Pre-operative estimation of primary breast cancer size: a comparison of clinical assessment, mammography and ultrasound

This prospective study aimed to determine which is the most precise modalit y for the pre-operative measurement of primary breast cancers: clinical pal pation; mammography; or ultrasound. Analysis of the difference between the measurement of the maximum tumour diameter by these three modalities and by the histological measurement was performed in 210 cases. Clinical palpatio n tended to overestimate tumour size and gave the largest standard deviatio n of the difference. Ultrasound and mammography both gave a similar standar d deviation of the difference, with ultrasound tending to underestimate tum our size. For all modalities, the standard deviation and the 95% confidence intervals of the difference increased with increasing tumour size. There i s little difference between the precision of ultrasound and mammography in measuring tumour size. The wide 95% confidence intervals for any method of pre-operative tumour measurement should be considered when planning patient management. (C) 2001 Harcourt Publishers Ltd.