Thirteen of 75 patients who had abnormal incidental findings in the breast after undergoing chest CT, or 17.3 percent, ended up indeed having breast cancer in a recent study, prompting the authors to recommend follow-up breast-specific imaging in all such cases.
The study was published online Oct. 7 in the Journal of Computer Assisted Tomography.
Thoracic radiologist Terrance Healey, MD, of Brown University and Rhode Island Hospital and colleagues reviewed the cases of more than 40,000 consecutive chest CTs performed for varied clinical reasons. Excluding the exams performed for staging newly diagnosed breast cancer, they found 258 exams from 218 unique patients had abnormal breast findings.
Then the researchers searched the EMR for subsequent breast imaging and pathology results.
Of the 13 out of 75 patients with malignant lesions first spotted incidentally on chest CT, eight had infiltrating ductal carcinoma, two had invasive lobular carcinoma two had lymphoma and one had intracystic papillary cancer with atypical features.
Four of the 75 underwent further workup and were found to have lesions that were benign—three with fibroadenoma and one with benign fibrocystic change.
The remaining 58 patients had dedicated breast imaging that brought back results classified as either BI-RADS 1 or 2 (negative or benign).
“Abnormal CT findings in the breast warrant additional evaluation with dedicated breast imaging to evaluate for a possible underlying malignancy,” Healey et al. conclude.