Radiologic patterns of distant organ metastasis in advanced breast cancer patients: A report of 114 computed tomography cases in private and public medical practice in Kinshasa

Abstract

Introduction Distant metastases from breast cancer represent a major determinant of prognosis and therapeutic decision-making. Computed tomography (CT) plays a central role in staging advanced disease, particularly in resource-limited settings where local epidemiological data remain scarce. Purpose To describe the radiological patterns of distant metastases detected on CT scans in patients with advanced breast cancer in Kinshasa. Methods A retrospective descriptive study was conducted over a five-year period (January 2020–January 2025) across four medical imaging centres in Kinshasa. Thoracoabdominopelvic CT scan reports from 114 patients diagnosed with stage IIIB and IV breast cancer were analysed. Metastases were identified according to predefined radiological criteria, and data were analysed using descriptive statistics. Results The mean age of patients was 52.9 years (range: 19–96 years). Thoracic metastases were observed in 98 patients (85.9%), abdominopelvic metastases in 67 patients (58.3%), and bone metastases in 40 patients (35.0%). The lungs were the most frequently affected site (75 cases), followed by the liver (46 cases). Bone metastases predominantly involved the spine (32 cases) and were mainly osteolytic in nature. Lymph node involvement was identified in 26 patients, primarily within the thoracic region. Multisite metastases were present in 74 patients (64.9%). Conclusion Advanced breast cancer in Kinshasa is characterised by a high prevalence of metastases, frequently multisystemic, with predominant involvement of the lungs and liver. CT imaging remains an essential tool for disease staging and treatment guidance in this setting.