Detection of malignant breast tumours in dense breast tissue: results of Tc-99m-tetrofosmin scintimammography related to surgery

Aims: To assess the contribution of (90m)Technetium tetrofosmin (Tc-99m-TF) scintimammography for staging of breast lesions in patients with a suspici ous or non-diagnostic mammogram to reduce unnecessary surgical procedures i n future. Methods: Fifty patients with suspicious physical examinations and/or mammog raphy underwent Tc-99m-TF breast imaging. Results: Scintimammography with Tc-99m-TF was positive in 37 patients (36 t rue positive, one false positive) and negative in 13 patients (12 true nega tive. one false negative). The detection of a malignant tumour by Tc-99m-TF was independent of the density of the breast tissue, In 33 patients with a malignant breast tumour Tc-99m-TF was diagnostic with respect to axillary status, but in four out of 19 patients with a histologically positive axill ary lymph node status, tumour involvement remained undetected by scintigrap hy. Moreover, in four patients, scintimammography revealed an additional di screte area of increased Tc-99m-TF uptake, which proved to be second primar y breast cancers. Conclusions: Tc-99m-TF scintimammography appears to be an accurate diagnost ic test in patients with a symptomatic breast lesion and a non-diagnostic m ammogram. also in those patients with dense breast tissue, This procedure m ay also have potential for the detection of second primary breast cancers i n an early stage.