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A practical guide to managing CT findings in the breast

  • Sayf Al-katib
    Correspondence
    Corresponding author.
    Affiliations
    Beaumont Health, Oakland University William Beaumont School of Medicine, Department of Diagnostic Radiology and Molecular Imaging, 3601 W 13 Mile Rd, Royal Oak, MI 48073, United States of America
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  • Gurpriya Gupta
    Affiliations
    Henry Ford Hospital, Department of Diagnostic Radiology, 2799 West Grand Blvd., Detroit, MI 48202, United States of America
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  • Andrea Brudvik
    Affiliations
    Beaumont Health, Oakland University William Beaumont School of Medicine, Department of Diagnostic Radiology and Molecular Imaging, 3601 W 13 Mile Rd, Royal Oak, MI 48073, United States of America
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  • Stacy Ries
    Affiliations
    Beaumont Health, Oakland University William Beaumont School of Medicine, Department of Diagnostic Radiology and Molecular Imaging, 3601 W 13 Mile Rd, Royal Oak, MI 48073, United States of America
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  • Jillian Krauss
    Affiliations
    Beaumont Health, Oakland University William Beaumont School of Medicine, Department of Diagnostic Radiology and Molecular Imaging, 3601 W 13 Mile Rd, Royal Oak, MI 48073, United States of America
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  • Michael Farah
    Affiliations
    Beaumont Health, Oakland University William Beaumont School of Medicine, Department of Diagnostic Radiology and Molecular Imaging, 3601 W 13 Mile Rd, Royal Oak, MI 48073, United States of America
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      Highlights

      • 17-50% of incidental findings in the breast on CT represent unsuspected breast cancer.
      • Macroscopic fat and macrocalcifications in the breast detected on CT can be considered benign
      • Suspicious findings include masses with irregular margins, mass-like enhancement, growth and unilateral axillary adenopathy.
      • Indeterminate CT findings in the breast include skin thickening and circumscribed rounded masses.
      • CT may detect masses that are occult on mammography and ultrasound, particularly in patients with dense breast tissue.

      Abstract

      While it is well accepted that CT is not an optimal imaging study to evaluate the breasts, findings on chest CT may be the first indication of an occult malignancy. The nonspecific appearance of breast findings and the lack of consensus guidelines for managing incidental breast findings may dissuade radiologists from thoroughly evaluating the breasts on CT. We review commonly encountered breast findings on CT and present an algorithm for managing incidentally detected breast findings.

      Keywords

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