title: Contrast-enhanced CT evaluation of clinically and mammographically occult multiple breast tumors in women with unilateral early breast cancer.
abstract: BACKGROUND
  Magnetic resonance imaging mammography is performed to determine the extent of lesions and to detect occult lesions, but preoperative diagnosis by breast computed tomography (CT) is less common.
  
  
  METHODS
  We performed a retrospective study of detection of mammographically occult multiple lesions using breast CT. The subjects were 407 female patients (median age: 56 years old; median tumor size: 1.9 cm) with breast cancer who underwent preoperative, contrast-enhanced breast CT.
  
  
  RESULTS
  CT detected 73 incidental-enhanced breast nodules (median size: 0.8 cm) in 73 patients that were undetectable by conventional methods. Age, size of the main lesion or laterality of lesions did not differ between patients with and without incidental nodules, but the frequency of mastectomy was significantly higher in those with incidental nodules. Of the 73 incidental nodules, 22 (30%) were in the same quadrant as the main lesion, 26 (36%) were in other quadrants and 25 (34%) were in the opposite breast. On qualitative diagnosis by CT, 48 were suspected to be malignant (66%), 17 benign (23%) and eight non-specific (11%). In histological evaluation of 44 of the 48 nodules suspected to be malignant, 24 were malignant (invasive carcinoma: 22, non-invasive carcinoma: 2); of seven of the 17 nodules suspected to be benign, all were benign; and of three of the eight non-specific nodules, one was non-invasive carcinoma. The discovery rate of clinically and mammographically occult multiple lesions by preoperative breast CT was 6%.
  
  
  CONCLUSIONS
  We conclude that breast CT is useful for the detection of occult lesions and choice of surgical procedure.
authors.affiliation: Department of Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. ntaira@md.okayama-u.ac.jp
authors.forename: Naruto
authors.initials: N
authors.lastname: Taira
authors.forename: Shozo
authors.initials: S
authors.lastname: Ohsumi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takabatake
authors.forename: Fumikata
authors.initials: F
authors.lastname: Hara
authors.forename: Seiki
authors.initials: S
authors.lastname: Takashima
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Aogi
authors.forename: Shigemitsu
authors.initials: S
authors.lastname: Takashima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.forename: Shigenori
authors.initials: S
authors.lastname: Sugata
authors.forename: Rieko
authors.initials: R
authors.lastname: Nishimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008327:Mammography; D008408:Mastectomy / Q000706:statistics & numerical data; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000473:pathology; D009382:Neoplasms, Unknown Primary / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media