Breast Cancer on Chest CT

CT is more commonly done to stage breast cancer.  That means we see how far the cancer has spread.  We can also see larger and more advanced cancer in the breast itself.  Breast cancer is rarely identified on CT alone.  Mammography is the accepted screening test for cancer.

What does breast cancer on CT look like?

Breast cancer on CT is sometimes identified when it is larger and more advanced.  We may see a mass or other tissue abnormality in the breast.  We can also see that it has spread.  This makes the diagnosis of breast cancer more sure.  However, the patient will still need a workup with dedicated breast imaging like mammography, ultrasound and possible biopsy.

CT is not accepted as an imaging test of the  breast.  Nevertheless, we see the breast on all chest CTs, at times partially.  We can identify abnormalities but we do not know what they are in most cases.  It is also important to remember that most breast abnormalities will not be seen on CT.

What can an abnormality of the breast be on chest CT?

Abnormalities on CT of the breasts when found may be normal breast tissue that looks different from the other side, a cyst, a benign breast tumor or cancer.  Abnormalities found on CT will need a workup.  We will not know the diagnosis from CT alone. Workup may include mammography, ultrasound, MRI and possible biopsy.

Staging breast cancer

More commonly, chest CT is used to stage breast cancer.  We are trying to see if and how far the cancer has spread.  Breast cancers can spread to lymph nodes, lungs, and bones.  The degree of spread can change the treatment and prognosis.

We can also see spread of the cancer to the upper abdomen on chest CT.   We can see metastasis to the liver, adrenal glands and lymph nodes in the upper abdomen.   Often, patients with breast cancer will also get CT of the abdomen and pelvis, brain imaging, bone scan or a PET scan for more complete staging.

A recurrence of breast cancer can also be identified on Chest CT. Sometimes we can see a mass in the breast where a prior surgery was done or in the adjacent tissues like the chest wall.  We can also see spread of the cancer in the chest.  Lymph nodes in the chest will appear enlarged.  We may see spots in the lungs called nodules.  We may see bone lesions which look like holes (lytic) or whiter then bone (sclerotic).

We more commonly use chest CT to see if breast cancer has spread.  Since every chest CT at least partially images the breasts, we can sometimes identify abnormalities in the breasts which represent breast cancer.  In most cases, more dedicated breast imaging will be needed to make a diagnosis.

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