Molecular Breast Imaging (MBI) in patients with newly diagnosed breast cancer. Does it have a role after mammography and Ultrasound?

Objectives The aim of the current study was assess the role of Molecular Breast Imaging (MBI) in patients with newly diagnosed breast cancer following mammography and Ultrasound.

Methods 61 patients newly diagnosed with breast cancer underwent MBI following mammography and US. A dual-headed gamma- camera composed of cadmium zinc telluride (CZT) detectors -Molecular Breast Imaging (MBI) was used for scintigraphic assessment. MRI was also available for correlation in 72% of the study patients. Breast imager and breast surgeons suggested treatment approach considering the findings on combined mammography and US data and again considering also the scintigraphic data.

Results In 25% of the study patients MBI identified true-positive unexpected sites of disease thus disease was more extensive than initially thought, being multicentric in 11% of the study patients. The additional data of MBI indicated a need to change the initial choice of treatment approach in 15% of patients. MRI identified all unexpected sites of disease seen by MBI and four additional once. MBI was false negative in small IDC, a case of DCIS and in two patients with intense background activity immediately after giving birth.

Conclusions MBI is valuable in patients with newly diagnosed cancer, mainly if mammography and US suggest a localized disease, as it reveals unexpected sites of disease thus may result in a change treatment approach. MBI is probably a valuable alternative if patients cannot have MRI either for individual reasons or if the modality is not within reach.

Research Support 99mTc-sestaMIBI tracer for MBI studies was supported by GE Healthcare