Skip to main content

Size matters


It is accepted that a proportion of patients treated by breast-conservation surgery for unifocal malignancy will undergo further surgery for residual disease. Preoperative planning for impalpable lesions involves a radiological prediction of the extent of disease. The optimal outcome is disease clearance achieved by one operation only. We have revisited our cases which required a subsequent theatre visit in order to facilitate an understanding of the factors involved in accurate lesion sizing and thereby reduce re-excision rates.


All women screened through the Wrexham centre with a positive diagnosis of in situ or invasive disease going on to have operative treatment over a 1-year period have been included. The lesions were double-read by experienced film readers to obtain a maximal dimension on two-view mammography and ultrasound where applicable. Each case was attributed a grading, 1 to 3, for ease of measurement. This was compared with the postoperative histology, reported by a specialist breast histopathologist. The size, type, grade, receptor status and nodal status were recorded for each case.


A total of 61 cases were selected. The preoperative prediction of size was closest to the mammographic measurement in 74% of cases, and to the ultrasound dimension in 21%. The remainder showed equal measurements on both.


The mammogram provides a more accurate prediction of lesion size when compared with ultrasound images. It should be borne in mind that a certain proportion of women will choose mastectomy over conservation regardless of the available option of conservation.

Author information

Authors and Affiliations


Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article

Powell, M., Bayley, B. Size matters. Breast Cancer Res 13 (Suppl 1), P37 (2011).

Download citation

  • Published:

  • DOI: