Three-dimensional helical CT of the breast: Accuracy for measuring extent of breast cancer candidates for breast conserving surgery

Objective. To evaluate the accuracy of three-dimensional (3D) helical compu ted tomography (CT) for assessing the extent of breast cancer of candidates for breast conserving surgery. Methods. Results of helical CT were studied in 144 lesions of 144 patients with breast cancer before breast-conserving surgery. A lesion was defined a s positive if focal enhancement was detected by CT within 100 s after contr ast material administration. After resection, tumors were histopathological ly mapped and correlated with the extent of 3D images. Results. Helical CT enabled detection of 143 tumors but not of one ductal c arcinoma in situ (DCIS). The median deviation of the tumor extension reveal ed by 3D helical CT images from pathological assessment was 7.7 mm (range 0 -60 mm). The extent of tumors was significantly correlated with CT measurem ents (r = 0.714, p < 0.0001). By multivariate analysis, the presence of inv asive tumors with intraductal extensions beyond the edge of the invasive tu mor and histologic type (DCIS) were significant risk factors for deviation of the tumor extension revealed by 3D helical CT images from pathological a ssessment. Conclusion. Three dimensional helical CT of the breast is an accurate preop erative imaging modality for assessing the extent of breast cancer candidat es for breast conserving surgery.