The role of scintimammography with Tc-99m-sestamibi as a complementary diagnostic technique in the detection of breast cancer

Purpose: To prospectively determine the clinical Value of scintimammography (Sc) with Tc-99m-sestamibi as a complementary method to triple diagnosis ( TD) in detecting malignant disease of the breast. Material and Methods. Ninety-six patients with 119 clinically or mammograph ically detected breast lesions underwent TD procedures, including clinical examination, mammography and fine-needle aspiration cytology. Prone planar Sc with Tc-99m-sestamibi was performed in all 96 patients. Five groups were defined for diagnosis: 1=normal; 2=benign; 3=probably benign; 4=highly sus pect of malignancy; and 5=malignant. All lesions were histopathologically e xamined. The results of each method pet se and the combination of TD with S c (TD+Sc) were analyzed. Results: Histopathology of the 119 surgically excised breast lesions found 83 malignant and 36 benign lesions. TD missed 6 of 83 carcinomas, resulting in a sensitivity of 92.7%. Sc alone showed sensitivity of 85.5%. The combi nation TD+Sc missed 1 of 83 carcinomas, and thus had a sensitivity of 98.7% . In mammographically dense breasts both TD and Sc detected 16 of 18 carcin omas, while the combination TD+Sc led to detection of all 18 carcinomas. Conclusion. Adding Sc to TD increases the sensitivity for detection of brea st carcinomas. Sc with Tc-99m-sestamibi is recommended as a complimentary m ethod to TD in selected cases such as mammographically dense breasts.