The accuracy of four methods of breast volume measurement compared with specimen volume: a prospective study

doi:10.3877/cma.j.issn.1674-0785.2021.10.008

Abstract

Abstract:

Objective

To prospectively compare the accuracy of four different methods (anthropometric, indirect, CT and MRI), with the mastectomy specimen volume as the gold standard, and provide clinical ideas to increase the rate of immediate breast reconstruction.

Methods

The patients who were diagnosed with breast cancer and received mastectomy at Peking University First Hospital between January 2020 and February 2021 entered the prospective study. Breast volumes were measured preoperatively by four different methods (anthropometric, indirect, CT and MRI). Specimen volume after mastectomy was measured with the water displacement method (the gold standard) in the operation room. The results were analyzed by correlation analysis. Linear regression and Bland-Altman analysis were also used to evaluate the consistency of the four methods and the gold standard respectively.

Results

A total of 47 patients (49 breasts) were enrolled in the prospective study. The correlation coefficients r of anthropometric, indirect, CT and MRI measurement methods were 0.625, 0.916, 0.994 and 0.995 (P＜0.001), respectively; the linear regression coefficients R² were 0.378, 0.835, 0.982 and 0.989 (P＜0.001), respectively. The Bland-Altman analysis also indicated that the four methods were significantly correlated with the gold standard.

Conclusion

The measurements of breast volume by four methods including anthropometric, indirect, CT and MRI are significantly correlated with the specimen volume. The accuracy of MRI is the best while CT has a higher clinical application value.

Key words: Breast volume, Breast reconstruction, 3D reconstruction

Zhaoyue Li, Bing Wen, Meng Li, Qian Liu. The accuracy of four methods of breast volume measurement compared with specimen volume: a prospective study[J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(10): 760-767.

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References 28

1	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020 [J]. CA Cancer J Clin, 2020, 70(1): 7-30.
2	Gradishar WJ, Anderson BO, Abraham J, et al. Breast cancer, version 3.2020, NCCN clinical practice guidelines in oncology [J]. J Natl Compr Canc Netw, 2020, 18(4): 452-478.
3	Halsted WS. The results of operations for the cure of cancer of the breast performed at the Johns Hopkins Hospital from June, 1889, to January, 1894 [J]. Ann Surg, 1894, 20(5): 497-555.
4	Patey DH. A review of 146 cases of carcinoma of the breast operated on between 1930 and 1943 [J]. Br J Cancer, 1967, 21(2): 260-269.
5	Kiebert GM, De Haes JC, Van De Velde CJ. The impact of breast-conserving treatment and mastectomy on the quality of life of early-stage breast cancer patients: a review [J]. J Clin Oncol, 1991, 9(6): 1059-1070.
6	Clough KB, Kaufman GJ, Nos C, et al. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery [J]. Ann Surg Oncol, 2010, 17(5): 1375-1391.
7	Paterson CL, Lengacher CA, Donovan KA, et al. Body image in younger breast cancer survivors: a systematic review [J]. Cancer Nurs, 2016, 39(1): E39-58.
8	程元甲, 陈晶晶, 张虹, 等. 早期乳腺癌病人保乳手术标本病理切缘评价临床价值研究 [J]. 中国实用外科杂志, 2019, 39(12): 1326-1330.
9	修秉虬, 郭瑢, 杨犇龙, 等. 中国乳腺癌术后乳房重建手术横断面调查研究 [J]. 中华肿瘤杂志, 2019, 41(7): 546-551.
10	郭瑢, 修秉虬, 苏永辉, 等. 中国乳腺癌术后植入物乳房重建现况调查 [J]. 中华外科杂志, 2019, 57(8): 616-621.
11	Qiao Q, Zhou G, Ling Y. Breast volume measurement in young Chinese women and clinical applications [J]. Aesthetic Plast Surg, 1997, 21(5): 362-368.
12	Kasielska-Trojan A, Mikołajczyk M, Antoszewski B. Breast idea volume estimator (BIVE) - a new tool for breast volume estimation-presentation and validation for women [J]. Plast Reconstr Surg, 2020, 146(6): 744e-748e.
13	中国抗癌协会乳腺癌专业委员会, 中国医师协会外科医师分会乳腺外科医师专委会, 吴炅, 等. 乳腺肿瘤整形与乳房重建专家共识(2018年版) [J]. 中国癌症杂志, 2018, 28(6): 439-480.
14	Choppin SB, Wheat JS, Gee M, et al. The accuracy of breast volume measurement methods: A systematic review [J]. Breast, 2016, 28: 121-129.
15	张叶, 傅荣, 王志军, 等. 超声自动乳腺全容积成像测量技术在乳房重建中的应用 [J]. 中国美容医学, 2014, 23(23): 1949-1954.
16	Kayar R, Civelek S, Cobanoglu M, et al. Five methods of breast volume measurement: a comparative study of measurements of specimen volume in 30 mastectomy cases [J]. Breast Cancer (Auckl), 2011, 5: 43-52.
17	乔群, 凌诒淳, 周刚, 等. 中国125名青年女性乳房体积测量 [J]. 中华整形烧伤外科杂志, 1991, 7(1): 1-3.
18	Bouman FG. Volumetric measurement of the human breast and breast tissue before and during mammaplasty [J]. Br J Plast Surg, 1970, 23(3): 263-264.
19	王凌宇, 栾杰, 李彦生, 等. CT数据三维重建乳房体积测量方法的建立及人为影响因素分析 [J]. 中华医学美学美容杂志, 2010, 16(2): 77-80.
20	Rha EY, Choi IK, Yoo G. Accuracy of the method for estimating breast volume on three-dimensional simulated magnetic resonance imaging scans in breast reconstruction [J]. Plast Reconstr Surg, 2014, 133(1): 14-20.
21	Osman NM, Botros SM, Ghany AFA, et al. Contralateral breast volume measurement during chest CT for postmastectomy breast reconstruction [J]. Int J Comput Assist Radiol Surg, 2015, 10(2): 141-147.
22	Erić M, Anderla A, Stefanović D, et al. Breast volume estimation from systematic series of CT scans using the Cavalieri principle and 3D reconstruction [J]. Int J Surg, 2014, 12(9): 912-917.
23	Moor EV, Westreich M, Bar-Ziv Y, et al. Derivation of final implant volume for breast reconstruction using three dimensional CT scan [J]. Eur J Plast Surg, 2000, 23(3): 138-141.
24	Fujii T, Yamaguchi S, Yajima R, et al. Accurate assessment of breast volume by computed tomography using three-dimensional imaging device [J]. Am Surg, 2012, 78(9): 933-935.
25	王凌宇, 栾杰, 李彦生, 等. CT数据三维重建测量乳房体积在乳房整形中的应用 [J]. 组织工程与重建外科杂志, 2012, 8(3): 150-153.
26	Yip JM, Mouratova N, Jeffery RM, et al. Accurate assessment of breast volume: a study comparing the volumetric gold standard (direct water displacement measurement of mastectomy specimen) with a 3D laser scanning technique [J]. Ann Plast Surg, 2012, 68(2): 135-141.
27	Atallah D, Arab W, El Kassis N, et al. Breast and tumor volumes on 3D-MRI and their impact on the performance of a breast conservative surgery (BCS) [J]. Breast J, 2020, 27(3): 252-255.
28	Kovacs L, Eder M, Hollweck R, et al. Comparison between breast volume measurement using 3D surface imaging and classical techniques [J]. Breast, 2007, 16(2): 137-145.

