Helical CT of the breast: detection of intraductal spread and multicentricity of breast cancer

PURPOSE: This study was performed to evaluate the clinical utility of postcontrast helical CT (HCT) scan for the detection of intraductal spread (DS) and multicentricity of breast cancer. MATERIALS AND METHODS: DS and multicentricity in 84 patients with invasive ductal carcinoma were evaluated by preoperative postcontrast HCT. The HCT protocol of 3-mm section width and 3 mm/sec table speed was used with the patients in a supine position. Scanning started 70sec after beginning the intravenous injection of 90 ml (27 gI) of contrast material at the rate of 1.5 ml/sec. The three-dimensional images were displayed. RESULTS: Eighty-four of 84 main tumors (100%) were shown as enhanced masses by postcontrast HCT. The sensitivity and specificity of HCT for the detection of DS and multicentricity were 60.0% (18/30) and 88.9% (48/54), and 88.9% (16/18) and 90.9% (60/66), respectively. When DS and multicentric lesions were combined, the sensitivity and the specificity were 76.3% (29/38) and 89.1% (41/46), respectively. CONCLUSION: HCT of the breast is effective in detecting DS and multicentric lesions of breast cancer and might be useful in helping surgeons to successfully perform breast-conserving surgery.