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Breast Cancer

, 10:198 | Cite as

The role of computed tomography in the selection of breast cancer treatment

  • Sadako Akashi-Tanaka
  • Takashi Fukutomi
  • Natsuko Sato
  • Kunihisa Miyakawa
Review Article

Abstract

Contrast-enhanced computed tomography (CE-CT) is one of the most sensitive imaging modalities. CE-CT plays a role in the following: (1) to determine the extent of breast cancer to select the appropriate breast conserving treatment (BCT). The sensitivity and specificity for the detection of extensive intraductal component (EIC) by CE-CT were 82–88% and 75–89%, respectively. The pathological extent of tumors significantly correlated with the extension revealed by CE-CT; (2) to determine the extent of resection following neoadjuvant chemotherapy, which is difficult to assess by other modalities; (3) to diagnose axillary lymph node metastasis. The sensitivity and specificity are 79–90% and 70–89%, respectively; (4) to identify occult breast cancer with axillary metastasis and to diagnose local recurrence after BCT.

Key words

Breast cancer CT scan Breast conserving Treatment Neoadjuvant chemotherapy Axillary lymph node 

Abbreviations

CE-CT

Contrast-enhanced computed tomography

MMG

Mammography

US

Ultrasonography

MD-CT

Multidetector-row computed tomography

BCT

Breast conserving treatment

EIC

Extensive intraductal component

3D

3-Dimensional

NAC

Neoadjuvant chemotherapy

SLN

Sentinel lymph node

CE

Clinical examination

References

  1. 1).
    Muramatsu Y, Akiyama N, Hanai K: Medical exposure in lung cancer screening by helical computed tomography.Jpn J Radiol Technol 52: 1–8, 1995.Google Scholar
  2. 2).
    Schnitt SJ, Connolly JL, Khettry U,et al: Pathologic findings in re-excision of the primary site in breast cancer patients considered for treatment by primary radiation therapy.Cancer 59: 675–681, 1987.PubMedCrossRefGoogle Scholar
  3. 3).
    Gage I, Schnitt S, Silver B,et al: Pathologic margin involvement and the risk of recurrence in patients treated with breast-conserving therapy.Cancer 78: 1921–1928, 1996.PubMedCrossRefGoogle Scholar
  4. 4).
    Healey EA, Osteen RT, Schnitt SJ,et al: Can the clinical and mammographic findings at presentation predict the presence of an intensive intraductal component in early stage breast cancer.Int J Radiat Oncol Biol Phys 17: 1217–1221, 1989.PubMedGoogle Scholar
  5. 5).
    Tsunoda-Shimizu H, Ueno E, Tohno E,et al: Ultrasonographic evaluation for breast conservative therapy.Jpn J Breast Cancer 11: 649–655, 1996 (in Japanese with English abstract).Google Scholar
  6. 6).
    Endo T, Ichihara S, Aoyama H,et al: The indications for breast conserving surgery on mammography.Jpn J Breast Cancer 11: 643–648, 1996 (in Japanese with English abstract).Google Scholar
  7. 7).
    Akashi-Tanaka S, Fukutomi T, Miyakawa K,et al: Diagnostic value of contrast-enhanced computed tomography for diagnosing the intraductal component of breast cancer.Breast Cancer Res Treat 49: 79–86, 1998.PubMedCrossRefGoogle Scholar
  8. 8).
    Akashi-Tanaka S, Fukutomi T, Miyakawa K,et al: Diagnostic value of enhanced computed tomography in the detection of the widely spreading intraductal component of breast cancer: case reports.Breast Cancer 4: 29–32, 1997.PubMedCrossRefGoogle Scholar
  9. 9).
    Akashi-Tanaka S, Fukutomi T, Miyakawa K,et al: Clinical use of contrast-enhanced computed tomography for decision making in breast conserving surgery.Breast Cancer 4: 280–284, 1997.Google Scholar
  10. 10).
    Uematsu T, Sano M, Homma K,et al: Three-dimensional helical CT of the breast: Accuracy for measuring extent of breast cancer candidates for breast conserving surgery.Breast Cancer Res Treat 65: 249–257, 2001.PubMedCrossRefGoogle Scholar
  11. 11).
    Akashi-Tanaka S, Fukutomi T, Miyakawa K,et al: Contrast-enhanced computed tomography for diagnosing the intraductal component and small invasive foci of breast cancer.Breast Cancer 8: 10–15, 2001.PubMedGoogle Scholar
  12. 12).
    Hiramatsu H, Enomoto K, Ikeda T,et al: Three-dimensional helical CT for treatment planning of breast cancer.Radiation Medicine 17: 35–40, 1999.PubMedGoogle Scholar
  13. 13).
    Furuhashi S, Karikomi M, Yano K: Contrastenhanced helical CT of the breast cancer: (CT and histopathological correlation).J Danso Eizo Kenkyuukai 27: 199–204, 2000 (in Japanese with English abstract).Google Scholar
