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Immunohistologic Assessment of Technetium-99m-MIBI Uptake in Benign and Malignant Breast Lesions

Departments of Radiology, Pathology, and Surgery, Harbor-UCLA Medical Center, Torrance, California; Department of Pathology, National Cancer Institute, Bethesda, Maryland; Pathology Consultants Medical Group, Torrance, California

Correspondence: For correspondence or reprints contact: Iraj Khalkhali, MD, Harbor-UCLA Professional Building, 21840 S. Normandie Ave., Suite 506, Torrance, CA 90502.

ABSTRACT

This study was undertaken to assess the relationship between the degree of ^99mTc-MIBI uptake in breast lesions and the following histologic factors: neovascularity, desmoplastic reaction, cellular proliferation and mitochondrial density. Methods: Forty-two patients who previously underwent MIBI breast imaging (4 false-negative, 12 false-positive, 15 true-negative, 11 true-positive) were studied. Immunohistochemical staining was performed for neovascularity (Factor VIII antigen), desmoplasia (alpha-actin antigen), mitochondrial density (mitochondrial antigen) and cellular proliferation (MIB-1 antigen). The degree of microscopic staining was correlated with region of interest measurements of MIBI uptake on scintigraphy. Results: There was a poor correlation between MIBI uptake and the degrees of neovascularity (r = 0.08, p > 0.05) and intracellular mitochondrial density (r = 0.04, p > 0.05)while there was a moderate correlation with cellular proliferation (r = 0.4, p < 0.05) and desmoplasia (r = 0.55, p < 0.001). Conclusion: The degree of MIBI uptake in breast lesions is multifactorial, but it appears to be related more to the degree of desmoplastic activity and cellular proliferation than neovascularity and mitochondrial density.

Key Words: technetium-99m-MIBI • scintimammography • angiogenesis • desmoplasia

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