CTs of the Chest include the breasts and can sometimes identify an abnormality like a mass. More often, CTs are done to stage breast cancer. That means we are looking to see if breast cancer has spread to other parts of the chest distant from the breasts. This can change the treatment and prognosis.
Breast mass on CT
We can see the breast tissue on chest CTs and therefore can sometimes see a mass. A mass will stand out from the background breast tissue. The larger masses and cancers are more likely to be identified. Smaller breast cancers will often not be apparent.
A breast mass on CT may not be cancer. Cysts and benign tumors of the breast will also be identified. We can not tell what a breast mass will be based on the CT alone. The patient will need a workup in a dedicated breast center.
Further testing is needed if a breast mass or abnormality is found on CT
The workup may include getting a mammogram, ultrasound, MRI and biopsy in some cases. The CT simply alerts us to an abnormality but we can not tell what it is. In some cases, an abnormality on CT may simply be breast tissue which is different from the other breast.
Mammograms are the standard initial screening of the breasts. Therefore a small percentage of cancers will be seen on CTs done of the chest. More often these cancers found on CT will be large and advanced.
Staging breast cancer is more common with CT
More often, breast cancer is staged on chest CTs. We look to see if the tumor has spread to lymph nodes. This is most common to the axilla or arm pit. In more advanced cases, we can see spread to the lymph nodes in the mediastinum and other parts of the chest.
Breast cancer can also spread to the lungs. We will see nodules or round spots in the lungs. Breast cancer can also spread to the bones. We can see the spread of cancer to the bones of the chest as lytic abnormalities or holes in the bone. Sometimes the spread will look sclerotic or whiter then normal bone.
We can also see spread of the breast cancer to abdominal organs like the liver. Chest CTs include the upper abdomen. We can sometimes see spread to organs like the liver and adrenal glands. We can see enlarged lymph nodes in the abdomen.
Breast cancer can be found on CTs of the chest at times. Often these are larger more advanced cancers. Screening with mammography or MRI in some cases are the preferred tests to screen for cancer. These tests can find small cancers that can be found before they spread.
We commonly use CT to see if breast cancer has spread. This may change the treatment and prognosis. Even if CT does find a mass, we do not know what it is and whether it is cancerous. A dedicated workup in a breast center will be needed.