SCINTIMAMMOGRAPHY WITH TC-99M TETROFOSMIN IN THE DIAGNOSIS OF BREAST-CANCER AND LYMPH-NODE METASTASES

The aim of the study was to evaluate the possible role of scintimammog raphy (SMM) with technetium-99m tetrofosmin in breast cancer. Thirty-t hree patients with breast disease and ten normal controls were include d in the study. Planar scintigraphic images in supine anterior, prone lateral and lateral views, with the patient lying in lateral recumbenc y, were acquired. A qualitative analysis evaluating both breasts and l ymph nodes was performed. All breast lesions were verified after surge ry and/or by fine-needle aspiration. In 8 of the 33 patients, mammogra phy was inconclusive because of mastectomy or dense breasts. For mammo graphy, a sensitivity of 95.6%, a specificity of 66.7% and an accuracy of 89.6% were obtained. At SMM, 26 out of 28 malignant lesions (avera ge size 2.8 cm, range 0.4-12 cm), including two recurrences, were dete cted with a 92.8% sensitivity, a 100% specificity and a 95.1% accuracy . The smallest detectable carcinoma measured 0.6 cm. Two false-negativ e results on SMM were found in a 0.4-cm intraductal carcinoma and in t he only mucinous papillary carcinoma in our series. With regard to lym ph node analysis, II out of 12 axillary metastases (sensitivity=91.6%) were detected. A false-positive result, yielding a specificity of 92. 3% was also obtained. A metastatic involvement of the internal mammary chain was observed. No uptake was seen in II benign mammary lesions o r at the level of the breast and axilla when neoplastic involvement wa s absent, In conclusion, SMM with Tc-99m-tetrofosmin is an effective t echnique for the evaluation of primary breast carcinomas, recurrences and lymph node metastases.