J Breast Cancer.  2010 Jun;13(2):198-205. 10.4048/jbc.2010.13.2.198.

The Preoperative Role of Breast-specific Gamma Imaging for the Breast Cancer Patients: In Comparison with Conventional Imaging Modality

• Hur SM
• Kim SH
• Lee SK
• Kim WW
• Choi JH
• Kim S
• Lee SJ
• Choi JY
• Choe JH
• Kim JH
• Kim JS
• Nam SJ
• Yang JH
• Lee JE

• KMID: 2286546
• DOI: http://doi.org/10.4048/jbc.2010.13.2.198

Abstract

PURPOSE
We wanted to assess the clinical efficacy of breast-specific gamma imaging (BSGI) as compared with that of conventional imaging modalities (mammography, ultrasonography and magnetic resonance imaging) as a preoperative examination for patients with breast cancer.
METHODS
From April to May 2009, a retrospective review was performed for the prospectively collected 143 patients who were diagnosed with breast cancer. All the patients received a conventional imaging examination and BSGI before definitive surgery. The patients underwent BSGI with intravenous injection of 30 mCi of (99m)Tc-sestamibi through the contralateral antecubital vein. After 10 minutes, the craniocaudal and mediolateral oblique images were obtained. All the imaging findings were correlated with the final pathologic examination.
RESULTS
The mean age of the patients was 49.7+/-9.4 years (range, 27-77). In 143 patients, 166 malignant lesions were identified by pathologic examination (invasive cancer: 96 (67.1%), ductal carcinoma in situ 14 (9.8%) and invasive cancer with carcinoma in situ 33 (23.1%). The conventional imaging modalities found 166 malignant lesions and BSGI found 156 malignant lesions. The rate of correspondence was 94.0% between the conventional imaging modalities and BSGI for malignant lesions. For BSGI, there were 4 false positive findings and 10 false negative findings. BSGI found no occult cancers that were missed by conventional imaging modality. For making the diagnosis of axillary lymph node metastasis, the sensitivity, specificity and accuracy were 33.3%, 92.1%, and 69.9% for BSGI, and 55.6%, 77.5%, and 69.2%, for ultrasonography, respectively.
CONCLUSION
BSGI may have the potentiality to make a correct diagnosis in breast cancer patients. However, in this study, it seems that BSGI is not superior to conventional imaging modalities. BSGI is not a standard method to evaluate breast cancer lesions before surgery.

Keyword

Axillary; Breast neoplasms; Gamma cameras; Lymph nodes; Technetium 99m Sestamibi

MeSH Terms

Breast
Breast Neoplasms
Carcinoma in Situ
Carcinoma, Intraductal, Noninfiltrating
Gamma Cameras
Humans
Injections, Intravenous
Lymph Nodes
Magnetic Resonance Spectroscopy
Neoplasm Metastasis
Prospective Studies
Retrospective Studies
Sensitivity and Specificity
Technetium Tc 99m Sestamibi
Veins
Technetium Tc 99m Sestamibi

Figure

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  Figure 1 Malignant lesion on imaging study. (A) Breast-specific gamma imaging in left craniocaudal and left mediolateral oblique view. (B) Mammography in left craniocaudal and left mediolateral oblique view. (C) Ultrasonography. (D) Magnetic resonance imaging. Pathologic examination demonstrated 1.6 cm-sized invasive ductal carcinoma.

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