Impact of scintimammography in management of breast cancer
Mammography is the most widely used diagnostic imaging method for screening and diagnosing breast cancer. Nevertheless, this technique has some limitations in that not all breast cancers are evident on mammograms, especially in dense or dysplastic breasts, patients with breast prosthesis or if the patient has previously undergone radiation, surgery or biopsy. Scintimammography (SM) is the functional imaging study of the breast with radiopharmaceuticals, such as 99mTc-labelled methoxyisobutylisonitrile (99mTc-MIBI). SM is currently used as a complementary test to mammography in patients with suspected breast cancers. This study was undertaken to evaluate the impact of SM on the management of patients with a suspicious lesion detected by palpation or mammography.
Methods. We performed a prospective study of 53 patients with a suggestion of breast cancer, either on palpation or mammography. Planar imaging was performed after injection of 99mTc-MIBI. Results were compared with histopathological analysis in all cases.
Results. Breast cancer was proven in 11 cases. SM had a sensitivity of 90.9% and a specificity of 97.6%. SM correctly evaluated multicentricity or bilaterality in 3 of 11 patients and detected axillary lymph node in 1 patient. SM made the diagnosis of benign lesions in 41 cases with doubtful diagnosis, thus potentially avoiding biopsy in 77% of cases.
Conclusion. SM is a useful complementary tool for the diagnosis and evaluation of disease extent in patients with an inconclusive diagnosis and can decrease the number of negative breast biopsies.
South African Journal of Radiology Vol. 10 (1) 2006: pp. 8-10