J Korean Radiol Soc.  1985 Dec;21(6):954-962. 10.3348/jkrs.1985.21.6.954.

Computed tomography of the breast cancer

• Chung SY
• Lee Y
• Bae SH
• Yoon JS
• Lee KC

• KMID: 2462394
• DOI: http://doi.org/10.3348/jkrs.1985.21.6.954

Abstract

The indication of CT for the breast lesions are 1) Unusually extensive or small breast caused technicaldifficulties in performing mammograms. 2) Questionable mammographic findings, especially in dense proliferativebreast parenchyme, 3) Microcancer. 4) Suspicious regional lymph node enlargement of invasion of the chest wall bybreast cancer. The diagnosis of breast CT in breast cancer is based on pathologic anatomic change andcharacteristic increase of mean CT No. of lesion following contrast enhancement. Authors analysed CT of the 34patients who were clinically suspected breast cancer, and compared with mammography. The results are as follows:1. Pathological diagnosis of 34 cases were 27 cases of breast cancer, 4 cases of fibrocystic disease, 2 cases offibroadenoma, and 1 case of intraductal pupilloma. The diagnostic accuracy of CT in 27 breast cancer was 93%(25cases) and mammography 71%(19 cases). 2. Corect diagnosis of CT in 7 benign breast disease is in 5 cases andmammography in 5 cases. 3. The most importment finding of CT in breast cancer is characteristic increase of CT No.of lesion following contrast enhancement (200ml, 65%): over average 50HU in 19 cases of 27 breast cancers, 30-50HUin a 6 cases, 20-30HU in 2 cases with tumor necrosis. 4. Compared with mammography, other more valuable CTfindings of breast cancer are axillary lymph node enlargement and adjacentic pectoral muscle invasion. 5. Inconclusion, Breast CT is considered as a valuable diagnostic tool in evaluation of breast cancer, but not of benign breast disease.

MeSH Terms

Breast Diseases
Breast Neoplasms*
Breast*
Diagnosis
Lymph Nodes
Mammography
Necrosis
Thoracic Wall

Figure

• 

  Fig. 1. A: Mammography show minimal subareolar parenchymal density of the right breast. B: Contrast-enhanced breast CT show characteristically enhancing nodule with spicules of breast cancer in subareolar area.

• 

  Fig. 2. A: Mammography show huge well defined homogeneous mass in lateral portion of breast. B. Contrast-enhanced breast CT scan show inhomogeneous mass with multiple internal necrosis of breast cancer. Combined axillary lymph nodes metastasis.

• 

  Fig. 3. A: Well defined multiple filling defects of lactiferous duct in intraductal papillomatosis on galactography. B: 111 defined, moderately enhancing subareolar density on breast CT.

• 

  Fig. 4. A: Marked enhancing mass in ROI (region of interest) on contrast-enhanced breast CT scan. B. Comparison of CT No. of ROI in precontrast and postcontrast study. Localized increased contrast enhancement over mean 50HU.

• 

  Fig. 5. A: Irregular marginated mass of breast cancer on mammography. B: Marked enhancing mass of breast cancer combined with multiple axillary lymph nodes metastasis on breast CT.

Reference

1.Martin JE. Breast imaging techniques mammography, ultrasonography, computed tomography, thermography, and transillumination. Radiol Clin North Am. 21:149–153. 1983.

2.Wolfe JN., Albert S., Belle S, et al. Breast parenchymal patterns and their relationship to risk for having or developing carcinoma. Radiol Chin North Am. 21:127–136. 1983.

3.Wolfe JN. Breast patterns as an index of risk for developing breast cancer. AJR. 126:1130–1139. 1976.

4.Chang CHJ., Nesbit DE., Fisher DR, et al. Computed tomogjraphic mammography using a conventional body scanner. AJR. 138:553–558. 1982.

5.Mailer JWT., van Waes PFGM., Koehler PR. Computed tomography of breast lesion comparison with X-ray mammography. J Comput Assist Tomogr. 7:650–754. 1983.

6.Chang CHJ., Sibala JL., Gallagher JH, et al. Computed tomography of the breast: a preliminary report. Radiology. 124:827–829. 1977.

7.Chang CHJ., Sibala JL., Fritz SL, et al. Computed tomographic evaluation of the breast. AJR. 131:459–464. 1978.

8.Chang CHJ., Sibala JL., Fritz SL, et al. Specific value of computed tomogjraphic breast scanner (CT/M) in diagnosis of breast diseases. Radiology. 132:647–652. 7979.

9.Kelsey JL., Hildreth NG., Thompson WD. Epidemiologic aspects of breast cancer. Radiol Clin North Am. 21:3.

10.Lyttle CR., Thorpe SM., DeSonbre ER, et al. Peroxidase Activity and iodide uptake in hormone-responsive and hormone-independent CR mouse mammary tumors. J Natl Cancer Inst. 62:1031–1034. 1079.

11.Chang CHJ., Sibala JL., Fritz SL, et al. Preoperative diagnosis of potentially precanceroug breast lesions by computed tomography breast scanner: preliminary study. Radiology. 129:209–210. 1978.

12.Eskin BA., Parker JA., Bassett JG, et al. Human breast uptake of radioactive iodine. Obstet Gynecol. 44:398–402. 1974.

13.Gisvold JJ., Reese DF., Karsell PR. Computed tomographic mammography (CT/M). AJR. 133:1143–1149. 1979.

14.Reese DF., Carmey JA., Gisvold JJ, et al. Computerized reconstructive tomogjraphy applied to breast pathology. AJR. 126:406–412. 7976.

15.Moskowitz Μ. Minimal breast cancer redux. Radiol Clin North Am. 21:93–113. 1983.

16.Sibala JL., Chang CHJ., 니η F. Computed tomography: diagnosis of mammographically and clinically occult carcinoma of the breast. Arch Surg. 776:774–777. 1981.

17.Hoeffken W., Lanyi Μ. Mammography 1st Ed: pp156-209, Georg Thieme, Stuttgart. 7977.

18.Sadowsky N., Kopans DB. Breast cancer. Radiol Clin North Am. 21:51–65. 1983.

19.오기근, 이경식, 손승국. 유방질환의각종방사선학적영상에관한연구. 대한방사선의학회. 3888. 21:223–236. 1985. ,.

20.조길호, 정경희, 황미수외. 유방질환의유방X-선촬영소견에대한고찰. 대한방사선의학회. 3888. 21:581–591. 1985.

21.Bassett LW., Gold RH. Mammography, thermography and ultrasound in breast cancer detection. 1st Ed: pp 73-31, Crune & Stratton, New York. 1983.