Focal Breast Lesions in Clinical CT Examinations of the Chest: A Retrospective Analysis (original) (raw)
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INCIDENTAL BREAST PATHOLOGY DETECTED IN CHEST COMPUTER TOMOGRAPHY (CT)
Objective To emphasize the importance of requested chest CT scan for cardiothoracic conditions for radiologist to evaluate the breast area this may impact patient’s management. Material and method A total number of 130 female patients whom underwent chest CT for cardiothoracic reasons, were retrospectively reviewed their images to evaluate and characterize breast lesions in a period between June 2016 –December 2017 at King Hussein Medical Center. The age of the patient’s ranges from (20-70 years) with the mean age 45 years. All scans were performed with Siemens definition dual source 64 slice CT scan, chest CT scan protocol with intravenous (IV) contrast media. The results will be analyzed by simple statistical method.
The chest radiologist's role in invasive breast cancer detection
Clinical Imaging, 2018
To assess the ability of chest CT to identify patients needing further evaluation of the breasts. Methods: IRB approval was obtained with a waiver of consent. Women with chest CT and mammogram within 12 months formed the cohort. A breast assessment and recommendation CT score (BARCS) analogous to mammographic BI-RADS was created and compared to the mammogram BI-RADS. Results: BARCS and mammographic BI-RADS management recommendations were concordant for 77.1%. 11 invasive cancers were detected; all by mammogram while CT missed 2. Conclusion: BARCS score should be studied in prospective trials. Chest CT might be the earliest opportunity to detect breast cancer.
Current Problems in Diagnostic Radiology, 2014
This pictorial review demonstrates computed tomography (CT) features with mammogram and, in some instances, ultrasound and positron emission tomography scan correlation of a wide spectrum of both malignant and benign findings on breast evaluation. Characterization of the margins, shape, pattern of enhancement, density, and associated findings is essential for accurate assessment of breast lesions during CT examination. Spiculated margins, irregular shape, and the presence of enhancement have a high predictive pattern for malignancy. The associated findings that could be seen include skin thickening, lymphadenopathy, architectural distortion, or chest wall or skin invasion. Nearly all detected breast calcifications on chest CT scans are benign. However, any breast masses and calcifications seen need further evaluation by other modalities, such as mammography or ultrasound or both. Malignant Entities The most highly predictive pattern for malignancy includes spiculated margins and irregular shape
Incidental breast lesions detected on CT: what is their significance?
British Journal of Radiology, 2010
An increasing number of breast lesions are being detected incidentally on CT. The aim of this study was to investigate the rate of referrals to the breast unit for assessment of lesions identified on CT and the resulting yield of previously undiagnosed breast malignancies from this pathway. A retrospective review was undertaken of CT examinations conducted over a period of 14 years. All patients (with no previous history of breast cancer) whose report contained the keyword ''breast'' and who were referred to a specialist breast unit for assessment were reviewed. CT lesion morphology and enhancement pattern were identified and compared with the final diagnostic outcome. 70 patients were identified by retrospective analysis, yielding 78 incidental breast lesions, of which 22 (28.2%) were malignant (category B5). This gave a positive predictive value (PPV) for malignancy of 28.2%. The best morphological predictor of malignancy was spiculation (PPV, 76%) and irregularity (PPV, 58%), whereas calcification patterns (PPV, 36%) were diagnostically unhelpful. Malignant lesions were likely to be larger (mean, 28.5 mm) than benign lesions (mean, 20.2 mm; p,0.05). In conclusion, 30% of incidental breast lesions in this large series of patients proved to be unsuspected breast cancers, particularly irregular spiculated masses. Referral for formal triple assessment of CT-diagnosed breast lesions is worthwhile, and careful examination of the breast should be a routine part of CT examinations.
