Mammary nodules as incidental findings on chest computed tomography: a retrospective analysis on their frequency and predictive value

Author:

Agliata Maria FrancescaORCID,Calabrò Naomi,Tricca Stefano,Rampi Anna Maria,Gambaro Anna Clelia Lucia,Ferrante Daniela,Carriero Alessandro

Abstract

Abstract Purpose To evaluate the frequency of mammary nodules as incidental findings on chest CT scans and to determine a correlation between semiological features and mammographic and histopathological outcomes. Methods A total of 42,864 chest CT scans performed on patients with breast-unrelated working diagnoses by the Radiology Department at AOU Maggiore della Carità, between 1st January 2016 and 30th April 2022, were analysed. Sixty-eight patients (3 males and 65 females) with mammary nodule CT detection were selected and subjected to mammography, mammary ultrasound and, eventually, biopsy. Results Thirty-five of the 68 patients received a histopathological confirmation of malignancy. According to Pearson’s Chi-square test, the CT features most likely associated with BI-RADS 5 following mammography were post-contrast enhancement (p = 0.001), margin irregularity (p = 0.0001), nipple retraction (p = 0.001), skin thickening (p = 0.024), and the presence of structurally atypical lymph nodes suspicious for metastatic involvement (p = 0.0001). The CT features predictive of a biopsy positive for malignancy were post-contrast enhancement (p = 0.0001), margin irregularity (p = 0.0001), and the presence of suspicious lymph nodes (p = 0.011). Finally, 63.4% of patients with a working diagnosis related to cancer were diagnosed with breast cancer. Conclusion Chest CT incidental findings of mammary nodules had a 0.21% incidence rate. The accurate description of some CT scan features, such as post-contrast enhancement, margin irregularity, nipple retraction, skin thickening and the presence of structurally atypical lymph nodes, may help to establish a radiological suspicion of malignancy, especially if these characteristics are supported by a working diagnosis of cancer.

Funder

Università degli Studi del Piemonte Orientale Amedeo Avogrado

Publisher

Springer Science and Business Media LLC

Subject

Radiology, Nuclear Medicine and imaging,General Medicine

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