This study aimed to determine the cancer yield for abnormal breast findings initially identified on chest computed tomography (CT).
This institutional review board–approved, Health Insurance Portability and Accountability Act–compliant study retrospectively reviewed reports of 41,217 consecutive chest CT examinations done from January 1, 2006, to December 31, 2011, to identify those with breast findings noted in the impression of the report. Examinations done for staging of newly diagnosed breast cancer were excluded. The electronic medical record was searched for any subsequent breast imaging and any corresponding pathology results. Cancer yield was calculated.
A total of 258 chest CT examinations with abnormal breast findings were identified in 218 unique patients. Average patient age was 65.6 years (range, 30–100 years). There were 207 women and 11 men. Of these, 75 patients had follow-up breast imaging in our system. One hundred forty-three patients did not have follow-up in our system and were excluded for purposes of cancer detection rate calculation. Thirteen of 75 patients were found to have lesions that were malignant: infiltrating ductal carcinoma (8), invasive lobular carcinoma (2), lymphoma (2), and intracystic papillary cancer with atypical features (1). Four of 75 patients underwent further workup and were found to have lesions that were benign: fibroadenoma (3) and benign fibrocystic change (1). The remainder of the 58 of 75 patients had dedicated breast imaging that was classified as either Breast Imaging Reporting and Data System score 1 or 2, and no further workup was performed. Cancer yield from CT findings was 17.3%.
Abnormal CT findings in the breast warrant additional evaluation with dedicated breast imaging to evaluate for a possible underlying malignancy. Cancer yield from CT findings in this study was 17.3%.
From the *Department of Diagnostic Imaging, Alpert Medical School at Brown University, Providence, RI; and
†Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA.
Received for publication July 29, 2017; accepted September 14, 2017.
Correspondence to: Saurabh Agarwal, MD, Department of Diagnostic Imaging, Alpert Medical School at Brown University, Providence, RI 02903 (e-mail: firstname.lastname@example.org).
All authors have no financial disclosures.
This study is institutional review board approved.