Breast cancer staging and follow-up: Contributions of chest computed tomography and dosimetric analysis

Breast cancer is the second most common malignant neoplasm among women worldwide. Computed tomography (CT) plays an important role in diagnosis, staging, follow-up, and metastatic assessment. This study aimed to evaluate the role of chest CT in patients with breast neoplasms at a public hospital and to compare dosimetric parameters with Diagnostic Reference Levels (DRLs), based on CTDI_vol and dose-length product (DLP). Related malignancies (ovarian and cervical) were included for preliminary analysis. A retrospective study of 334 elective outpatient chest CT examinations performed in 2025 was conducted. All patients were female, with a mean age of 59.04 ± 12.57 years, and most (65.40%) were within the recommended screening age range (50-74 years), while 15.19% were aged 40-49 years. DICOM data were obtained from two 64-slice CT scanners: Philips Incisive (CT A) and Canon Aquilion (CT B). CTDIvol and DLP values for CT A were stratified by clinical indication. Percentile analysis (P25-P75) showed lower CTDI_vol values for CT A (4.06-5.82 mGy) compared with CT B (4.99-8.83 mGy), while DLP values were higher in CT A (146.97-201.45 mGy cm) than in CT B (94.51-201.49 mGy cm). Median CTDI_vol values were 4.70 and 7.65 mGy, and DLP values were 169.42 and 141.36 mGy cm for CT A and CT B, respectively. The P75 values remained below international DRLs for adult chest CT and CT for radiotherapy planning. These findings highlight the importance of continuous dosimetric assessment to optimize CT protocols and ensure radiation protection in patients undergoing treatment.