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Breast Lesions Incidentally Detected with CT: What the General Radiologist Needs to Know¹

¹ From the Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637. Presented as an education exhibit at the 2006 RSNA Annual Meeting. Received March 6, 2007; revision requested March 29 and received May 9; accepted May 16. H.M. is a stockholder in R2 Technology, consults for Riverain Medical and MEDIAN Technologies, and receives research support from R2 Technology, Mitsubishi Space Software, General Electric, and Eastman Kodak; G.M.N. is a member of the speakers bureau for Fuji Photo Film and the advisory board for Konica Minolta; all other authors have no financial relationships to disclose. Address correspondence to S.D.K. (e-mail: Sheela.Konda{at}uchospitals.edu).

Although breast abnormalities are frequently overlooked at multidetector computed tomography (CT) or inaccurately assessed, multidetector CT can reveal sufficient detail in many cases to allow confident diagnosis. It is important for general radiologists to characterize breast lesions incidentally found at CT as benign, indeterminate, or sufficiently suspicious to warrant further work-up. Irregular margins, irregular shape, and rim enhancement are the features most predictive of malignancy. Postoperative changes in the breast may mimic a malignancy; therefore, it is important to obtain an accurate history as to the timing of biopsy or surgery and to follow the changes in lesion morphology over time. Any mass with benign features at CT requires additional validation of benignity with demonstration of long-term stability or additional diagnostic mammographic work-up with or without sonographic evaluation. Accurate description and classification of breast lesions detected with CT enhance the value of the radiologist’s report and contribute to appropriate case management.

© RSNA, 2007