The role of Tc-99m-sestamibi scintimammography and colour Doppler ultrasonography in the evaluation of breast lesions

In the present study we evaluated comparatively the diagnostic value of mam mography, of Tc-99m-sestamibi scintimammography (sestamibi-SC) and of colou r Doppler ultrasonography (CD-US) in 116 breast lesions. Diagnosis was base d on histopathological examination. Overall, out of 86 malignant tumours, 8 0 (93%) and 75 (87%) had a positive sestamibi-SC and positive C-D-US, respe ctively. Out of 30 benign lesions, 25 (83%) and 26 (87%) had a negative ses tamibi-SC and negative CD-US respectively. The true positive results were s imilar in palpable and in non.-palpable lesions for both methods. Out of 19 nonpalpable malignant tumours, mammography confirmed malignancy in only on e case (5%), which was significantly lower than the results obtained by ses tamibi-SC (89%; P x 0.0001) and by CD-US (74%; P = 0.0001). In palpable mal ignant tumours, by using mammography, true positive results were obtained i n 54/67 (80.5%) patients, which was significantly lower than the results ob tained by sestamibi-SC (94%; P = 0.03) and marginally different to the resu lts obtained by CD-US (91%; P = 0.13). It is concluded that sestamibi-SC an d CD-US are useful tools in clarifying the nature of breast lesions in case s with doubtful mammography. The clinical value of these diagnostic procedu res in guiding subsequent therapeutic interventions requires further invest igation. ((C) 2001 Lippincott Williams & Wilkins).