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.
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.
Authors: Emilio Bombardieri; Cumali Aktolun; Richard P Baum; Angelika Bishof-Delaloye; John Buscombe; Jean François Chatal; Lorenzo Maffioli; Roy Moncayo; Luc Mortelmans; Sven N Reske Journal: Eur J Nucl Med Mol Imaging Date: 2003-12 Impact factor: 9.236