项目	例数	百分比（%）
年龄
≤35岁	2	4.26
＞35岁	45	95.74
绝经
未绝经	14	29.79
已绝经	33	70.21
是否下垂
否	32	68.09
是	15	31.91
新辅助治疗
否	37	78.72
是	10	21.28
是否存在多个病灶
否	43	91.49
是	4	8.51
肿瘤最大径
＜20 mm	26	55.32
20~50 mm	18	38.30
≥50 mm	3	6.38
肿瘤病理类型
浸润性癌	39	82.98
原位癌	8	17.02
测量方法完成度
线性测量法	47	100.00
间接测量法	47	100.00
CT测量法	47	100.00
MRI测量法	13	27.66
标本排水法	47	100.00

项目	例数	百分比（%）
年龄
≤35岁	2	4.26
＞35岁	45	95.74
绝经
未绝经	14	29.79
已绝经	33	70.21
是否下垂
否	32	68.09
是	15	31.91
新辅助治疗
否	37	78.72
是	10	21.28
是否存在多个病灶
否	43	91.49
是	4	8.51
肿瘤最大径
＜20 mm	26	55.32
20~50 mm	18	38.30
≥50 mm	3	6.38
肿瘤病理类型
浸润性癌	39	82.98
原位癌	8	17.02
测量方法完成度
线性测量法	47	100.00
间接测量法	47	100.00
CT测量法	47	100.00
MRI测量法	13	27.66
标本排水法	47	100.00

测量方法	乳房数（例）	平均乳房体积（cm³）	范围（cm³）	r值	P值
线性测量法	49	486.63±426.20	50.91~2203.71	0.625	＜0.001
间接测量法	49	380.47±261.85	67.26~1784.24	0.916	＜0.001
CT测量法	49	549.65±286.54	193.00~1845.83	0.994	＜0.001
MRI测量法	14	696.53±434.53	327.62~1837.12	0.995	＜0.001
标本排水法	49	556.94±306.73	180.00~2000.00	-	-

测量方法	乳房数（例）	平均乳房体积（cm³）	范围（cm³）	r值	P值
线性测量法	49	486.63±426.20	50.91~2203.71	0.625	＜0.001
间接测量法	49	380.47±261.85	67.26~1784.24	0.916	＜0.001
CT测量法	49	549.65±286.54	193.00~1845.83	0.994	＜0.001
MRI测量法	14	696.53±434.53	327.62~1837.12	0.995	＜0.001
标本排水法	49	556.94±306.73	180.00~2000.00	-	-

测量方法	R²	B（95%CI）	常量（95%CI）（cm³）	P值
线性测量法	0.378	0.450（0.285~0.615）	337.914（231.785~444.042）	＜0.001
间接测量法	0.835	1.073（0.934~1.212）	148.829（85.231~212.428）	＜0.001
CT测量法	0.982	1.061（1.018~1.103）	-26.099（-52.240~0.042）	＜0.001
MRI测量法	0.989	1.085（1.016~1.155）	-52.454（-109.208~4.299）	＜0.001

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