Significance of computed tomography in the diagnosis of recurrent breast cancer involving the chest wall and mediastinum

Twenty-five patients in whom abnormal findings of the anterior chest wall were seen on computed tomography (CT) were examined. Some of the patients also underwent x-ray tomography and bone scans with sup(99m)Tc-MDP. CT findings were compared with those obtained by x-ray tomography and bone scans. Diagnostic efficacy was evaluated as remarkably effective (++), effective (+), equivocal (+-), and ineffective (-). As for the efficacy in diagnosing recurrent breast cancer and various chest diseases, (++) was seen in 44 % by CT, in 29 % by bone scans, and in 21 % by x-ray tomography; the corresponding figures for (+) were 56 %, 53 %, and 68 %, respectively. As for diagnostic efficacy for recurrent cancer involving the anterior chest wall, CT had higher sensitivity in detecting recurrence involving the thoracic bones (93 % in ++ and +) and in detecting recurrence to the soft tissues including lymph nodes (96 % in ++ and +) than bone scans (80 % in ++ and +) and x-ray tomography (90 % in ++ and +). CT is therefore considered indispensable for the search of the anterior chest wall. However, because it has limitations of qualitative diagnosis, combined use of the three modalities will improve the diagnostic accuracy. (Namekawa, K.)