Optimization of X-ray mammography and technetium-99m methoxyisobutylisonitrile scintimammography in the diagnosis of non-palpable breast lesions.
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%.
Uriarte
I
I
Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Carril
J M
JM
Quirce
R
R
Gutiérrez-Mendiguchía
C
C
Blanco
I
I
Banzo
I
I
Vega
A
A
Hernández
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi