Imaging techniques currently used for the diagnosis of breast cancer are reviewed and compared. Besides mammography, magnetic resonance imaging, positron emission tomography, and thallium-201 scintimammography, a new role of technetium-99m sestamibi scintimammography is discussed. It is concluded that while mammography remains the procedure of choice in screening asymptomatic women for breast cancer, other imaging methods play an important role in detecting malignancies in symptomatic patients. 99mTc-sestamibi scintimammography has high sensitivity and improves the specificity of conventional mammography for the detection of breast cancer; with this technique, prone imaging is preferable to supine imaging. 99mTc-sestamibi scintimammography thus deserves further study as a screening technique.

Review of imaging techniques for the diagnosis of breast cancer: a new role of prone scintimammography using technetium-99m sestamibi

The role of 99mTc-sestamibi and other conventional radiopharmaceuticals in breast cancer diagnosis

PURPOSE: To prospectively evaluate a high-resolution breast-specific gamma camera for depicting occult breast cancer in women at high risk for breast cancer but with normal mammographic and physical examination findings. MATERIALS AND METHODS: Institutional Review Board approval and informed consent were obtained. The study was HIPAA compliant. Ninety-four high-risk women (age range, 36–78 years; mean, 55 years) with normal mammographic (Breast Imaging Reporting and Data System [BI-RADS] 1 or 2) and physical examination findings were evaluated with scintimammography. After injection with 25–30 mCi (925–1110 MBq) of technetium 99m sestamibi, patients were imaged with a high-resolution small-field-of-view breast-specific gamma camera in craniocaudal and mediolateral oblique projections. Scintimammograms were prospectively classified according to focal radiotracer uptake as normal (score of 1), with no focal or diffuse uptake; benign (score of 2), with minimal patchy uptake; probably benign (score of 3), wit...

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Occult breast cancer: Scintimammography with high-resolution breast-specific gamma camera in women at high risk for breast cancer

The role of 99mTc methoxyisobutylisonitrile in imaging breast cancer

Clinical applications of 99mTc-sestamibi scintimammography.

Because of reports that negative mammographic findings have resulted in a delay of treatment in patients with breast cancer, the authors reviewed their experience with mammography in 160 patients, admitted to the Sir Mortimer B. Davis-Jewish General Hospital in Montreal over a 28-month period, who had histologically verified carcinoma of the breast. Of these patients 153 had clinically palpable masses and 7 had occult carcinomas. The mammogram was considered to be positive for carcinoma in 112 (73.2%) and negative in 41 (26.8%). In 44 patients under the age of 50 years the mammogram was positive in 26 (59.1%) and negative in 18 (40.9%), a significant difference (P less than 0.05). There was no significant difference between the findings of mammograms read by the hospital radiologists and those read by community radiologists. This study confirms the findings of others that mammography is not a reliable technique for evaluating the clinically suspicious breast lesion and must not be used as a substitute for biopsy of such lesions.

P H Niloff

Papers

False-negative mammograms in patients with breast cancer