Incidental breast cancer (Spectral CT)

Case contributed by John Razkala
Diagnosis certain


Chest pain, tachycardia and dyspnea.

Patient Data

Age: 70 years
Gender: Female



Right breast lesion at 9 o'clock from the nipple with regional node involvement.

Focal interventricular septal myocardial hypo-perfusion.

Case Discussion

Spectral CT can obtain different material datasets such as iodine mapping and low-energy monochromatic images which can improve cancer detection and differentiation 1.

In this case, the iodine maps highlight enhancing malignant lesions in the right breast and adjacent lymph node, later confirmed by core needle biopsy.

The area of myocardial hypo-perfusion in the interventricular septum indicates ischemic injury which is clinically relevant to the presentation with chest pain.

Pathology report:

  • Right Breast core biopsy: Adenocarcinoma.

  • Right Lymph node biopsy: Invasive Adenocarcinoma.

Case courtesy of Dr. Zane Sherif.

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