Pelvic computed tomography of breast carcinoma patients. Should it routinely be added to abdominal computed tomography?

Background: This study was conducted to determine if pelvic computed tomography (CT) should routinely be appended to abdominal CT in the workup of patients with breast carcinoma.

Methods: The abdominal-pelvic CTs of 139 breast carcinoma patients (195 exams) were reviewed. Scans were grouped by indication and whether pelvic pathology was known before CT. Pelvic CT results were correlated with their effect on patient management.

Results: Among the 119 patients without pre-CT evidence of pelvic disease, a nonosseous pelvic metastasis was identified in only 1; this patient also had liver metastases and management was not changed. No unsuspected pelvic CT finding altered therapy for breast carcinoma. However, three patients underwent surgery for asymptomatic masses discovered on pelvic CT; all were benign.

Conclusions: Pelvic CT is unlikely to affect the management of patients with breast carcinoma by detecting occult metastatic disease.