Liu Yuanyuan, Liao Xuerui, He Yakun, He Fawei, Ren Jing, Zhou Peng, Zhang Xin
Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, 55 # South Renmin Road, Chengdu, 610041, Sichuan, China.
Department of Ultrasound, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, 610041, China.
BMC Womens Health. 2025 Apr 4;25(1):159. doi: 10.1186/s12905-025-03679-2.
Accurate size and stage estimation is important to monitor tumor response and plan further treatment in breast cancer patients undergoing neoadjuvant chemotherapy. To evaluate the accuracy of imaging findings [ultrasound (US) and magnetic resonance imaging (MRI)] for tumor size and stage estimations in early breast cancer patients and to elucidate the factors influencing tumor stage assessment.
We retrospectively enrolled consecutive women having pathologically confirmed breast cancer (stage T1/T2, 199 patients and 201 lesions) and preoperative records available for both US and MRI. The concordance between imaging-determined and pathological tumor size and stage was explored. The McNemar's test was conducted to compare the concordance between imaging-determined tumor size and imaging-determined tumor stage. Multivariate logistic regression was used to analyze the factors that influenced the accuracy.
The concordance between US-determined and pathological tumor size (71.1%) was comparable to MRI-pathology concordance (72.6%). MRI-determined stage concordance (73.6%) was comparable to US-determined stage concordance (69.2%). Tumors with a larger pathological size, were more likely to be underestimated by US or MRI in terms of tumor size and stage (all P < 0.05).
Tumor size and tumor stage concordance did not significantly differ between US and MRI in early breast cancer patients; US could be the first choice for tumor size estimation and tumor staging.
准确的肿瘤大小和分期评估对于监测接受新辅助化疗的乳腺癌患者的肿瘤反应以及规划进一步治疗至关重要。目的是评估影像学检查结果[超声（US）和磁共振成像（MRI）]在早期乳腺癌患者中对肿瘤大小和分期评估的准确性，并阐明影响肿瘤分期评估的因素。
我们回顾性纳入了连续的经病理证实为乳腺癌的女性患者（T1/T2期，199例患者，201个病灶），且有术前US和MRI检查记录。探讨了影像学确定的肿瘤大小和分期与病理结果之间的一致性。采用McNemar检验比较影像学确定的肿瘤大小与影像学确定的肿瘤分期之间的一致性。使用多因素逻辑回归分析影响准确性的因素。
US确定的肿瘤大小与病理结果的一致性（71.1%）与MRI - 病理一致性（72.6%）相当。MRI确定的分期一致性（73.6%）与US确定的分期一致性（69.2%）相当。病理大小较大的肿瘤在肿瘤大小和分期方面更有可能被US或MRI低估（所有P < 0.05）。
在早期乳腺癌患者中，US和MRI在肿瘤大小和肿瘤分期的一致性方面无显著差异；US可作为肿瘤大小评估和肿瘤分期的首选。
