and 4b-5 groups revealed that the correlation coefficient of the category 3–4a group was 0.262 (P=0.129), which was lower than the coefficient of 0.502 (P<0.01) identified in the category 4b-5 group (Figs. 1 and 2). These findings indicate that histological underestimation occurs more commonly when a target lesion is confirmed as malignant following complete excision of the USG category 3 or 4a lesion using VABB compared with incisional biopsy only for lesions in USG category 4b or above.


Differences between the clinical and histopathological tumor stages in breast cancer diagnosed using vacuum-assisted breast biopsy.

Park HL, Hong JS, Chang SY, Huh JY, Shin JE, Kim JY, Shim JY, Noh S - Oncol Lett (2015)

Bivariate correlation analysis of the post-operative final pathological size and the initial ultrasonography-determined size in US category 4b-5 lesions [correlation coefficient (r)=0.502; P<0.01; r2=0.252]. US, ultrasound.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356268&req=5

f2-ol-09-04-1662: Bivariate correlation analysis of the post-operative final pathological size and the initial ultrasonography-determined size in US category 4b-5 lesions [correlation coefficient (r)=0.502; P<0.01; r2=0.252]. US, ultrasound.
Mentions: Analysis on ultrasound BI-RADS categorization revealed that in 27 of 43 category 3–4a cases (62.8%), in which complete excision by VABB, the pathological tumor size was smaller than the USG-determined size, while only 10 cases (23.3%) revealed the opposite result (Table III). An analysis of the aforementioned results by T staging also demonstrated that the pathological tumor size was smaller than the USG-determined size in 100% of pT1a cases, 77.8% of pT1b cases, 33.3% of pT1c cases, 66.7% of pT2 cases and 0% of pT3 cases, again indicating that the bigger the pathological tumor size, the less likely it is that histological underestimation occurs. However, 88 out of 164 cases (53.7%) in category 4b-5, where an incisional biopsy by VABB was performed, revealed that the pathological tumor size was smaller than the USG-determined size (Table IV). Further analysis of the category 4b-5 results by tumor-node-metastasis (TNM) staging showed that the pathological tumor size was smaller than the USG-determined size in 88.9% of pT1a cases, 82.8% of pT1b cases, 46.8% of pT1c cases, 45.8% of pT2 cases and 0.0% of pT3 cases, confirming that the larger the pathological tumor size, the less likely it is that histological underestimation takes place. Simple correlation analysis on the category 3–4a and 4b-5 groups revealed that the correlation coefficient of the category 3–4a group was 0.262 (P=0.129), which was lower than the coefficient of 0.502 (P<0.01) identified in the category 4b-5 group (Figs. 1 and 2). These findings indicate that histological underestimation occurs more commonly when a target lesion is confirmed as malignant following complete excision of the USG category 3 or 4a lesion using VABB compared with incisional biopsy only for lesions in USG category 4b or above.

Bottom Line: The present study aimed to determine the difference between the clinical tumor stage (T stage) based on pre-operative ultrasound and the histopathological T stage subsequent to surgery in vacuum-assisted breast biopsy (VABB)-diagnosed breast cancer.The histopathological tumor size was found to be smaller compared with the USG-determined size in 92.3% of pT1a, 75.5% of pT1b, 44.2% of pT1c, 47.7% of pT2 and 0% of pT3 cases.The smaller the primary tumor at the time of diagnosis by VABB, the higher the likelihood of pathological underestimation on post-operative histopathological assessment compared to pre-operative USG.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kangnam CHA Hospital, CHA University College of Medicine, Seoul 135-080, Republic of Korea.

ABSTRACT

The present study aimed to determine the difference between the clinical tumor stage (T stage) based on pre-operative ultrasound and the histopathological T stage subsequent to surgery in vacuum-assisted breast biopsy (VABB)-diagnosed breast cancer. Tumor sizes measured ultrasonography (USG) and histologically were retrospectively calculated and analyzed using paired t-tests in 209 patients diagnosed with breast cancer using VABB. The patients were classified into two groups, consisting of breast imaging reporting and data system (BI-RADS) category 4a or below, who underwent complete resection by VABB, and BI-RADS category 4b or above, who underwent incisional biopsy by VABB. The histopathological tumor size was found to be smaller compared with the USG-determined size in 92.3% of pT1a, 75.5% of pT1b, 44.2% of pT1c, 47.7% of pT2 and 0% of pT3 cases. Furthermore, the histopathological tumor size was smaller compared with the USG-determined size in 62.8% of cases classified as BI-RADS category 3-4a and in 53.7% of cases classified as BI-RADS category 4b-5. The smaller the primary tumor at the time of diagnosis by VABB, the higher the likelihood of pathological underestimation on post-operative histopathological assessment compared to pre-operative USG.

No MeSH data available.


Related in: MedlinePlus