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This study aimed to determine whether differences in the static field strength of 1.5-T and 3.0-T MRI systems affect the diagnostic results of tumor size measurement in breast cancer and to compare them with the results of tumor size in surgical pathology diagnosis. We adopted a retrospective and case-control study design. We included patients with a suspected or confirmed diagnosis of breast cancer who underwent breast MRI at our hospital between January 2017 and March 2023. Diffusion-weighted imaging (DWI), gadolinium-enhanced T1-weighted (Gd-T1WI) MRI, and tumor size from surgical pathology were compared via a significance difference test and correlation analysis between the two groups. A total of 36 patients met the selection criteria (15 for 1.5-T and 21 for 3.0-T). The mean ratio of pathologic tumor length to diameter was not significantly different between groups for each device (p=0.653); for 1.5-T MRI, the ratio of DWI to pathology was 1.042±0.361 and the ratio of Gd-T1WI to pathology was 1.107±0.314 with no significant difference between the ratios (p=0.345). The correlation coefficient between the two groups was r=0.730 (p=0.002). 3.0T MRI showed that the ratio of DWI to pathology was 0.893±0.197, while the ratio of Gd-T1WI to pathology was 1.062±0.177, showing significant difference between the two (p<0.001). The correlation coefficient between the two groups was 0.695 (p<0.001). While there was no significant difference in the ratios of tumor length diameter measured by 1.5-T Gd-T1WI and DWI compared to pathology, there was a significant difference in the ratios of tumor length diameter measured by 3.0-T DWI and Gd-T1WI compared to pathology. Hence, only 3.0-T DWI can lead to a potential underestimation of tumor length. [ABSTRACT FROM AUTHOR]