Pitfalls of the lactating breast on computed tomography

Breasts are usually only incidentally included in computed tomography (CT) scans of the abdomen and chest in spite of the fact that pathologic findings are not rare. Because postpartum women are normally healthy, they rarely require examination; therefore, the presentation of lactating breasts on a CT scan is poorly known. The most common postpartum breast feature is engorgement, which is characterized by painful swelling associated with a sudden increase in milk volume, lymphatic and vascular congestion, and interstitial edema. Its appearance on a CT scan does not seem to have been described in the literature to date. The CT picture of a lactating breast shows the enlarged gland with bilateral cord- and mass-like hyperattenuated tissue. After abrupt cessation of breast-feeding, the edema component supervenes and breast tissue may become hypoattenuated. In such cases, further ultrasound evaluation is needed. We present 3 cases of postpartum breast engorgement as seen on CT.