HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mathieu, I. Articles by Lonneux, M. Search for Related Content PubMed PubMed Citation Articles by Mathieu, I. Articles by Lonneux, M.

Inconclusive Triple Diagnosis in Breast Cancer Imaging: Is There a Place for Scintimammography?

¹ Department of Nuclear Medicine, Clinique Sainte-Elisabeth, Namur, Belgium
² Department of Radiology, Clinique Sainte-Elisabeth, Namur, Belgium
³ Department of Radiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
⁴ Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium

Scintimammography (SM) can be used as a complementary test to mammography in patients with suspected breast cancers. This study was undertaken to evaluate the impact of SM on the management of patients with a doubtful or discordant triple diagnosis—that is, mammography, ultrasound, and fine-needle aspiration cytology. The clinical question was variable: initial diagnosis of cancer, suspicion of recurrence, doubtful tumor extension, or search for a primary tumor.

Methods: We performed a retrospective study of 118 procedures in 104 patients with a suggestion of breast cancer, either at initial presentation or after treatment (relapse), with an inconclusive triple diagnosis. Planar and tomographic imaging was performed after injection of ^99mTc-labeled methoxyisobutylisonitrile (^99mTc-MIBI). Results were compared with histopathologic analysis (surgery or core biopsy) in 82 cases and with clinical and imaging follow-up in 36 cases.

Results: Breast cancer was proven in 69 cases. SM-SPECT had a sensitivity of 88.4% and a specificity of 67%. Eleven cancers were detected by SPECT, although planar images were negative. SM-SPECT was more sensitive in patients scanned at initial presentation (95%) than in those with suspected recurrence (81%). SM-SPECT correctly evaluated multicentricity or bilaterality in 8 of 11 patients and resulted in an increased tumor size in 8 patients. Overall, SM-SPECT modified the patient management in 58 of 118 cases (49%): SM made the diagnosis of cancer in 30 cases with doubtful or discordant triple diagnosis and ruled out malignancy in 28 cases.

Conclusion: SM-SPECT is a useful complementary tool for the diagnosis and evaluation of disease extent in patients with an inconclusive triple diagnosis including fine-needle aspiration. The procedure altered the patient management in 49% of the population. These results must be confirmed in a prospective trial.

Key Words: scintimammography • SPECT • breast cancer • triple diagnosis

Related articles in JNM:

THIS MONTH IN JNM

JNM 2005 46: 8a-9a. [Full Text]  

This article has been cited by other articles:

				V. Papantoniou, N. Ptohis, and S. Tsiouris Diffuse Tracer Uptake in Scintimammography: Not as Nonspecific or Benign as Originally Believed? J. Nucl. Med., March 1, 2006; 47(3): 554 - 555. [Full Text] [PDF]

				O. Schillaci Is There a Clinical Role for Scintimammography in Breast Cancer Diagnosis? J. Nucl. Med., October 1, 2005; 46(10): 1571 - 1573. [Full Text] [PDF]