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Background
Mammography has a positive predictive value in the detection of breast cancer of 15%
to 25%. Ten percent of patients with breast cancer present with normal mammograms;
however, the false negative rate is increased in younger patients. The purpose of
this study was to evaluate the effectiveness of Tc-99m Sestamibi imaging in the diagnosis
of breast disease.
Methods
Images were collected on 147 women. Patients were evaluated with a combination of
physical examination, sonography, and mammography. Each patient received 20 millicuries
of Tc-99m Sestamibi intravenously. Anterior and lateral images were obtained, the
latter with the patient prone and the breast in the dependent position.
Results
One hundred seven patients showed no enhancement (negative scan). Seven of these patients
were found at biopsy to have carcinoma. Five had ductal carcinoma in-situ (DCIS) with
no associated mass, 1 had an incidental 3 mm focus of invasive ductal carcinoma (IDC),
and 1 had a 5-cm cystic lesion with IDC. Forty-one patients showed focal enhancement
on their scans (positive scan). Thirty-six were found to have either invasive or in-situ
cancer. Four of the 5 patients with benign findings had sclerosing adenosis. The positive
and negative predictive values for scintimammography in this group of patients were
88% and 93%, respectively. The sensitivity and specificity were 84% and 95%, respectively.
Conclusions
We conclude that scintimammography is a highly specific test that deserves study as
a modality to further refine the indications for breast surgery.
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Article info
Footnotes
**Presented at the 48th Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, April 28–May 1, 1996.
Identification
Copyright
© 1996 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc.
