Tc-99m Sestamibi Scintimammography in palpable and now-palpable breast lesions

Breast carsinoma is the second most common cancer affecting women. Many studies have demonstrated that mammography and physical examination are the most effective method for early breast cancer detection. However mammography has some limitations. It is less reliable for detecting lesions in patients with dense breasts, severe fibrotic disease and has low positive predictive value. The aim of our study was to determine the diagnostic accuracy of Tc-99m sestamibi scintimammography in patients with palpable and non-palpable breast lesions. The study population included 53 (42-60 years of age) women with a clinically palpable mass in the breast and/or suspicious mammographic finding. Eighteen patients (33%) had palpable lesions and 35 (67%) had non-palpable lesions. Anterior, left and right lateral, ipsilateral posterior oblique (30°) images were obtained 15 min after the injection of 20mCi Tc-99m sestamibi. Every planar image was acquired for 10 min. All images were evaluated independent of the mammographic and pathologic results, and each other. Scintimammography was considered positive if a well-defined uni or multifocally increased uptake in breast tissue was demonstrated in at least one view. Uniform distrubution of the tracer or diffuse uptake was interpreted as negative. Positive sestamibi was the criterion for malignancy, negative sestamibi was the criterion for benign lesion. Excisional biopsy were performed in all patients irrespective of the scintigraphic results.This study showed that Tc-99m sestamibi scintimammography is a valuable complementary tool in all patients of this study and mammographical subgroup. Scintimammography could be a useful method for the detection of breast lesions and their differential diagnosis in clinical use. Our mammographic subgroup results are promisisng but further investigations are needed to improve its clinical use. 38