Cancer Yield of Incidental Breast Lesions Detected on Chest Computed Tomography

Healey, Terrance T.; Agarwal, Saurabh; Patel, Ronak; Ratanaprasatporn, Lisa; Ratanaprasatporn, Linda; Lourenço, Ana P.

doi:10.1097/rct.0000000000000696

Cited by 13 publications

(5 citation statements)

References 12 publications

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“…One limitation of this study is the risk of misclassification of non-OBSP-screened cancers (e.g., some may have been symptomatic) and symptomatic cancers (e.g., some may have been incidental, although this is likely uncommon). 46 – 48 Also, the definition of O-BAS we used is imperfect; it reflects the institution that renders the diagnosis, which may differ from the institution conducting the remainder of the diagnostic workup. Moreover, some institutions function like an O-BAS (e.g., have all the necessary equipment and personnel), but do not have patient navigation or a funding agreement with the OBSP.…”

Section: Discussionmentioning

confidence: 99%

Differences in breast cancer diagnosis by patient presentation in Ontario: a retrospective cohort study

Habbous

Homenauth

Barisic

et al. 2022

cmajo

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Background: In Ontario, patients with breast cancer typically receive their diagnoses through the Ontario Breast Screening Program (OBSP) after an abnormal screen, through screening initiated by a primary care provider or other referring physician, or through follow-up of symptoms by patients’ primary care providers. We sought to explore the association of the route to diagnosis (screening within or outside the OBSP or via symptomatic presentation) with use of OBSP-affiliated breast assessment sites (O-BAS), wait times until diagnosis or treatment, health care use and overall survival for patients with breast cancer. Methods: In this retrospective cohort study, we used the Ontario Cancer Registry to identify adults (aged 18–105 yr) who received a diagnosis of breast cancer from 2013 to 2017. We excluded patients if they were not Ontario residents or had missing age or sex, or who died before diagnosis. We used logistic regression to evaluate factors associated with categorical variables (whether patients were or were not referred to an OBAS, whether patients were screened or symptomatic) and Cox proportional hazards regression to identify factors associated with all-cause mortality. Results: Of 51 460 patients with breast cancer, 42 598 (83%) received their diagnoses at an O-BAS. Patients whose cancer was first detected through the OBSP were more likely than symptomatic patients to be given a diagnosis at an O-BAS (adjusted odds ratio 1.68, 95% confidence interval [CI] 1.57 to 1.80). Patients screened by the OBSP were given their diagnoses 1 month earlier than symptomatic patients, but diagnosis at an O-BAS did not affect the time until either diagnosis or treatment. Patients referred to an O-BAS had significantly better overall survival than those who were not referred (adjusted hazard ratio 0.73, 95% CI 0.66 to 0.80). Interpretation: Patients screened through the OBSP were given their diagnoses earlier than symptomatic patients and were more likely to be referred to an O-BAS, which was associated with better survival. Our findings suggest that individuals with signs and symptoms of breast cancer would benefit from similar referral processes, oversight and standards to those used by the OBSP.

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Section: Discussionmentioning

confidence: 99%

Differences in breast cancer diagnosis by patient presentation in Ontario: a retrospective cohort study

Habbous

Homenauth

Barisic

et al. 2022

cmajo

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“…Even though mammary tumours still represent a minority of the incidentalomas requiring further investigation (0.6–1%), statistically significant incidence rates of breast cancer have been reported in patients subsequently directed to mammography, ranging between 17 and 36% [ 5 – 7 ]. These nodules include primary or secondary malignancies, as well as benign tumours such as cysts, fibroadenomas, gland thickening areas, lipomas, and dystrophic calcifications [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Mammary nodules as incidental findings on chest computed tomography: a retrospective analysis on their frequency and predictive value

Agliata,

Calabrò,

Tricca

et al. 2023

Radiol med

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Purpose To evaluate the frequency of mammary nodules as incidental findings on chest CT scans and to determine a correlation between semiological features and mammographic and histopathological outcomes. Methods A total of 42,864 chest CT scans performed on patients with breast-unrelated working diagnoses by the Radiology Department at AOU Maggiore della Carità, between 1st January 2016 and 30th April 2022, were analysed. Sixty-eight patients (3 males and 65 females) with mammary nodule CT detection were selected and subjected to mammography, mammary ultrasound and, eventually, biopsy. Results Thirty-five of the 68 patients received a histopathological confirmation of malignancy. According to Pearson’s Chi-square test, the CT features most likely associated with BI-RADS 5 following mammography were post-contrast enhancement (p = 0.001), margin irregularity (p = 0.0001), nipple retraction (p = 0.001), skin thickening (p = 0.024), and the presence of structurally atypical lymph nodes suspicious for metastatic involvement (p = 0.0001). The CT features predictive of a biopsy positive for malignancy were post-contrast enhancement (p = 0.0001), margin irregularity (p = 0.0001), and the presence of suspicious lymph nodes (p = 0.011). Finally, 63.4% of patients with a working diagnosis related to cancer were diagnosed with breast cancer. Conclusion Chest CT incidental findings of mammary nodules had a 0.21% incidence rate. The accurate description of some CT scan features, such as post-contrast enhancement, margin irregularity, nipple retraction, skin thickening and the presence of structurally atypical lymph nodes, may help to establish a radiological suspicion of malignancy, especially if these characteristics are supported by a working diagnosis of cancer.

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“…1,2 Computed tomography (CT) has always been considered an inaccurate method for breast evaluation; however many studies have shown that conventional chest CT is able to detect malignant breast lesions. [3][4][5][6][7][8][9][10] Dedicated CT devices developed for breast assessment, using technologies, such as "cone beam" and "phase contrast," have shown promising results. [11][12][13][14] However, only few studies have evaluated the performance of conventional multide-tector CT (MDCT) devices in the evaluation of breast lesions (Table 1).…”

mentioning

confidence: 99%

“…Computed tomography (CT) has always been considered an inaccurate method for breast evaluation; however many studies have shown that conventional chest CT is able to detect malignant breast lesions 3–10 . Dedicated CT devices developed for breast assessment, using technologies, such as “cone beam” and “phase contrast,” have shown promising results 11–14 .…”

mentioning

confidence: 99%

Iodinated Contrast Enhancement of Breast Cancer on Prone Multidetector Computed Tomography—Preliminary Findings

Felipe

Barbosa

Chojniak

et al. 2022

J Comput Assist Tomogr

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Cancer Yield of Incidental Breast Lesions Detected on Chest Computed Tomography

Abstract: Abnormal CT findings in the breast warrant additional evaluation with dedicated breast imaging to evaluate for a possible underlying malignancy. Cancer yield from CT findings in this study was 17.3%.

Cited by 13 publications

References 12 publications

Differences in breast cancer diagnosis by patient presentation in Ontario: a retrospective cohort study

Differences in breast cancer diagnosis by patient presentation in Ontario: a retrospective cohort study

Mammary nodules as incidental findings on chest computed tomography: a retrospective analysis on their frequency and predictive value

Iodinated Contrast Enhancement of Breast Cancer on Prone Multidetector Computed Tomography—Preliminary Findings

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