The role of scintimammography with 99m tc-sestamibi as a complementary diagnostic technique in the detection of breast cancer

Abstract

Purpose: To prospectively determine the clinical value of scintimammography (Sc) with ^99mTc-sestamibi as a complementary method to triple diagnosis (TD) in detecting malignant disease of the breast.

Material and Methods: Ninety-six patients with 119 clinically or mammographically detected breast lesions underwent TD procedures, including clinical examination, mammography and fine-needle aspiration cytology. Prone planar Sc with ^99mTc-sestamibi was performed in all 96 patients. Five groups were defined for diagnosis: 1 = normal; 2 = benign; 3 = probably benign; 4 = highly suspect of malignancy; and 5 = malignant. All lesions were histopathologically examined. The results of each method per se and the combination of TD with Sc (TD + Sc) were analyzed.

Results: Histopathology of the 119 surgically excised breast lesions found 83 malignant and 36 benign lesions. TD missed 6 of 83 carcinomas, resulting in a sensitivity of 92.7%. Sc alone showed sensitivity of 85.5%. The combination TD + Sc missed 1 of 83 carcinomas, and thus had a sensitivity of 98.7%. In mammographically dense breasts both TD and Sc detected 16 of 18 carcinomas, while the combination TD + Sc led to detection of all 18 carcinomas.

Conclusion: Adding Sc to TD increases the sensitivity for detection of breast carcinomas. Sc with ^99mTc-sestamibi is recommended as a complimentary method to TD in selected cases such as mammographically dense breasts.