A total of 34 patients were registered between July 2009 and June 2012. The mean age was 53.5 years. The median follow-up time was 23.7 months (2-24 months). The age at the time of recurrence, state of menopause, T and N stage, histologically invasive diameter, number of lymph node metastases at initial diagnosis, histological grade, HER2 status, estrogen receptor (ER) status, progesterone receptor (PgR) status (priority order was defined as status at recurrence → that at the time of surgery → that at the initial diagnosis), interval from the resection of the primary lesion until recurrence (<12, 12-24, and ≥24 months), and site of recurrence are shown in Table 1.

As I understand, "histologically invasive diameter" stands for "maximal diameter of the area invaded by the primary tumour". But how is it measured in live patients?

In my understanding, one can't get a whole slice of tissue (histology) out of a living person to determine where exactly the tumor ends - but it's hard to estimate from one-off biopsies. The shape of the tumour might be irregular, and one or two biopsies won't help establish it precisely.

Maybe histology is somehow combined with imaging in order to establish the diameter?

  • 2
    That is a good answer @DeNovo, perhaps convert it using a reference to "clear margins" I think is good enough
    – DoctorWhom
    Jan 28, 2019 at 4:34
  • 2
    @DoctorWhom done!
    – De Novo
    Jan 28, 2019 at 14:16

1 Answer 1


These patients were staged on surgery. Typically whole tumor is excised with clear margins confirmed intraoperatively. Note the measurement is diameter of the primary tumor. Nodes and mets are assessed separately. As personal commentary, I would say characterization of the primary tumor (including diameter) is something you can be much more certain of than identification of nodes (lymph node involvement) and mets (metastases).

You can read about this in Schwartz's Principles of Surgery, Chapter 10, in particular the subsection on Surgical Management of Primary Tumors. As discussed in that section, the goal of surgical management is excision of the tumor with clear margins. Clear margins means the outermost tissue (the margins) are free of cancer (clear).

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