SCINTIGRAPHIC IMAGING OF BREAST-CANCER - A REVIEW

Scintimammography is a recently verified technique that will expand th e use of nuclear medicine to a new group of patients in whom scintigra phic imaging has not been widely used. If performed correctly, and in certain groups of patients, it delivers a sensitivity as high as X-ray mammography or magnetic resonance imaging (MRI) in palpable tumours b ut with greater specificity. It is best used in patients in whom X-ray mammography, ultrasound and MRI prove non-diagnostic or unhelpful, pa rticularly those women with dense breasts or who have had previous bre ast surgery. The mechanism of uptake of Tc-99(m)- MIBI in breast tissu e is only partly understood and in itself may help in determining impo rtant aspects of tumour function, such as the response to cytotoxic ch emotherapy. Other scintigraphic methods for imaging breast cancer may be able to look at other aspects of cancer function, for example blood supply, metabolic rate or the in vivo assessment of oestrogen or soma tostatin receptor status. This in turn may be useful in planning treat ment. Metastatic disease may best be monitored with F-18-FDG PET, whic h has a sensitivity greater than MRI but a similar specificity. Much f urtner work will need to be done on the use of nuclear medicine in bre ast cancer, but the addition of unique functional information to the a natomical data from X-ray and MRT should benefit future patients' mana gement.