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Revista chilena de radiología

versión On-line ISSN 0717-9308


PIZZOLON F, Flavia et al. Preoperative CT staging of breast cancer patients: Alternative to MRI in a public hospital. Rev. chil. radiol. [online]. 2014, vol.20, n.4, pp.135-140. ISSN 0717-9308.

The preoperative study in search of multifocality, multicentricity and bilaterality is essential for the proper therapeutic management of breast cancer. The reference standard to accomplish this is breast Magnetic Resonance Imaging (MRI). Based on the literature, we adapted the thorax CT protocol for the study of the breast. The aim of this paper is to demonstrate the feasibility of CT with emphasis on the breast, as an alternative to preoperative MRI in places where it is not available. Pre-operative CT was performed in all patients with newly diagnosed breast cancer between August 2013 and September 2014. The studies were reviewed retrospectively and according to the results, were divided into four categories. Group 1: CT provided no new information. 1A: concordant with conventional screening procedures (previous mammogram (Mx) and ultrasound (US)), 1B: cancer visible on Mx and/or US, but without representation on CT. Group 2: On detection of additional lesions, radiological staging was improved, without changing the type of surgical approach. Group 3: Demonstrated new non-malignant lesions and caused unnecessary surgery. Group 4: Successfully changed the type of surgery planned based on conventional studies. In the 13 months, 47 preoperative mammary CT were performed in 46 patients (ages: from 34 to 81 years, average 56.7 years). The distribution by groups was: Group 1A (79%), Group 1B (8,3%), Group 2 (8.3%), Group 3 (0%) and Group 4 (4.1%). In 87.5% of the studies the primary lesion was visualized and its extension could be evaluated. Six cancers were not identified: they corresponded to one case in which no intravenous contrast was administered due to renal failure, a positive negative, where there were only axillary lymphadenopathy of pulmonary origin and four DCIS (8.3%). In our practice, preoperative CT favorably influenced therapeutic decision-making, improved the radiological staging in the 8.3%, and successfully changed the surgical approach in the 4.1% of the patients.

Palabras clave : Breast cancer; CT; Staging.

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