Technetium-99m sestamibi scintimammography to improve diagnostic accuracy of conventional mammography in patients with palpable breast masses
Keywords:
Technetium Tc 99m, sestamibi, diagnostic use, radionuclode imagingAbstract
Objective: To assess technetium-99m sestamibi scintimammography (99mTc-Mibi) comparatively with conventional mammography in women with clinically suspicious palpable breast masses referred to the National Cancer Institute.
Materials and Methods: Both a conventional mammography and a 99mTc-Mibi scintimammography were performed in 45 consecutive patients with palpable breast masses. Mammography results were classified according to the Breast Imaging Reporting and Data System (Bi-rads). Prone-lateral planar scintigraphic images were obtained 10 and 90 minutes after the intravenous administration of 20 mCi of 99mTc-Mibi. Core biopsies were performed to establish final diagnoses.
Results: Cancer was confirmed in 41 of 49 breast masses. Sensitivity and positive predictive values were 95% and 91% respectively for scintimammography, whereas for conventional mammography they respectively were 76% and 100%. Eight of 10 false-positive results obtained by conventional mammography occurred in women with dense and/or nodular radiographic breast patterns. They were all correctly diagnosed by scintimammography.
Conclusion: 99mTc-Mibi scintimammography could be included in the diagnostic algorithm of patients with palpable breast masses, especially if they have dense and/or nodular, Bi-rads 1,2 or 3 radiographic breast patterns.
Author Biographies
Amelia de los Reyes, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología E. S. E., Grupo de Medicina Nuclear, Bogotá, D.C., Colombia.
Augusto Llamas, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología E. S. E., Grupo de Medicina Nuclear, Bogotá, D.C., Colombia.
References
Globocan 2002. Disponible en: <http://wwwdep.iarc.fr.
Olsen O, Gptzsche PC. Screening for breast cancer with mammography (Cochrane Review). In: The Cochrane Library. Issue 1. Oxford: Update Software; 2005.
Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination and breast US, and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology 2002;225:165-175.
https://doi.org/10.1148/radiol.2251011667
Verbeek ALM. The influence of breast density on the sensitivity of mammography screening. Eur J Cancer 2004;40 Supl 2:57.
https://doi.org/10.1016/S1359-6349(04)90621-0
Kopans D. The positive predictive value of mammography. AJR 1992;158:521-526.
https://doi.org/10.2214/ajr.158.3.1310825
Prats E, Aisa F, Abós MA, Villavieja L, Garcia López F, Asenjo MJ, et al. Mammography and 99mTc-MIBI scintimmamography in suspected breast cancer. J Nucl Med 1999;40:296-301.
Polan RL, Klein BD, Richman RH. Scintimammography in patients with minimal mammographic or clinical findings. Radiographics 2001;21:641-653.
https://doi.org/10.1148/radiographics.21.3.g01ma26641
Liberman M, Sampalis F, Mulder DS, Sampalis JS. Breast cancer diagnosis by scintimammography: a meta-analysis and review of the literature. Breast Cancer Res Treat 2003;80:115-126.
https://doi.org/10.1023/A:1024417331304
Sampalis FS, Denis R, Picard D, Fleiszer D, Martin G, Nassif E, et al. International prospective evaluation of scintimammography with (99m) technetium sestamibi. Am J Surg 2003;185:544-549.
https://doi.org/10.1016/S0002-9610(03)00077-1
American College of Radiology (ACR). ACR Birads-Mammography. In: Breast Imaging Reporting and Data System. Breast Imaging Atlas. 4ed. Reston (Virginia): American College of Radiology; 2003.
Lanin DR, Harns RP, Swanson FH, Edwards MS, Swanson MS, Pories WJ. Difficulties in diagnosis of carcinoma of the breast in patient less than fifty years of age. Surg Gynecol Obstet 1993; 177:457-462.
Waxman AD. The role of 99mTc-Methoxyisobutilisonitrile in imaging breast cáncer. Sem Nucí Med 1997;27:40-54.
https://doi.org/10.1016/S0001-2998(97)80035-9
Biersak HJ, Palmedo H, Bender H, Krause T. Nuclear nedicine and breast cáncer. Nucl Med Ann 2000;41:1973-1979.
Edelken S. Mammography and palpable cancer of the breast. Cancer 1988;61:263-265.
https://doi.org/10.1002/1097-0142(19880115)61:2<263::AID-CNCR2820610211>3.0.CO;2-Z
Coveney EC, Geraghty JG, O'Laoide R, Hourihane JB, O Higgins NJ. Reasons underlying negative mammography in patients with palpable breast cancer. Clin Radiol 1994;49:123-125.
https://doi.org/10.1016/S0009-9260(05)83454-3
The Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. Clinical practice guidelines for the care and treatment of breast cancer. CMAJ 1998; 158 Supl: 3-8.
Thurfjell E. Breast densitiy and the risk of breast cancer. N Engl J Med 2002;347:866.
https://doi.org/10.1056/NEJMp020093
Schillaci O, Buscombe JR. Breast scintigraphy today: indications and limitations. Eur J Nucl Med Mol Imaging 2004;31Supl:35-45.
https://doi.org/10.1007/s00259-004-1525-x
Rhodes DJ, O'ConnorMK, Phillips SW, SmithRL, Collins DA. Molecular breast imaging: a new technique using technetium Tc-99m scintimammography to detect small tumors of the breast. Mayo Clin Proc 2005;80:24-30.
https://doi.org/10.1016/S0025-6196(11)62953-4
Boyd NF, Dite GS, Stone J, Gunasekara A, English DR, McCredie MR, et al. Heritability of mammographic density, a risk factor for breast cancer. N Engl J Med 2002;347:886-894.
https://doi.org/10.1056/NEJMoa013390
Khalkhali I, Villanueva-Meyer J, Edell SL, Conolly JL, Schnitt S J, Baum JK, et al. Diagnostic accuracy of 99mTc-sestamibi breast imaging: multicentric trial results. J Nucl Med 2000;41:1973-1979.
Primic-Zakelj M. Screening mammography to early detection of breast cancer. Ann Oncol 1999; 10 Supl: 121-127.
https://doi.org/10.1023/A:1008310503380
Sun SS, Hsieh JF, Tsai SC, Ho YJ, Kao CH. Expression of drug resistance protein related to 99mTc-MIBI breast imaging. Anticancer Res 2000;20:2021-2026.
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