Comparison between incidental malignant and benign breast lesions detected by computed tomography: A systematic review

Bach, Andreas; Abbas, Jasmin; Jasaabuu, Cholpan; Schramm, Dominik; Wienke, Andreas; Surov, Alexey

doi:10.1111/1754-9485.12046

Cited by 29 publications

(24 citation statements)

References 20 publications

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“…[6][7][8]12 With increasing use of CT for a variety of diagnostic pathways, breast incidentalomas are identified more frequently, even though benign and malignant lesions might not be safely distinguished from each other on standard chest CT imaging. 13 In our patient, CT revealed additional lesions in the subcutaneous fat throughout the body, facilitating the diagnosis. Histopathology can be useful for determining the type of panniculitis, differentiation from other lesions, and guiding the therapy.…”

Section: Discussionsupporting

confidence: 50%

Nonsuppurative Nodular Panniculitis of the Breast

Rotaru

Punga

Codreanu

et al. 2015

Clinical Breast Cancer

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Section: Discussionsupporting

confidence: 50%

Nonsuppurative Nodular Panniculitis of the Breast

Rotaru

Punga

Codreanu

et al. 2015

Clinical Breast Cancer

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“…author Porter G et al [11] Hussain A et al [9] Hussain A et al ▶ Fig. 4 Box plot diagrams visualizing the quotient of densities measured in the index breast lesions and in the pectoralis musculature on the left side as well as the maximum lesion diameters on the right side stratified according to benign vs. malignant etiology in the 78 index lesions with known biological potential, respectively.…”

Section: Discussionmentioning

confidence: 99%

Focal Breast Lesions in Clinical CT Examinations of the Chest: A Retrospective Analysis

Krug

Houbois

Grinstein

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TPurpose Based on radiological reports, the percentage of breast cancers visualized as incidental findings in routine CT examinations is estimated at ≤ 2 %. In view of the rising number of CT examinations and the high prevalence of breast cancer, it was the goal of the present study to verify the frequency and image morphology of false-negative senological CT findings. Materials and MethodsAll first contrast-enhanced CT examinations of the chest in adult female patients carried out in 2012 were retrospectively included. A senior radiologist systematically assessed the presence of breast lesions on all CT images using the BI-RADS system. All BI-RADS ≥ 3 notations were evaluated by a second senior radiologist. A consensus was obtained in case of differing BI-RADS assessments.Reference diagnoses were elaborated based on all available clinical, radiological and pathological data. The findings of the CT reports were classified according to the BI-RADS system and were compared with the retrospective consensus findings as well as with the reference diagnoses. ResultsThe range of indications comprised a broad spectrum including staging and follow-up examinations of solid tumors/lymphoma (N = 701, 59.9 %) and vascular (190,16.2 %), inflammatory (48, 4.1 %) and pulmonologic (22, 1.9 %) issues. BI-RADS 1/2 classifications were present in 92.5 % and BI-RADS 6 classifications were assessed in 1.7 % of the 1170 included examinations. 68 patients (5.8 %) had at least one lesion retrospectively classified as BI-RADS 3 -5. The histological potential was known in 57 of these lesions as benign (46, 3.9 %) or malignant (11, 0.9 %). 13 BI-RADS 4/5 consensus assessments (1.1 %) were false-positive. 2 of the 10 lesions classified as being malignant based on the further clinical and radiological course were not mentioned in the written CT reports (0.2 %). Both false-negative CT reports were therapeutically and prognostically irrelevant. ConclusionThe relative frequency of BI-RADS 3 -5 findings was 5.8 %. It reflects the situation encountered in clinical imaging for primarily non-senologic questions and therefore differs from what would be expected in a dedicated screening program. The rates of known false-positive BI-RADS 4/5 findings in the retrospective evaluations (1.1 %) and of false-negative findings in the written CT reports (0.2 %) reflect the different diagnostic approaches of image-based senological screening and radiological examinations indicated in order to solve clinical problems not primarily concerning the breast region. Statements regarding the prevalence of clinically occult breast cancers can only be made with caution in the presented, highly selective group of patients due to the often incomplete visualization of breast tissue and the retrospective approach. Key points▪ Intramammary mass and non-mass lesions needing clarification may be present in up to 5.8 % of all contrast enhanced CT-examinations of the female chest. ▪ Irregular forms, unscharp/spiculated margins, inhomogeneous matrices and a pronounced c...

