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Small Hypoattenuating Hepatic Lesions at Contrast-enhanced CT: Prognostic Importance in Patients with Breast Cancer¹

¹ From the Department of Radiology, University of California San Francisco, Box 0628, M-372, 505 Parnassus Ave, San Francisco, CA 94143-0628. Received September 11, 2003; revision requested November 24; final revision received March 18, 2004; accepted April 8. Address correspondence to F.V.C (e-mail: fergus.coakley@radiology.ucsf.edu).

PURPOSE: To retrospectively determine the prognostic importance of small hypoattenuating hepatic lesions at contrast material–enhanced computed tomography (CT) in patients with breast cancer.

MATERIALS AND METHODS: This retrospective study was approved by the committee on human research. Written informed consent was not required. The authors retrospectively identified 153 patients with breast cancer who underwent serial abdominal CT and who did not have definite liver metastases present at initial CT. The mean age was 56 years (age range, 27–93 years). Two readers independently recorded the presence, size, and number of small (15 mm or less in diameter) hypoattenuating hepatic lesions at initial CT. Another reader independently recorded the presence or absence of definite hepatic metastases at final CT. The association between the presence, size, and number of small hypoattenuating hepatic lesions at initial CT and the subsequent development of metastases was analyzed by using Kaplan-Meier analysis.

RESULTS: One or more small hypoattenuating hepatic lesions were seen at initial CT in 54 of 153 patients (35%). After a median follow-up of 584 days (range, 16–1827 days), definite hepatic metastases developed in 43 of 153 patients (28%), including 15 of 54 patients (28%) with hypoattenuating lesions at initial CT and 28 of 99 patients (28%) without hypoattenuating lesions at initial CT. Findings from the Kaplan-Meier analysis showed no association between the presence (P = .56), size (P = .55), or number (P = .30) of small hypoattenuating hepatic lesions at initial CT and the subsequent development of hepatic metastases.

CONCLUSION: In patients with breast cancer who do not have definite hepatic metastases at initial examination, there is no evidence that small hypoattenuating hepatic lesions seen at initial CT contribute to an increased risk of subsequently developing hepatic metastases.

© RSNA, 2004

Index terms: Breast neoplasms, metastases, 00.32 • Liver neoplasms, CT, 761.1211 • Liver neoplasms, secondary, 761.332

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