A retrospective chart review of clinicopathological findings from radiological examination, core biopsies and surgical excisions of breast tumours in Manitoba, Canada

Abstract

Breast carcinoma is the most common cancer diagnosed in Canadian women. Effective screening and early diagnosis of breast carcinoma can increase the survival of breast carcinoma patients. Diagnostic imaging and core biopsy procedures are routinely employed as pre-operative breast carcinoma diagnostic tools. The utility of imaging and core biopsy is dependent on their ability to accurately and reliably detect and characterize malignant tumours. We retrospectively reviewed 266 invasive breast carcinoma patient records in Manitoba, Canada from 2018 to 2019. The aim of the study was to evaluate the level of agreement between diagnostic findings reported from the imaging, core biopsy and surgical excision specimens of breast carcinoma. Level of suspicion on imaging and BI-RADS score were concordant with pathologic tumour type in 85-86% and 100% of cases. Imaging and pathologic tumour size and stage were significantly correlated (R = 0.475, p = <0.001) and concordant in 8% and 53% of cases, respectively. Concordance of pathologic and imaging tumour size was significantly higher in tumours ≤2 cm (p = 0.007). Tumour size ≤2 cm (p = 0.014) and IDC histologic type (p = 0.003) significantly increased the likelihood of tumour stage concordance. Assessment of axillary lymph node disease on imaging and pathology were significantly correlated (p = <0.001). Imaging accurately predicted lymph node status in 74% of patients. Agreement between lymph node status on imaging and pathology was significantly higher in tumours ≤2 cm (p = 0.009). CNB accurately identified breast carcinoma in 99.6% of patients. Histologic grade on CNB and surgical excision were significantly correlated (p = <0.001) and concordant in 62% of cases. Rate of concordance was significantly higher in grade 2 tumours (p = <0.001). A significant correlation (p = <0.001) and concordance rate of 79% were noted between histologic type reported on CNB and surgical excision. The likelihood of histologic type concordance was significantly greater in IDC tumours than other histologic types (p = <0.001). Overall, imaging and CNB of IBC patients in Manitoba, Canada was observed to have reasonable accuracy and reliability in the detection and characterization of breast carcinoma.