Chest CTs include the breasts. Occasionally, we see abnormalities like nodules and masses. Nodules are round abnormalities that are different then the background breast tissue. Nodules on chest CT can represent many different diagnosis. They can be benign all the way to breast cancer.
Chest CTs can not tell us what a nodule or abnormality may be. Chest CTs alert the referring physician and patient that an abnormality may be present and needs a workup with dedicated breast imaging. Breast imaging will include mammography, ultrasound, and MRI. A breast biopsy may be needed in some cases.
What can a breast nodule on CT be?
A breast nodule on CT can simply represent nodular breast tissue which is normal. The breast tissue may look different then the other breast. A nodule can be a benign abnormality like a cyst or benign breast tumor. A nodule can also be a breast cancer. The CT can not tell those possibilities apart in most cases.
CT is not good at identifying breast cancers. Screening the breasts with a mammogram is the best way to identify small cancers which can be cured. CT more commonly identifies cancers which are advanced or large.
CT is also good at staging breast cancer. This means we look to see where the breast cancer has spread. This can be to lymph nodes, lungs, and bones. If we see a breast mass in the setting of cancer elsewhere in the chest, we can be more confident that we are dealing with breast cancer. This can change the treatment and prognosis of the cancer.
What will be done for a breast nodule on chest CT?
A nodule in the breast on chest CT does not mean cancer. It simply means that the radiologist reading the CT has seen something which he feels needs additional testing. CT is not an accepted test to evaluate the breasts. But since we see the breasts on CT, at times we can identify important abnormalities.
It is also important to remember that CT will not identify most breast cancers. This is especially true if the cancer is small. Therefore, continued screening is needed even if you have had a chest CT and imaging of the breasts.
A breast nodule on CT is therefore a non specific finding. The diagnosis is not clear but the radiologist interpreting the scan believes that it may represent an abnormality. Further testing will include a workup in a breast center.