J Korean Soc Radiol.  2017 Feb;76(2):96-103. 10.3348/jksr.2017.76.2.96.

Detection of Breast Abnormalities on Enhanced Chest CT: Correlation with Breast Composition on Mammography

• Cho EM
• Kang H
• Shin YG
• Yun JH
• Oh KS
• Park S

• KMID: 2367856
• DOI: http://doi.org/10.3348/jksr.2017.76.2.96

Abstract

PURPOSE
To investigate the capability of enhanced chest computed tomography (CT) for detecting breast abnormalities and to assess the influence of breast composition on this detectability.
MATERIALS AND METHODS
From 2000 to 2013, 75 patients who underwent mammography, breast sonography, and enhanced chest CT within one month and had abnormalities on sonography were included. Detection rate of breast abnormality on enhanced chest CT was compared among 4 types of breast composition by the Breast Imaging Reporting and Data System. Contribution of breast composition, size and enhancement of target lesions to detectability of enhanced chest CT was assessed using logistic regression and chi-square test.
RESULTS
Of the 75 target lesions, 34 (45.3%) were detected on enhanced chest CT, corresponding with those on breast sonography; there were no significantly different detection rates among the 4 types of breast composition (p = 0.078). Breast composition [odds ratio (OR) = 1.07, p = 0.206] and enhancement (OR = 21.49, p = 0.998) had no significant effect, but size (OR = 1.23, p = 0.004) was a significant contributing factor influencing the detectability of enhanced chest CT for breast lesions.
CONCLUSION
About half of the cases (45.3%) demonstrated breast lesions on chest CT corresponding with target lesions on sonography. Breast composition defined on mammography did not affect the detectability of enhanced chest CT for breast lesions.

MeSH Terms

Breast*
Humans
Information Systems
Logistic Models
Mammography*
Multidetector Computed Tomography
Thorax*
Tomography, X-Ray Computed*
Ultrasonography

Figure

• 

  Fig. 1 57-year-old woman with invasive ductal carcinoma diagnosed through sonography-guided needle biopsy. A. Craniocaudal mammography of the left breast shows heterogeneously dense breast and it is classified as breast composition type c. There is a high density mass with irregular shape, indistinct margin, fine pleomorphic calcification (arrows). B. Contrast-enhanced chest CT shows about 53 mm sized enhancing mass in the left breast which is irregular shaped with lobulated margin. Associated skin thickening is also noted. C. US image shows a corresponding about 50 mm sized mass in the lower medial portion of left breast which is hypoechoic irregular mass with a heterogeneous internal echo pattern and classified as BI-RADS assessment category 5. BI-RADS = Breast Imaging Reporting and Data System, US = ultrasonography

• 

  Fig. 2 42-year-old woman with fibroadenoma diagnosed through vacuum assisted biopsy. A. Craniocaudal mammography of the right breast shows extremely dense breast and it is classified as breast composition type d. There is no evidence of mass nor suspicious morphology of calcification. B. Contrast-enhanced chest CT shows a subcentimetered oval shaped enhancing mass with smooth margin in the right breast (arrow). C. US image shows a corresponding 9 mm sized mass in the upper outer portion of right breast which is well circumscribed oval hypoechoic mass with parallel orientation and classified as BI-RADS assessment category 3. BI-RADS = Breast Imaging Reporting and Data System, US = ultrasonography

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