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Congress: ECR24
Poster Number: C-22175
Type: EPOS Radiologist (scientific)
DOI: 10.26044/ecr2024/C-22175
Authorblock: C. Liu1, U. Ali1, G. Raghunathan2, G. Dadayal2; 1Leeds/UK, 2Keighley/UK
Disclosures:
Cindy Liu: Nothing to disclose
Uzair Ali: Nothing to disclose
Girish Raghunathan: Nothing to disclose
Guneesh Dadayal: Nothing to disclose
Keywords: Breast, CT, MR, Diagnostic procedure, Cancer
Results

A total of 108 patients had incidental findings on CT or MRI that warranted a referral to the breast clinic.

Fig 2: Overview of our patient cohort in the two-year period.
After an assessment in the breast clinic, 30 patients had an ultrasound-guided biopsy performed. Seventeen patients had confirmed B5 breast malignancy (with histology showing two ductal carcinoma-in-situs and fifteen invasive carcinomas), giving a positive predictive value (PPV) for malignancy of 16%. Three of these patients had metastatic breast cancer. The remaining patients (13/30) had biopsy results showing B1-B3 histological findings with majority receiving a B2 diagnosis.
Fig 3: Overview of biopsy results with examples of histology results.
Our positive predictive value (PPV) for malignancy of 16% was in general lower in comparison to current literature.1-5

Common features amongst our cohort of malignant breast cancer cases included the presence of spiculations, irregular margins, rounded in shape, increased density or enhancement patterns. On review of the current literature, there are varied suggestions of the typical features of malignant breast lesions with a systematic review conducted between 1988 to 2012 suggesting malignant lesions tended to be larger in size, rounded in shape and have a higher density compared to benign lesions.1

Fig 4: Examples of four patients with confirmed B5 nodules on Computerised Tomography imaging.

We identified that the size of the breast nodule was not a reliable characteristic, with a large proportion of benign and malignant nodules measuring between 10-20 mm.

Fig 5: Comparison of the sizes in malignant versus benign breast nodules.
Majority (13/17) of the confirmed cases had no lymphadenopathy on clinical or radiological assessment, suggesting that the absence of lymphadenopathy on a patient with an incidental breast nodule ought not to dissuade a radiologist from referring a patient for onward breast clinic review. This was comparable to the findings by Porter et. al where they found only a third of their patients had associated axillary lymphadenopathy.5
GALLERY