Chest and upper abdominal computed tomography scan findings in patients with established breast cancer

Abstract

Background: Computed tomography (CT) of the chest and/or abdomen is usually done in patients with breast cancer for staging regardless of their grade, size, lymph node, or clinical signs/symptoms in Nigeria. This study aimed to determine the diagnostic yield of chest and upper abdominal CT for metastasis, metastatic pattern, and incidental findings in patients with breast cancer in our environment. Methodology: A retrospective study of all 300 confirmed breast cancer patients who reported for chest/abdominal computed tomographic scans in a tertiary diagnostic center in Lagos between October 2021 and December 2021. Data were extracted from their CT images/radiological reports and analyzed using SPSS version 23 for Windows, P <0.05. Results: Three hundred patients with established breast cancer were examined, within the age range of 24–83 years, median of 51 years, and mean of 50.91 ± 11.9 years. The majority were female 298 (99.3%) and within the 50–59-year (101, 33.7%) age group. Most had unilateral breast cancer 286 (95%) with left-sided predominance (146, 49%). Metastasis was seen in 183 (61%) patients with nodes being the most common site 158 (52.7%). Solitary metastasis was seen in 91 (30.3%) of the participants, predominating in the lymph nodes 69 (23%), followed by lungs 17 (5.7%), P < 0.01. Two-organ involvement was in 59 (19.7%), and the most common combination was lung and node 32 (10.7%), followed by liver and node 8 (2.7%). Metastasis was most common in the 50–59-year age group, 64 (21.3%). Conclusion: Chest and abdominal CT yielded a definitive diagnosis of metastasis in more than 50% of the patients. The most common structure affected was the lymph nodes. Chest CT is therefore imperative in patients with late presentation of breast cancer.