TL-201 SCINTIGRAPHY, MAMMOGRAPHY AND ULTRASONOGRAPHY IN THE EVALUATION OF PALPABLE AND NONPALPABLE BREAST-LESIONS - A CORRELATIVE STUDY

Purpose: To determine the feasibility of T1-201 as a tumor localizing agent in palpable and nonpalpable breast lesions, in comparison with m ammography and ultrasonography (US), and to evaluate the contribution of these modalities to each other in obviating biopsy. Materials and M ethods: Seventy-two palpable and nonpalpable breast lesions were prosp ectively classified as benign, indeterminate, or malignant according t o the sonographic and mammographic criteria and were further analized with T1-201 scanning. These classifications were compared with biopsy results. The sensitivity, specificity, accuracy, false positive and fa lse negative rates (FPR, FNR), negative and positive predictive values (npv, ppv) were calculated for each individual modality and combinati on of modalities to evaluate the contribution of these three technique s to each other. Results: Of 72 lesions 52 were histologically maligna nt and 20 were benign. Overall, mammography was the most sensitive (92 %) and T1-201 was the most specific (75%) of the three modalities. Mam mography + T1 combination was the most specific (90%) and accurate (97 %) of dual combinations. In mammographically or sonographically indete rminate cases, T1-201 was much more specific (75% versus 37% for mammo graphy and US) and more accurate (82% versus 36% for mammography and 5 4% for US) than the other two modalities, and mammography + T1 combina tion was significantly superior to other dual combinations (87% specif ic and 91% accurate). Use of T1-201 scanning as an adjunct to mammogra phy + US combination increased the specificity, ppv, and accuracy rate s overall, particularly in mammographically or sonographically indeter minate cases. Conclusions: In mammographically and sonographically ind eterminate breast lesions thallium scanning may be offered as a third step of investigation to obviate biopsy. (C) 1997 Elsevier Science Ire land Ltd.