Comparison between high-resolution helical CT and pathology in breast examination

Purpose: To determine whether high-resolution helical CT can show the architectural features of breast carcinomas of non-limited extent (non-BCLE) and to establish the CT characteristic morphology of non-BCLE. Material and Methods: We prospectively studied high-resolution helical CT of 136 invasive breast carcinomas before breast-conserving surgery. Non-BCLE were defined as ductal carcinomas in situ and invasive carcinomas beyond 1 cm from the edge of the dominant mass. Non-BCLE were defined as positive if enhanced beyond 1 cm from the edge of the focal enhancement on CT. After surgical resection, specimens were sliced in serial sections at 5-mm intervals, and the gross morphology and histology were correlated with the appearance of the preoperative CT lesion images. Results: Non-BCLE were present in 47 invasive carcinomas. The sensitivity and specificity of non-BCLE evaluation by high-resolution helical CT were 70% and 89%, respectively. The morphology of non-BCLE on CT agreed with histologic findings. The morphological pattern on CT significantly correlated with intraductal tumor density adjacent to invasive tumor. Conclusion: Comparison of high-resolution helical CT with histologic data suggests that demonstration of a non-BCLE morphology can make the CT breast carcinoma local staging more accurate.