Department of Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University, Seoul, Korea.
Breast J. 2012 Sep;18(5):453-8. doi: 10.1111/j.1524-4741.2012.01280.x. Epub 2012 Aug 16.
Despite the fact that mammography has been the golden standard in breast cancer detection for several decades, its sensitivity decreases for women with dense breast tissue, which happens to be common in Korea. As an alternative, breast ultrasonography can be effective diagnostic modalities that complement the defect of mammography. Recently, breast-specific gamma imaging (BSGI) has been introduced as a new diagnostic modality for breast cancer. This study was designed to analyze the effectiveness of BSGI in particular. In a retrospective study, 471 patients underwent BSGI, breast ultrasonography, and mammography simultaneously during the period between February 2009 and March 2010. The indications of BSGI were as follows: (a) patient who was diagnosed with malignancy prior to surgery, (b) patient who is under follow up after cancer surgery, (c) patient with lesions which cannot be evaluated by breast ultrasonography or mammography, (d) patient with multiple benign lesions, and (e) patient with suspicious lesion who refuses biopsy. Among these patients, 121 patients underwent biopsy, whereas others were followed up with imaging studies. We compared the BSGI results with those of mammography, breast ultrasonography, and pathology. The mean age of the patients was 49.63 ± 10.43 years. There were 107 patients with 110 malignant lesions and 364 patients with benign lesions. Total 474 lesions were evaluated. The sensitivities of BSGI, mammography, and breast ultrasonography were 94.45%, 93.64%, and 98.18%, respectively, whereas the specificities of BSGI, mammography, and breast ultrasonography were 90.93%, 90.66%, and 87.09%, respectively. The sensitivity and specificity of BSGI for axillary lymph node (LN) status were 44.7 4% and 87.88%, respectively. BSGI is a good complementary imaging modality with high sensitivity and high specificity for breast cancer detection. However, it has low efficacy for the evaluation for axillary LN status.
尽管乳腺 X 线摄影术在过去几十年一直是乳腺癌检测的金标准，但对于乳腺组织致密的女性，其敏感性会降低，而这种情况在韩国很常见。作为替代方法，乳腺超声检查可以作为一种有效的诊断方法来补充乳腺 X 线摄影术的不足。最近，乳腺特异性伽马成像（BSGI）已被引入作为一种新的乳腺癌诊断方法。本研究旨在专门分析 BSGI 的效果。在一项回顾性研究中，2009 年 2 月至 2010 年 3 月期间，471 例患者同时接受了 BSGI、乳腺超声检查和乳腺 X 线摄影术检查。BSGI 的适应证如下：（a）术前诊断为恶性肿瘤的患者，（b）癌症手术后随访的患者，（c）乳腺超声或乳腺 X 线摄影术无法评估的病变患者，（d）多发性良性病变的患者，（e）拒绝活检的可疑病变患者。在这些患者中，有 121 例患者接受了活检，其余患者接受了影像学检查。我们将 BSGI 结果与乳腺 X 线摄影术、乳腺超声检查和病理学结果进行了比较。患者的平均年龄为 49.63 ± 10.43 岁。有 107 例患者有 110 个恶性病变，364 例患者有良性病变。共评估了 474 个病变。BSGI、乳腺 X 线摄影术和乳腺超声检查的灵敏度分别为 94.45%、93.64%和 98.18%，BSGI、乳腺 X 线摄影术和乳腺超声检查的特异性分别为 90.93%、90.66%和 87.09%。BSGI 对腋窝淋巴结（LN）状态的灵敏度和特异性分别为 44.74%和 87.88%。BSGI 是一种良好的补充成像方式，具有较高的乳腺癌检测灵敏度和特异性。然而，它对腋窝 LN 状态的评估效果不佳。
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