  14. 14).
    Kanamaru H, Yokoyama H, Shirakawa H,et al: Value of helical computed tomography in diagnosing the extent of intraductal spread of breast cancer.Jpn J Breast Cancer 16: 125–131, 2001 (in Japanese with English abstract).Google Scholar
  15. 15).
    Tozaki M, Yamashita A, Kawakami M,et al: Diagnosis of breast cancer extent using dynamic multidetector-row CT: correlation between MPR imaging and pathological cross-sections.Nippon Acta Radiol 60: 560–567, 2000 (in Japanese with English abstract).PubMedGoogle Scholar
  16. 16).
    Ishida T: Preoperative detection of EIC and multifocal lesions of breast cancer; in comparison of 3-D CT and 3-D MRI as new modalities.J Jap Surg Soc 102: 74, 2001 (in Japanese).Google Scholar
  17. 17).
    Hisamatsu K: 2001 personal communicationGoogle Scholar
  18. 18).
    Fisher B, Bryant J, Wolmark N,et al: Effect of preoperative chemotherapy on the outcome of women with operative breast cancer.J Clin Oncol 16: 2672–2685, 1998.PubMedGoogle Scholar
  19. 19).
    Hortobagyi GN: Treatment of locally advanced and inflammatory breast cancer. In: Harris JR, Lippman ME, Morrow M, Osborne CK eds, Diseases of the Breast, 2nd ed, Lippincott Williams & Wilkins, Philadelphia, pp645–650, 1999.Google Scholar
  20. 20).
    Akashi-Tanaka S, Fukutomi T, Watanabe T,et al: Accuracy of contrast-enhanced computed tomography in the prediction of residual breast cancer after neoadjuvant chemotherapy.Int J Cancer (Radiat Oncol Invest) 96: 66–73, 2001.CrossRefGoogle Scholar
  21. 21).
    Guiliano AE, Jones R, Brennan R,et al: Sentinel lymphadenectomy in breast cancer.J Clin Oncol 15: 2345–2350, 1997.Google Scholar
  22. 22).
    Morrow M, Harris JR: Local management of invasive breast cancer. In: Harris JR, Lippman ME, Morrow M, Osborne CK eds, Diseases of the Breast, 2nd ed, Lippincott Williams & Wilkins, Philadelphia, pp549–550, 1999.Google Scholar
  23. 23).
    March D, Wechsler R, Kurtz A,et al: CT-pathologic correlation of axillary lymph nodes in breast carcinoma.J Comput Assist Tomogr 15: 440–444, 1991.PubMedCrossRefGoogle Scholar
  24. 24).
    Ogawa Y, Nishioka A, Hamada N,et al: Recent progress of imaging diagnosis for breast cancer.Jpn J Breast Cancer 11: 243–253, 1996 (in Japanese with English abstract).Google Scholar
  25. 25).
    Suzuki M, Nagashima K, Yagata H,et al: Computed tomographic evaluation of axillary lymph node metastases from breast cancer.J Jap Surg Associ 60: 898–903, 1999 (in Japanese with English abstract).Google Scholar
  26. 26).
    Nishie H, Hirooka Y, Kaibara N,et al: Preliminary study of diagnosis of lymph nodes metastasis of breast cancer by preoperative CT scan.J Jap Surg Associ 61: 1118–1122, 2000 (in Japanese with English abstract).Google Scholar
  27. 27).
    Newman J: Recent advances in breast cancer imaging.Radiologic Technol 71: 35–54, 1999.Google Scholar
  28. 28).
    Uematsu T, Sano M, Homma K: In vivo high-resolution helical CT of small axillary lymph nodes in patients with breast cancer.AJR 176: 1069–1074, 2001.PubMedGoogle Scholar
  29. 29).
    Pierga J, Mouret E, Dieras V,et al: Prognostic value of persistent node involvement after neoadjuvant chemotherapy in patients with operable breast cancer.Br J Cancer 83: 1480–1487, 2000.PubMedCrossRefGoogle Scholar
  30. 30).
    Lluch A, Cervantes A, Pardo J,et al: Assessment of primary tumor and axillary involvement in breast cancer after neoadjuvant chemotherapy. A comparison of clinical examination, mammography, ultrasonography and CT-scan.Proc Am Soc Clin Oncol 14: 135–240, 1995.Google Scholar
  31. 31).
    Hagay C, Cherel P, De-Maulmont C,et al: Contrastenhanced CT: value for diagnosing local breast cancer recurrence after conservative treatment.Radiol 200: 631–638, 1996.Google Scholar
  32. 32).
    Akashi-Tanaka S, Fukutomi T, Miyakawa K,et al: Contrast-enhanced computed tomography detection of occult breast cancers presenting as axillary masses.Breast Cancer Res Treat 55: 97–101, 1999.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 2003

Authors and Affiliations

  • Sadako Akashi-Tanaka
    • 1
  • Takashi Fukutomi
    • 1
  • Natsuko Sato
    • 2
  • Kunihisa Miyakawa
    • 2
  1. 1.Division of Breast SurgeryNational Cancer Center HospitalJapan
  2. 2.Department of Diagnostic RadiologyNational Cancer Center HospitalJapan

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