The accuracy of mammogram and ultrasound in assessment of tumour size and lymph node involvement in invasive breast cancer

Abstract EN

Objectives: The purpose of our study is to assess the accuracy of mammogram and ultrasound in pre-operative prediction of the tumour size and lymph node involvement in patients with invasive breast carcinoma.

Methods: A retrospective study includes 200 female patients, aged 35 – 75 years diagnosed with invasive breast carcinoma at King Hussein Medical Center from October 2014 to August 2018.

All patients underwent either modified radical mastectomy or breast conserving surgery with axillary dissection.

Results of pre-operative mammogram and ultrasound were collected and compared with the final histopathologic findings.

Results: 84/200 patients (42%) had the same tumour size in both mammographic and histopathologic results.

The mammographic tumour size was underestimated in 76 patients (38%), and overestimated in 40 patients (20%).

The mean value of underestimation and overestimation of tumour size were 6.96 ± 4.70 mm and 5.30 ± 4.04 mm respectively.

The difference and correlation of the mean size between mammography and histopathology were statistically significant (t=-3.83, p=0.000; r=0.93, p<0.05).

Moreover mammography accurately determined the tumour size (versus pathological size) within 5 and 10mm, in 77 and 90% of cases, respectively.

Sensitivity and specificity of axillary ultrasound to detect the lymph node metastasis were 87 and 67% respectively.

Conclusion: The mammography does not seem to be very accurate in detecting the tumour size.

The axillary ultrasound is quite sensitive and moderately specific in the diagnosis of axillary lymph node metastasis.