{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T14:10:21Z","timestamp":1789999821778,"version":"4.0.1"},"reference-count":28,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: This study aimed to evaluate the concordance of preoperative digital breast tomosynthesis (DBT)- and magnetic resonance imaging (MRI)-measured tumor size with the pathological gold standard in invasive breast cancer and how this varies by molecular subtype and breast density (BI-RADS). Methods: This single-center, retrospective cohort study included 55 patients with unifocal invasive breast cancer who underwent preoperative DBT and MRI (1.5 T) followed by surgery within \u226460 days. Agreement with pathological size was assessed using Pearson\u2019s correlation, Lin\u2019s CCC, and Bland\u2013Altman analysis; measurements within \u00b120% of pathological size were classified as concordant, with DBT\/MRI rates compared using McNemar\u2019s test. Subgroup analyses were performed by molecular subtype and breast density. Results: The mean pathological tumor size was 21.7 \u00b1 10.7 mm. Pearson\u2019s r was 0.784 for DBT and 0.785 for MRI (Lin\u2019s CCCs were 0.775 and 0.783). Bland\u2013Altman bias was \u22121.16 mm for DBT and +0.10 mm for MRI, with wider limits of agreement for MRI. Concordance (\u00b120% threshold) was 54.5% for DBT and 45.5% for MRI, a non-significant difference (McNemar p = 0.38). Subtype- and density-stratified findings were directionally consistent but based on small subgroups and are hypothesis-generating only. Conclusions: In this cohort, DBT showed correlation and agreement with pathology comparable to MRI, without a statistically significant difference in concordance rate. Subgroup heterogeneity suggests DBT may hold value as a complementary sizing tool where MRI is unavailable, pending confirmation in larger, prospective, multicenter studies with independent reader validation.<\/jats:p>","DOI":"10.3390\/diagnostics16183034","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:50:03Z","timestamp":1789995003000},"page":"3034","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Concordance of Digital Breast Tomosynthesis (DBT) and Magnetic Resonance Imaging (MRI) Measured Tumor Size with the Pathological Gold Standard: A Retrospective Cohort Analysis by Molecular Subtype and Breast Density"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0958-6581","authenticated-orcid":false,"given":"Abdulkadir","family":"Eren","sequence":"first","affiliation":[{"name":"Radiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul 34214, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8667-1125","authenticated-orcid":false,"given":"Emrah","family":"Karatay","sequence":"additional","affiliation":[{"name":"Radiology, Sultan 2. Abdulhamid Han Training and Research Hospital, Istanbul 34668, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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