Wilczek B, Aspelin P, Boné B, Pegerfalk A, Frisell J, Danielsson R
Center for Surgical Sciences, Division of Radiology, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.
Acta Radiol. 2003 May;44(3):288-93. doi: 10.1080/j.1600-0455.2003.00054.x.
The aim of this study was to determine the clinical value of scintimammography with 99m-Tc-MIBI (Sc) as a complementary method to the triple diagnostic procedure in the diagnosis of breast lesions.
Ninety-six consecutive patients with 65 palpable and 54 non-palpable breast lesions were included in a prospective study. All lesions were evaluated by clinical examination, mammography and fine-needle-aspiration cytology (FNAC), called triple diagnostic procedure (TD). Prone planar scintimammography with 99m-Tc-MIBI was performed in all patients. Five groups were defined for diagnosis: 1 = normal; 2 = benign; 3 = probably benign; 4 = highly suspect of malignancy; and 5 = malignant. In the calculations, groups 1-3 were considered benign, and 4-5 malignant. All lesions were excised and examined histologically. The additional value of Sc + TD procedure was studied separately for palpable and non-palpable lesions.
Histologically, 83 malignant and 36 benign lesions were found in the 119 breast lesions. Sensitivity for malignancy in palpable lesions of TD alone and of the combination TD + Sc were 95.6% and 100%, respectively. Sensitivity for malignancy in non-palpable lesions of TD and TD + Sc was 89.1% and 97.2%, respectively.
Adding scintimammography to the triple diagnostic procedure increased the sensitivity for the detection of both palpable and non-palpable breast cancers, but decreased the specificity.