Breast lesions incidentally detected with CT: what the general radiologist needs to know

Although breast abnormalities are frequently overlooked at multidetector computed tomography (CT) or inaccurately assessed, multidetector CT can reveal sufficient detail in many cases to allow confident diagnosis. It is important for general radiologists to characterize breast lesions incidentally found at CT as benign, indeterminate, or sufficiently suspicious to warrant further work-up. Irregular margins, irregular shape, and rim enhancement are the features most predictive of malignancy. Postoperative changes in the breast may mimic a malignancy; therefore, it is important to obtain an accurate history as to the timing of biopsy or surgery and to follow the changes in lesion morphology over time. Any mass with benign features at CT requires additional validation of benignity with demonstration of long-term stability or additional diagnostic mammographic work-up with or without sonographic evaluation. Accurate description and classification of breast lesions detected with CT enhance the value of the radiologist's report and contribute to appropriate case management.