Value of tomography in detecting breast masses and discriminating malign and benign lesions
Turkish Journal of Surgery, 2019
Objective: The main purpose of the present study was to determine the effectivity of computerized tomography (CT) in detecting breast masses and discriminating masses as malignant or benign. Material and Methods: After having received the institutional local ethics committee approval, an experienced radiologist who did not participate in the study created a patient pool by searching our health center's Pathology department database between 2010 and 2018. The group created consisted of dense and non-dense breast types equally and included approximately similar percentages of benign and malignant breast mass sizes. Finally, 70 subjects were included: 30 females with definite malign, 20 with definite benign breast masses, and 20 without any breast pathology based on mammography and ultrasonography results, who were considered as the control group. Three experienced Radiologists (R1, R2, R3) who were not aware of the final diagnosis evaluated all images independently. Radiologist performance was assessed by calculating the area under the receiver operating characteristic curve (AUC) and interobserver reliability values were estimated by intraclass correlation coefficient (ICC) analysis. Results: The diagnostic accuracy suitability of CT according to BI-RADS scores for R1, R2 and R3 were found as p< 0.001, p< 0.001 and p< 0.001, respectively. There were significant interobserver reliability rates between all investigators (p= 0.0001). Conclusion: CT may be used as a valuable diagnostic tool in discriminating breast masses with further training in widely varying appearances of normal breast tissues leading to false positive findings.
Breast mass assessment on chest CT: Axial, sagittal, coronal or maximal intensity projection?
Clinical Imaging, 2020
The goal of this work is to determine the optimal projection to detect breast masses on Chest CT. Methods: Institutional Review Board (HIPPA compliant) approval was obtained with a waiver of consent. 10 image pairs of Chest CT images containing breast masses were selected for review by 10 chest radiologists: the pairs consisted of axial, sagittal, coronal and axial MIP images (MIP images) with each projection compared to a MIP and with one another. For each pair, the image where the mass was most conspicuous was recorded. Results: MIPs were preferred to any cross sectional projection 82% of the time; sagittal (63%) or coronal (63%) images were preferred to the axial projection. When sagittal and coronal images were compared there was no preference. Conclusions: MIP images should be obtained and reviewed for breast pathology; sagittal or coronal projections may provide additional information.
The need to be all inclusive: Chest CT scans should include imaged breast parenchyma
Clinical imaging
The benefits of early diagnosis and treatment of breast cancer are well established. Thoracic CT which is performed with increased frequency for lung cancer screening can diagnose breast cancer earlier then might be possible clinically. The imaged and radiation exposed breasts must be included in their entirety on images which are reviewed by the radiologist. Because of concerns about how altering the field of view might affect image quality, we advocate for inclusion of the entire breast on the soft tissue series, which can be viewed on mediastinal window settings and expose the patient to no additional radiation.
CT scanning of the breast using a conventional CT scanner
Journal of Computed Tomography, 1981
Using a conventional body CT scanner, computed tomography of the breast was performed on 32 patients known to have or suspected of having breast masses. Xeromammograms were available for comparison in all cases. All mass lesions were histologically proved. Seven patients were examined prone, 25 supine. The prone position yielded pictures that resembled craniocaudal mammograms. Breast asymmetry, skin thickening, stranding from a mass to the chest wall, calcification, and axillary lymphadenopathy could be demonstrated by means of CT. The portion of the breast adjacent to the chest wall was more readily examined by means of CT than by conventional mammography. Internal mammary nodes could not be demonstrated.
La radiologia medica
Purpose To evaluate the frequency of mammary nodules as incidental findings on chest CT scans and to determine a correlation between semiological features and mammographic and histopathological outcomes. Methods A total of 42,864 chest CT scans performed on patients with breast-unrelated working diagnoses by the Radiology Department at AOU Maggiore della Carità, between 1st January 2016 and 30th April 2022, were analysed. Sixty-eight patients (3 males and 65 females) with mammary nodule CT detection were selected and subjected to mammography, mammary ultrasound and, eventually, biopsy. Results Thirty-five of the 68 patients received a histopathological confirmation of malignancy. According to Pearson’s Chi-square test, the CT features most likely associated with BI-RADS 5 following mammography were post-contrast enhancement (p = 0.001), margin irregularity (p = 0.0001), nipple retraction (p = 0.001), skin thickening (p = 0.024), and the presence of structurally atypical lymph nodes ...