Posy Jane Seifert DO, Presenter: Nothing to Disclose

Andrea Lynn Arieno BS, Abstract Co-Author: Nothing to Disclose

Renee Morgan RT, Abstract Co-Author: Nothing to Disclose

To review lesions that were mammographically occult and imaged with cone beam breast Computed Tomography (CT) with or without contrast.

From June 2008 to December 2012, 411 subjects were prospectively enrolled in 2 IRB approved studies; all had non contrast CT (NCCT) and 69 had contrast enhanced CT (CECT). 27 lesions in 25 subjects were considered to be mammographically occult at diagnostic work-up and are the basis of this study; all had NCCT and 18 also had CECT. Data recorded included subject demographics, method of detection, lesion characteristics, core biopsy pathology and open surgical pathology when applicable.

25 subjects with 27 lesions were determined to be mammographically occult but detected by diagnostic work-up; all were masses. Of the 27 lesions, 19 were detected by breast CT. Average lesion size at diagnostic work-up was 1.5cm (range 0.3 to 4cm). Average lesion size on breast CT was 1.4cm (range 0 .3 to 4.5cm). Overall, 10 lesions were biopsy-proven malignant; 9 invasive and 1 non-invasive. Sixteen lesions were biopsy-proven benign and 1 atypical. Eight lesions were mammographically occult and also CT occult, but found on ultrasound. One was biopsy proven invasive ductal carcinoma, one was atypical and 6 were biopsy proven benign. 8 mammographically occult lesions were detected by CT only; 6 seen on both NCCT and CECT, 1 only on CECT and 1 only on NCCT (this subject did not have CECT). After additional work-up, 5 were biopsy proven invasive carcinomas and 3 were benign. Two of the 5 malignancies were seen and biopsied with MRI, 2 were seen on MRI, but went directly to surgery; the fifth malignancy, seen only on CT, proceeded to surgery for final diagnosis. The 3 benign findings were seen and biopsied with US.  

In this small study, breast CT (NCT and CECT) showed value in detecting mammographically occult lesions. CT detected 19 lesions that were not detected by mammography and additionally was able to detect one new lesion not detected on any other imaging. Out of all cancers in this cohort, only one was not seen by CT. This study showed that CT has the potential to have high sensitivity for the detection of breast lesions.

Breast CT is a new imaging technology that may have a role in the detection of breast disease. In this small study cohort, breast CT demonstrated the ability to detect mammographically occult lesions.

Seifert, P, Arieno, A, Morgan, R, Cone Beam Breast Computed Tomography’s Ability to Detect Mammographically Occult Lesions.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13014608.html