Radiologists should remain alert to incidental breast lesions on chest CT to reduce missed cancers. The most common breast finding on chest CT is a mass, and features such as irregular shape, non-circumscribed margins, and strong contrast enhancement may indicate malignancy. According to recent research, chest CT has higher than expected sensitivity, specificity, and diagnostic accuracy for the detection of breast cancer. The specificity and accuracy of contrast enhanced, and non-contrast scans are comparable, but the sensitivity is slightly lower without intravenous contrast. Chest CT was reported to have fewer false positive findings, likely because its three-dimensional imaging reduces tissue overlap. However, reliable differentiation between benign and malignant lesions remains limited, as chest CT has a wider field of view and poorer breast specific resolution when compared to dedicated breast imaging. Careful interpretation and correlation with dedicated breast imaging are still crucial.