Scintimammography in Patients with Mammographic Changes

Full text: Objective: The purpose of our study was to evaluate the role of scintimammography in the diagnosis of breast cancer in association with mammography in patients with BI-RADS score at least 2 on MM examination (possible benign) or with previous surgical interventions. Material and method: A total of 71 patients (mean age 52, 4±4,7 years) with suspected breast tumors were examined using a clinic protocol including physical examination, conventional mammography (MM), scintimammography (SM) and histologic exam. 31 patients underwent ultrasonography, 9 patients underwent also MRI scans. 2 patients underwent whole-body scan with 99m-Tc-MDP for detection of bone metastases. For scintimammography we have used a PICKER-AXIS double-head camera. MRI scans were performed using a MAGNETOM HARMONY 1.0 T . X-Ray mammograms were performed using a MELODY scanner. Scintimammography: Lateral prone and supine images were obtained at 15 minutes after administration of 20 mCi of 99m-Tc-Sestamibi or 99m-tc-Tetrofosmin (MYOVIEW), in the contralateral arm to the breast lesion. Subsequently, excisional biopsy and/or fine needle aspiration biopsy were performed. Imaging results were compared with biopsies. Results: We have analyzed the results according with clinical symptoms, age distribution, lesion location, lesion size, and in correlation with BIRADS score. 55 patients (77,46%) were confirmed with malignant lesions. 16 patients (22,53%) were confirmed with benign lesions. Conclusions: Tc-99m Sestamibi scintimammography is a valuable complementary tool in the diagnosis of breast palpable lesions, with a high sensitivity and specificity compared with X-Ray conventional mammogram. We suggest its use as an adjuvant technique in patients with inconclusive X-Ray mammograms (dense breast tissue, previous surgical interventions) and possible in BI-RAD categories 3 and 4 (studies with higher number of patients required). (author)