BENIGN VERSUS MALIGNANT BREAST DISEASE - COMPARISON OF CONTRAST-ENHANCED MR-IMAGING AND TC-99M TETROFOSMIN SCINTIMAMMOGRAPHY

PURPOSE: To compare technetium-99m tetrofosmin scintimammography with contrast material-enhanced magnetic resonance (MR) imaging in the char acterization of palpable breast masses. MATERIALS AND METHODS: Forty-s even patients (mean age, 51 years) with a Palpable breast mass were pr ospectively examined with scintimammography, MR imaging, and conventio nal mammography 2 weeks before fine-needle aspiration biopsy. RESULTS: In three patients, MR imaging was aborted, Of the remaining 44 patien ts, 21 had biopsy-proved cancer and 23 had benign disease. The sensiti vity of mammography was 81%; specificity, 82%; positive predictive val ue (PPV), 85%; and negative predictive value (NPV), 78%. The sensitivi ty of scintimammography was 95%; specificity, 91%; PPV, 91%; and NPV, 95%. The sensitivity of MR imaging was 90%; specificity, 91%; PPV, 90% ; and NPV, 91%. In 11 patients with previous breast cancer, scintimamm ographic findings were positive in all four with tumor recurrence and negative in all seven with benign disease. Masses were correctly chara cterized with MR imaging in eight of these 11 patients. CONCLUSION: Al though both techniques accurately differentiate benign from malignant palpable breast masses, scintimmagraphy is more accurate in the posttr eatment breast. Because of lower cost, wider availability, and high pa tient acceptance, scintimammography may provide a valuable alternative to MR imaging for noninvasive characterization of palpable breast dis ease.