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Incidental focal uptake in the breast and axilla on FDG PET: Clinical considerations and differential diagnosis

      Highlights

      • Positron emission tomography/computed tomography (PET/CT) provides simultaneous metabolic and anatomic assessment of disease.
      • PET has limited sensitivity and specificity for detecting primary breast cancers.
      • Additionally, CT provides limited value due to inferior contrast and spatial resolution as compared to digital mammography.
      • Incidental focal breast or axillary FDG uptake on PET/CT can present a diagnostic challenge. We present a review of differential considerations.

      Abstract

      Incidental focal FDG uptake in the breast or axilla on PET/CT performed for evaluation of extra-mammary primary disease presents a diagnostic challenge. Radiologists must consider a broad differential diagnosis, assess clinical history, and judiciously employ other imaging modalities such as mammography, ultrasound and MRI in the pursuit of findings which help narrow the differential diagnosis. Tissue sampling may be reserved for nondiagnostic imaging scenarios.

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