Flanagan D A, Gladding S B, Lovell F R
Department of General Surgery, Blodgett Memorial Medical Center, Grand Rapids, Michigan, USA.
Am Surg. 1998 Jul;64(7):670-2; discussion 673.
99Tc-sestamibi prone scintimammography (SMM) is a new, noninvasive method of imaging breast tumors. A pilot study has suggested that SMM increases the specificity of mammography, and that SMM could be used as an adjunct to mammography to reduce the number of mammographically indicated biopsies. The goal of this study was to further evaluate the efficacy of SMM in diagnosing or excluding breast carcinoma. This was a prospective case series with each patient serving as her own control. All subjects who had an abnormal mammogram, a palpable breast mass, or both were eligible for inclusion. All patients underwent breast examination, conventional mammography, SMM, and breast biopsy. Of the 81 women originally enrolled, 79 women with 80 lesions completed the study. SMM produced the following results: a sensitivity of 81 per cent, a specificity of 81 per cent, a positive predictive value of 61 per cent, and a negative predictive value of 92 per cent. These values were significantly lower than the pilot study results at a power of 80 per cent and P = 0.05. Our results indicate that SMM does not increase the specificity of conventional mammography and has a low negative predictive value. We would not recommend it as a screening technique to avoid biopsy.
99锝-甲氧基异丁基异腈俯卧位乳腺闪烁造影术（SMM）是一种新型的乳腺肿瘤无创成像方法。一项初步研究表明，SMM可提高乳腺X线摄影的特异性，且可作为乳腺X线摄影的辅助手段以减少乳腺X线摄影提示活检的数量。本研究的目的是进一步评估SMM在诊断或排除乳腺癌方面的疗效。这是一项前瞻性病例系列研究，每位患者均作为自身对照。所有乳腺X线摄影异常、可触及乳腺肿块或两者皆有的受试者均符合纳入标准。所有患者均接受了乳腺检查、传统乳腺X线摄影、SMM及乳腺活检。最初纳入的81名女性中，79名女性的80个病灶完成了研究。SMM得出以下结果：灵敏度为81%，特异性为81%，阳性预测值为61%，阴性预测值为92%。在检验效能为80%且P = 0.05时，这些数值显著低于初步研究结果。我们的结果表明，SMM并未提高传统乳腺X线摄影的特异性，且阴性预测值较低。我们不建议将其作为避免活检的筛查技术。