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“…Swensen et al (1) Diagnostic criteria are needed to distinguish benign and malignant breast lesions on chest CT. In the literature, although some authors reported irregular spiculated/stellate contour structure, rim-style enhancement and axillary lymphadenopathy as the most specific features for diagnosis of breast cancer on CT (5, 10), findings that does not meet these criteria and resemble benign breast tumors have also been reported (11,12). Invasive ductal carcinoma presents with dense, spiculated lesions with early-phase contrast enhancement, while lobular carcinoma presents with asymmetric increased density that is occasionally accompanied by skin thickening or irregular bordered lesions.…”

Section: Discussionmentioning

confidence: 99%

Incidental Breast Lesions Detected on Computed Thorax Tomography

et al. 2015

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Objective: Although mammography is the primary imaging method of the breast, incidental benign and malignant breast lesions are increasingly being detected on computed tomographies (CTs) performed to detect different pathologies. Therefore, the detection and accurate identification of these lesions is important. In this study, we aimed to evaluate the frequency, morphological features, and results of incidental breast lesions on CTs performed for the detection of extramammarian pathologies. Materials and Methods:Incidental breast lesions on CTs performed in our department between 2011 and 2013 were evaluated. Patients who had previously diagnosed breast lesions were excluded from the study. The inclusion criteria were histopathologic diagnose and being followed -up for at least 2 years. Results:The study population consisted of 33 women whose mean age was 55±1.38 (37-78) years. Of the 33 women, 12 (36%) had malignant and 21 (64%) had benign or normal findings. The most common malignant lesion was invasive ductal carcinoma, and the most common benign lesion was fibroadenoma. Ill-defined contour and lymphadenopathy in malignant lesions and well-defined contour in benign lesions were the most important CT findings. Conclusion:Breast must be carefully evaluated if it is included in the scans. An accurate report of breast lesions gives an opportunity for early diagnosis and treatment. Keywords: Computed tomography, thorax, breast, incidental findings IntroductionCurrently, mammography, ultrasound and magnetic resonance imaging (MRI) are the basic radiologic methods to diagnose breast diseases. However, the widespread use of multislice computed tomography (CT) in the last decade increased the rate of incidentally detected breast lesions in return, although, it is not a primary breast imaging method. Especially new generation multi-slice CTs with high spatial resolution reveal structures and pathologies that could not be previously viewed in detail. With the widespread use of multislice CT scans and higher resolution, the rate of detecting incidental findings unrelated to the main disease is increasing. These incidental findings sometimes lead to unnecessary further investigations and follow-up that result in higher cost and anxiety (1). Another problem related to this issue is radiologists' being specialized according to the field of pathology. That is why, they may fail to identify pathologies outside this area. For example, when a radiologist specialized in chest CT evaluates the breast tissue within the cross-sectional area, she/he can misinterpret or overlook some abnormalities (2).It has previously been shown that CT may detect incidental breast lesions during pulmonary and cardiac imaging. There are studies describing the characteristics of breast lesions incidentally detected on CT. However, these studies are limited in number (3-8).The aim of this study was to assess the frequency, CT features and results of breast lesions that were referred to our clinic after being detected by CT scans obtained to in...

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Comparison between incidental malignant and benign breast lesions detected by computed tomography: A systematic review

Abstract: Benign and malign breast incidentalomas are not safely distinguished from each other on standard chest CT. Therefore, all breast incidentalomas should be evaluated by further radiological/histological investigations.

Cited by 29 publications

References 20 publications

Nonsuppurative Nodular Panniculitis of the Breast

Nonsuppurative Nodular Panniculitis of the Breast

Focal Breast Lesions in Clinical CT Examinations of the Chest: A Retrospective Analysis

Incidental Breast Lesions Detected on Computed Thorax Tomography

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