Research Article| Volume 172, ISSUE 5, P483-486, November 1996

Scintimammography in the diagnosis of breast cancer

  • Edward J. Clifford
    Requests for reprints should be addressed to Edward J. Clifford, MD, Department of Surgery, St. Paul Medical Center, 5909 Harry Hines Blvd., Dallas, Texas 75235.
    From the Departments of Surgery, St. Paul Medical Center, 5909 Harry Hines Blvd., Dallas, Texas, USA
    Search for articles by this author
  • Carlos Lugo-Zamudio
    FRom the Department of Nuclear Medicine, St. Paul Medical Center, 5909 Harry Hines Blvd., Dallas, Texas, USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.


      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.


      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.


      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.


      We conclude that scintimammography is a highly specific test that deserves study as a modality to further refine the indications for breast surgery.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Parker SL
        • Tong T
        • Bolden S
        • Wingo PA
        Cancer s tatistics CA.
        Cancer J Clin. 1996; 65: 5-27
        • Fever EJ
        • Wn LM
        • Boring CC
        • et al.
        The lifetime risk of devel-oping breast cancer.
        JNCI. 1993; 85: 892-897
        • Ma L
        • Fishell E
        • Wright B
        • et al.
        Case control study of factors associated with failure to detect breast cancer by mammography.
        JNCI. 1993; 84: 781-785
        • Dierks DB
        • Katy B
        Lawsuits for failure diagnose breast cancer: tumor biology in causation and risk management strategies.
        Surg Oncol Clin N Am. 1994; 3: 125-139
        • McKenna R
        The abnormal mammogram, Radiographic findings, diagnostic options, pathology and stage of cancer diagnosis.
        Cancer. 1994; 74: 244-255
        • Balon HR
        • Fink-Bennett DM
        • Stoffer SS
        Technitium-99m uptake by recurrent Hurtle cell carcinoma of the thyroid.
        J Nucl Med. 1992; 33: 1393-1395
        • Tastekin G
        • Turgut M
        • et al.
        Preoperative localization of parathyroid carcinoma using Tc-99m MIBI.
        Clin Nucl Med. 1993; 18: 217-219
        • O'Tuama LA
        • Packard AG
        • Treves SD
        • et al.
        SPECT imaging of pediatric brain tumor with hexakis methoxyisobutyl isonitrile 99m technitium.
        J Nucl Med. 1990; 31: 2040-2041
        • Host H
        • Lund E
        Age as a prognostic factor in breast cancer.
        Cancer. 1986; 57: 2217-2221
        • Miller A
        • Baines CJ
        • To T
        • Wall C
        Breast cancer detection and death rates among women age 40–49 years.
        Can Med Assoc J. 1992; 147: 1459-1476
        • Kopans DB
        Breast cancer detection in an institution: is mammography detrimental?.
        Cancer. 1993; 72: 1457-1460
        • Khalkhali I
        • Cutrone JA
        • Mena IG
        • et al.
        Scintimammography: the complimentary role of Tc-99m Sestamibi prone breast imaging for the diagnosis of breast carcinoma.
        Radiology. 1995; 196: 421-426
        • Kahlkahli I
        • Mena I
        • Jouanne E
        • et al.
        Prone scintimammography in patients with suspicion of carcinoma of the breast.
        J Am Coll Surg. 1994; 178: 491-497
        • Taillefer R
        • Roubidoux A
        • Lambert R
        • et al.
        Technitium 99m sestamibi prone scintimammography to detect primary breast cancer and axillary lymph node involvement.
        J Nucl Med. 1995; 36: 1758-1765
        • Piccolo S
        • Lastoria S
        • Mainolfi C
        • et al.
        Technitium 99m methylene diphosphonate Scintimammography to image primary breast cancer J.
        Nud Med. 1995; 36: 718-724
        • Maurer AH
        • Caroline DF
        • Jadali FJ
        • et al.
        Limitations of craniocaudal thallium 201 and technitium 99m sestamibi mammoscintigraphy.
        J Nucl Med. 1995; 36: 1696-1700
        • Khalkhali I
        • Cutrone J
        • Mena I
        • et al.
        Technitium 99m Sestamibi Scintimammography of breast lesions: clinical and pathological foltowup.
        J Nucl Med. 1995; 36: 1784-1789
        • Muller ST
        • Guth-Tougelids B
        • Creutzig H
        Imaging of malignant tumors with Tc-99m MIBI SPECT.
        Eur J Nucl Med. 1987; 25 (Abstract.): 562
        • Carvalho PA
        • Chiu ML
        • Kronaug JF
        • et al.
        Subcellular distribution and analysis of Tc-99m MIBI in isolated profused rat hearts.
        J Nucl Med. 1992; 33: 1516-1521
        • Maublant JC
        • Zheng Z
        • Rapp M
        • et al.
        In vitro uptake of Tc-99m teboroxime in carcinoma cell lines and normal cell lines:comparison with technitium m sestamibi and T1-201.
        J Nucl Med. 1993; 34: 1949-1952
        • Delmon-Mongeon I
        • Piwnica-Worms D
        • Van Der Abbeelead
        • et al.
        Uptake of the cation hexakis (2-methoxyiso-butylisonitrile) -technitium-99m by human carcinoma cell lines in vitro.
        Cancer Res. 1990; 50: 2198-2202
        • Crane P
        • Onthank D
        • Retos C
        • et al.
        Technitium-99m Sestamibi retention in the c-neu oncomouse: an in-vivo model for breast tumor imaging.
        J Nucl Med. 1994; 35 (Abstract): 21