Intramammary incidental findings on staging computer tomography

Purpose: Incidental findings are a common feature in computer tomographic examinations of the chest. Breast incidentalomas, however, were described only sporadically. The purpose of this study was to evaluate retrospectively incidental breast findings and to compare radiological features of benign and malignant breast lesions.

Materials and methods: From January 2006 to December 2010 a total of 8105 computer tomographic examinations were performed at our institution. In 89 patients incidental breast lesions were diagnosed. 64 of the identified patients were referred for further clinical, radiological, and hystopathological examination. All patients were female with a median age of 62 years, range 39-82 years.

Results: A total of 98 breast lesions were identified in the 64 patients. The mean size was 12.0±8.0 mm. Primary breast carcinoma was identified in 9, breast metastases in 27, and benign findings in 28 patients. Malignant lesions demonstrated more often marked enhancement and showed a higher density compared with benign lesions. Benign findings were more often lobular in shape and had spiculated margins. Most of the breast metastases were round or oval in shape with circumscribed margins and marked homogenous enhancement. There was no significant difference between the breast cancer and benign findings groups in the characteristics of the lesions.

Conclusion: The breast is a very important region and should be carefully evaluate on chest CT. There are no certain radiological criteria to differentiate between malignant and benign breast lesions on CT. Therefore all breast incidentalomas should be evaluated by further radiological/histological investigations.