Costs associated with evaluation of incidental breast lesions identified on computed tomography

Br J Radiol. 2016;89(1059):20140847. doi: 10.1259/bjr.20140847. Epub 2015 Dec 9.

Abstract

Objective: The purpose of this study was to calculate the costs associated with the evaluation of breast incidentalomas (BI) identified on CT.

Methods: All CT scans of the thorax performed at the radiological department of the University Hospital of the Martin-Luther-University Halle-Wittenberg between the years 2006 and 2014 were reanalysed retrospectively. 111 patients with BI were identified. The radiological and clinical reports of these cases were examined, and the costs of all further diagnostic procedures performed to clarify the detected BI were calculated.

Results: In 31 (27.9%) of the 111 patients, BI were not further investigated. Of the remaining 80 (72.1%) cases of BI, primary breast carcinoma was diagnosed in 10 (12.5%) cases, breast involvement by lymphoma in 7 (8.8%) cases, intramammary metastases in 19 (23.7%) cases and different benign findings in 44 (55.0%) cases. The total costs associated with clarification of BI in our institution (n = 53) amounted to €14,045.71. The costs per BI were €265.01 and per newly identified breast cancer €1560.63.

Conclusion: Breast lesions incidentally detected on CT should be categorized as major incidental findings because of the high frequency of malignancy. The radiologist should carefully evaluate the breast on CT images and all identified BI should be clarified. The clarification of BI is associated with a low economic burden in comparison with screening programmes for primary breast cancer.

Advances in knowledge: The radiologist should carefully evaluate the breast on CT and all identified BI should be clarified. The evaluation of BI is associated with a low economic burden.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / economics*
  • Contrast Media
  • Female
  • Humans
  • Incidental Findings*
  • Male
  • Mammography / economics*
  • Mammography / methods*
  • Middle Aged
  • Radiographic Image Enhancement
  • Retrospective Studies
  • Tomography, X-Ray Computed / economics*

Substances

  • Contrast Media