Optimization of X-ray mammography and technetium-99m methoxyisobutylisonitrile scintimammography in the diagnosis of non-palpable breast lesions

Eur J Nucl Med. 1998 May;25(5):491-6. doi: 10.1007/s002590050248.

Abstract

The purpose of this study was to evaluate the contribution of technetium-99m methoxyisobutylisonitrile (MIBI) scintimammography to the early diagnosis of breast cancer in 78 patients with non-palpable breast lesions detected by mammography. In all cases biopsy was indicated and they were classified into three groups according to the mammographic findings: high (28), intermediate (30) and low (20) mammographic probability of malignancy. Histological diagnosis confirmed 37 benign and 41 malignant lesions. In the high-probability group 99mTc-MIBI scintimammography changed the four false-positives into true negatives at the expense of two false-negatives; in the intermediate group it changed nine of the 17 false-positives into true-negatives at the expense of one false-negative, and in the low-probability group it changed five of the 16 false-positives into true-negatives without false-negatives. Applying scintimammography to patients included in the intermediate and low-probability groups together, 14 of the 33 mammographic false-positives were changed into true-negatives with 1 false-negative; thus, 41% of the unnecessary biopsies would have been avoided. When MIBI scintimammography was applied to the low-probability group, the negative predictive value was 100% and the unnecessary biopsies would have been reduced by 31%.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Breast / pathology
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / epidemiology
  • Female
  • Humans
  • Mammography*
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Radionuclide Imaging
  • Radiopharmaceuticals*
  • Sensitivity and Specificity
  • Technetium Tc 99m Sestamibi*

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi