Abstract
Objective
The aim of this study was to evaluate the adjunctive benefits of breast-specific gamma imaging (BSGI) versus magnetic resonance imaging (MRI) in breast cancer patients with dense breasts.
Methods
This study included a total of 66 patients (44.1 ± 8.2 years) with dense breasts (breast density >50%) and already biopsy-confirmed breast cancer. All of the patients underwent BSGI and MRI as part of an adjunct modality before the initial therapy. Of 66 patients, the 97 undetermined breast lesions were newly detected and correlated with the biopsy results.
Results
Twenty-six of the 97 breast lesions proved to be malignant tumors (invasive ductal cancer, n = 16; ductal carcinoma in situ, n = 6; mixed or other malignancies, n = 4); the remaining 71 lesions were diagnosed as benign tumors. The sensitivity and specificity of BSGI were 88.8% (confidence interval (CI), 69.8–97.6%) and 90.1% (CI, 80.7–95.9%), respectively, while the sensitivity and specificity of MRI were 92.3% (CI, 74.9–99.1%) and 39.4% (CI, 28.0–51.7%), respectively (p < 0.0001). MRI detected 43 false-positive breast lesions, 37 (86.0%) of which were correctly diagnosed as benign lesions using BSGI. In 12 malignant lesions <1 cm, the sensitivities of BSGI and MR imaging were 83.3% (CI, 51.6–97.9%) and 91.7% (CI, 61.5–99.8%), respectively.
Conclusion
BSGI showed an equivocal sensitivity and a high specificity compared to MRI in the diagnosis of breast lesions. In addition, BSGI had a good sensitivity in discriminating breast cancers ≤1 cm. The results of this study suggest that BSGI could play a crucial role as an adjunctive imaging modality which can be used to evaluate breast cancer patients with dense breasts.
Similar content being viewed by others
References
Barrett SV. Breast cancer. J R Coll Physicians Edinb. 2010;40:335–9.
Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27, 825 patient evaluations. Radiology. 2002;225:165–75.
Rosenberg RD, Hunt WC, Williamson MR, Gilliland FD, Wiest PW, Kelsey CA, et al. Effects of age, breast density, ethnicity, and estrogen replacement therapy on screening mammographic sensitivity and cancer stage at diagnosis: review of 183, 134 screening mammograms in Albuquerque, New Mexico. Radiology. 1998;209:511–8.
Anastassiades O, Iakovou E, Stavridou N, Gogas J, Karameris A. Multicentricity in breast cancer. A study of 366 cases. Am J Clin Pathol. 1993;99:238–43.
Vaidya JS, Vyas JJ, Chinoy RF, Merchant N, Sharma OP, Mittra I. Multicentricity of breast cancer: whole-organ analysis and clinical implications. Br J Cancer. 1996;74:820–4.
Drew PJ, Turnbull LW, Chatterjee S, Read J, Carleton PJ, Fox JN, et al. Prospective comparison of standard triple assessment and dynamic magnetic resonance imaging of the breast for the evaluation of symptomatic breast lesions. Ann Surg. 1999;230:680–5.
Iagaru A, Masamed R, Keesara S, Conti PS. Breast MRI and 18F FDG PET/CT in the management of breast cancer. Ann Nucl Med. 2007;21:33–8.
Kuhl CK, Mielcareck P, Klaschik S, Leutner C, Wardelmann E, Gieseke J, et al. Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? Radiology. 1999;211:101–10.
Lehman CD, Gatsonis C, Kuhl CK, Hendrick RE, Pisano ED, Hanna L, et al. MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med. 2007;356:1295–303.
Khalkhali I, Mena I, Jouanne E, Diggles L, Venegas R, Block J, et al. Prone scintimammography in patients with suspicion of carcinoma of the breast. J Am Coll Surg. 1994;178:491–7.
Taillefer R. Clinical applications of 99 mTc-sestamibi scintimammography. Semin Nucl Med. 2005;35:100–15.
Babuccu O, Peksoy I, Kargi E, Hoşnuter M, Ozdemir H, Gündoğdu S, et al. The value of scintimammography in reduction mammaplasties: a preliminary study. Aesthetic Plast Surg. 2003;27:296–300.
Khalkhali I, Baum JK, Villanueva-Meyer J, Edell SL, Hanelin LG, Lugo CE, et al. (99 m)Tc sestamibi breast imaging for the examination of patients with dense and fatty breasts: multicenter study. Radiology. 2002;222:149–55.
Lumachi F, Ferretti G, Povolato M, Marzola MC, Zucchetta P, Geatti O, et al. Accuracy of technetium-99 m sestamibi scintimammography and X-ray mammography in premenopausal women with suspected breast cancer. Eur J Nucl Med. 2001;28:1776–80.
Arslan N, Oztürk E, Ilgan S, Urhan M, Karaçalioglu O, Pekcan M, et al. 99Tcm-MIBI scintimammography in the evaluation of breast lesions and axillary involvement: a comparison with mammography and histopathological diagnosis. Nucl Med Commun. 1999;20:317–25.
Palmedo H, Grünwald F, Bender H, Schomburg A, Mallmann P, Krebs D, et al. Scintimammography with technetium-99m methoxyisobutylisonitrile: comparison with mammography and magnetic resonance imaging. Eur J Nucl Med. 1996;23:940–6.
Brem RF, Floerke AC, Rapelyea JA, Teal C, Kelly T, Mathur V. Breast-specific gamma imaging as an adjunct imaging modality for the diagnosis of breast cancer. Radiology. 2008;247:651–7.
Brem RF, Schoonjans JM, Kieper DA, Majewski S, Goodman S, Civelek C. High-resolution scintimammography: a pilot study. J Nucl Med. 2002;43:909–15.
Brem RF, Petrovitch I, Rapelyea JA, Young H, Teal C, Kelly T. Breast-specific gamma imaging with 99mTc-Sestamibi and magnetic resonance imaging in the diagnosis of breast cancer—a comparative study. Breast J. 2007;13:465–9.
Fischer U, Kopka L, Grabbe E. Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology. 1999;213:881–8.
Bilimoria KY, Cambic A, Hansen NM, Bethke KP. Evaluating the impact of preoperative breast magnetic resonance imaging on the surgical management of newly diagnosed breast cancers. Arch Surg. 2007;142:441–5. (discussion 445–7).
Bluemke DA, Gatsonis CA, Chen MH, DeAngelis GA, DeBruhl N, Harms S, et al. Magnetic resonance imaging of the breast prior to biopsy. JAMA. 2004;292:2735–42.
Brem RF, Fishman M, Rapelyea JA. Detection of ductal carcinoma in situ with mammography, breast specific gamma imaging, and magnetic resonance imaging: a comparative study. Acad Radiol. 2007;14:945–50.
Mettler FA Jr, Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology. 2008;248(1):254–63.
Acknowledgments
This research was supported by the Ewha Womans University Research Grant of 2010-1683-1-1.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kim, B.S. Usefulness of breast-specific gamma imaging as an adjunct modality in breast cancer patients with dense breast: a comparative study with MRI. Ann Nucl Med 26, 131–137 (2012). https://doi.org/10.1007/s12149-011-0544-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12149-011-0544-5