Incidental Breast Findings on Chest CT: Rates of Report and Follow-Up.

Objective: This study aims to determine the incidence and types of breast findings detected on chest CTs at our institution and assess rates of subsequent follow-up imaging and breast cancer screening. Methods: A retrospective review of all chest CTs performed at our institution over a 2-year period (1/1/2022-1/1/2024) was conducted, demonstrating 1540 patients above the age of 40 with incidental breast findings identified using a text search of the reports, and follow-up recommendations were documented. Clinical outcomes were analyzed for cases with recommended dedicated breast imaging. Results: Incidental breast findings were detected in 14.3% of chest CTs in women above or at the age of 40. Further breast imaging was recommended in 54 cases, with 21 cases having associated dedicated breast imaging performed. Of these, corresponding dedicated workup revealed predominantly benign findings, with 82% representing benign or likely benign etiologies and only 4 cases representing malignancy. The likelihood of performing follow-up imaging was influenced by the language used in the report, with a 40% completion rate for studies using definitive wording as compared to 0% for optional wording. Conclusion: There is a considerable rate of incidental breast findings visualized on chest CTs, which are predominantly benign. However, as there is a potential for visualization of malignant lesions, standardized reporting and follow-up protocols are essential to ensure proper evaluation and management. Further research is needed for evaluating and standardizing the potential use of chest CTs for assessing incidental breast lesions.