Background: Breast cancer is among the top three cancers affecting women across the world and its incidence is increasing worldwide. The size of lump at the time of initial treatment has a direct bearing on the prognosis. Therefore accuracy in detecting the exact size of lump with clinical assessment,imaging modalities like ultrasound and mammography are important tools of management. Neoadjuvant chemotherapy has become an accepted part of breast cancer treatment.Accurate assessment of lump before and after chemotherapy will indicate the response to treatment. The size of lump found in pathological specimen is the gold standard of exact dimension of the lump. Clinical examination, ultrasonography and mammography have all been used to assess the size of the lump and correlate their accuracy in assessing the actual size of lump in pathological specimen after surgery. There are conflicting reports about the accuracy of these tests in various studies conducted so far.

Aim: The aim of the study is to identify the best modality, among Clinical examination, ultrasonography and mammography to assess the size of lump by correlating it to the actual size as found in the pathological specimen after surgery.

Methods: This is a retrospective study of 53 cases of confirmed of breast cancer treated at Adichunchcnagiri hospital and research center BG Nagara over a period of five years from Feb 2011 to Feb 2016. These patients had undergone Physical examintion, ultrsonography and mammography before surgery. Patients who had not undergone both imaging tests in addition to clinical examination were excluded. The data was compiled and correlation of the size of the breast lump was compared with that found after surgical removal of the lump.

Results: Mean age of the study group was 53.5 years. The mean tumour size measured on clinical assessment was 10.77cm, 8.49cm on , mammography and 7.43cm on ultrasonography. Mean histopathological tumour size was 8.66cm.

Conclusion: Mammographic size correlated closest to the size of the lump found in pathological specimen. Clinical examination underestimated and ultrasonography tended to overestimate the size.