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False-positive helical CT findings of multifocal and multicentric breast cancer: is attenuation of tumor useful for diagnosing enhanced lesions?

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Abstract

Objective

To analyze helical CT false-positive multifocal breast cancers and to assess the relevance of the attenuation of tumors for diagnosing enhanced lesions.

Methods

Helical CT studies of 156 invasive breast cancers before breast conserving surgery were examined. A lesion was defined as positive if focal enhancement was detected by CT within 100 seconds after contrast material administration. The attenuation and enhancement percent ratio [(post-contrast value/pre-contrast value)%] were obtained. Attenuation of false-positive and malignant lesions was compared.

Results

Helical CT enabled the detection of all 156 invasive tumors with 95 intraductal tumor extensions. The sensitivity and specificity of multifocal/multicentric disease detection by helical CT were 69% and 90%, respectively. False-positive multifocal/multicentric findings were obtained in 11 (7%) of 156 cases. The mean value of the enhancement percent ratio of the index tumors was 237%. Significant differences in the attenuation on post-contrast enhanced scans between the enhanced lesions (index tumors; mean, 82 HU), the true-positive multifocal/multicentric lesions (mean, 73 HU), the false-positive multifocal/multicentric lesions (mean, 87 HU) and normal breast tissue (mean, 32 HU) were found (p < 0.0001). The attenuation of the true-positive multifocal/multicentric lesions on post-contrast enhanced scans was significantly less than that of the false-positive multifocal/multicentric lesions (p = 0.03).

Conclusion

Attenuation of tumor is not useful for differential diagnosis of enhanced lesions on helical CT of the breast. The presence of enhancement alone does not always indicate a malignant lesion. Breast Cancer 9:62-68, 2002.

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Abbreviations

CT:

Computed tomography

MR:

Magnetic resonance

HU:

Hounsfield units

References

  1. Uematsu T, Shiina M, Kobayashi S,et al: Helical CT of the breast: detection of intraductal spread and multicentricity of breast cancer.Nippon Acta Radiologica 57: 85–88, 1997 (in Japanese with English abstract).

    PubMed  CAS  Google Scholar 

  2. Uematsu T, Sano M, Homma K,et al: Three-dimensional helical CT of the breast: Accuracy for measuring extent of breast cancer candidates for breast conserving surgery.Breast Cancer Res Treat 65: 249–257, 2001.

    Article  PubMed  CAS  Google Scholar 

  3. Uematsu T, Sano M, Homma K,et al: Staging of palpable T1-2 invasive breast cancer with helical CT.Breast Cancer 8: 125–130, 2001.

    Article  PubMed  CAS  Google Scholar 

  4. Akashi-Tanaka S, Fukutomi T, Miyakawa K,et al: Diagnostic value of contrast-enhanced computed tomography for diagnosing the intraductal component of breast cancer.Breast Cancer Res Treat 49: 79–86, 1998.

    Article  PubMed  CAS  Google Scholar 

  5. Hiramatsu H, Enomoto K, Ikeda T,et al: Three-dimensional helical CT for treatment planning of breast cancer.Radiat Med 17: 35–40, 1999.

    PubMed  CAS  Google Scholar 

  6. Heywang SH, Wolf A, Pruss E,et al: MR imaging of the breast with Gd-DTPA: use and limitations.Radiology 171: 95–103, 1989.

    PubMed  CAS  Google Scholar 

  7. Weinreb JC, Newstead G: MR imaging of the breast.Radiology 196: 593–610, 1995.

    PubMed  CAS  Google Scholar 

  8. Safir J, Zito JL, Greshwind ME,et al: Contrast-enhanced breast MRI for cancer detection using a commercially available system- a perspective.Clin Imaging 22: 162–179, 1998.

    Article  PubMed  CAS  Google Scholar 

  9. Kuhl CK, Mielcareck P, Klaschik S,et al: Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions?Radiology 211: 101–110, 1999.

    PubMed  CAS  Google Scholar 

  10. Kinkel K, Helbich TH, Esserman LJ,et al: Dynamic high-spatial-resolution MR imaging of suspicious breast lesions: diagnostic criteria and interobserver variability.AJR 175: 3543, 2000.

    Google Scholar 

  11. Sardanelli F, Calabrese M, Zandrino F,et al: Dynamic helical CT of breast tumors.J Comput Assist Tomogr 22: 398–407, 1998.

    Article  PubMed  CAS  Google Scholar 

  12. Chang CHJ, Nesbit DE, Fisher DR,et al: Computed tomographic mammography using a conventional body scanner.AJR 138: 553–558, 1982.

    PubMed  CAS  Google Scholar 

  13. Hagay C, Cherel PJP, de Maulmont CE,et al: Contrastenhanced CT: value for diagnosing local breast cancer recurrence after conservative treatment.Radiology 200: 631–638, 1996.

    PubMed  CAS  Google Scholar 

  14. Orel SG, Schnall MD, LiVolsi VA,et al: Suspicious breast lesions: MR imaging with radiologic-pathologic correlation.Radiology 190: 485–493, 1994.

    PubMed  CAS  Google Scholar 

  15. Stamper PC, Herman S, Hippenstein DL,et al: Suspect breast lesions: findings at dynamic gadolinium-enhanced MR imaging correlated with mammographic and pathologic features.Radiology 197: 387–395, 1995.

    Google Scholar 

  16. Gilles R, Zafrani B, Guinebretiere JM,et al: Ductal carcinoma in situ: MR imaging-histopathologic correlation.Radiology 1995: 415–419, 1995.

    Google Scholar 

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Authors and Affiliations

  1. Departments of Radiology, Japan

    Takayoshi Uematsu

  2. Departments of Surgery, Japan

    Muneaki Sano

  3. Departments of Pathology, Niigata Cancer Center Hospital, Japan

    Keiichi Homma

Authors
  1. Takayoshi Uematsu
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  2. Muneaki Sano
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  3. Keiichi Homma
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Corresponding author

Correspondence to Takayoshi Uematsu.

Additional information

Reprint requests to Takayoshi Uematsu, the Department of Radiology, Niigata Cancer Center Hospital, 2-15-3, Niigatashi, Kashiwagicho, Niigata 951-8566, Japan.

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Uematsu, T., Sano, M. & Homma, K. False-positive helical CT findings of multifocal and multicentric breast cancer: is attenuation of tumor useful for diagnosing enhanced lesions?. Breast Cancer 9, 62–68 (2002). https://doi.org/10.1007/BF02967549

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  • DOI: https://doi.org/10.1007/BF02967549

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