Learning objectives
This exhibit aims to present and describe various cases of benign and malignant breast lesions incidentally found on CT images of oncologic patients.
The goal is to familiarize the reader with the CT appearance of a variety of breast abnormalities to enable the reviewer to detect and characterize those lesions on CT scans as either clearly benign,
indeterminate,
or sufficiently suspicious as to warrant further work-up.
Background
Mammography and ultrassonography are currently the preferred examinations for breast cancer screening.
However,
multidetector CT may occasionally provide the first images of the breast lesion when thoracic scanning is performed for pulmonary or cardiac disease.
Furthermore,
in a multimodality oncology centre patients carry a scheduled follow up,
generally with CT scans,
as so a variety of breast lesions are identified occasionally.
Findings and procedure details
Various breast lesions can be observed in CT images,
including inflammatory,
infectious and post procedure findings (scars,
seromas) as well as malignant lesions such as breast primary (carcinoma,
lymphoma,
sarcoma) and secondary breast or other tumors metastasis.
BREAST CT LEXICON
Accurate assessment of breast lesions requires standardized terminology to describe and categorize abnormal findings.
For mammography,
breast US,
and breast MR imaging,
the Breast Imaging Reporting and Data System lexicon of the American College of Radiology provides the framework for standardized interpretation.
Similarly,
breast lesions...
Conclusion
Various breast lesions can be observed in CT images,
including inflammatory,
infectious and post procedure findings (scars,
seroma),
as well as malignant lesions such as breast primary (carcinoma,
lymphoma,
sarcoma) and secondary breast or other tumors metastasis.
Irregular and spiculated margins,
irregular shape,
and rim enhancement are the most highly predictive features for malignancy in CT studies (figure 29).
Also washout pattern on postcontrast images and diffuse regional enhancement have high positive predictive value for malignancy.
CT is very sensitive for the detection of coarse...
References
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Diseases of the...