title: Use of 99Tcm-MIBI in the assessment of patients with suspected recurrent breast cancer.
abstract: A prospective trial was performed to assess the accuracy of 99Tcm-methoxyisobutyl isonitrile (99Tcm-MIBI) scintimammography and X-ray mammography in 18 patients (mean age 58 years, range 46-79 years) with suspected recurrent breast cancer in the breast and/or loco-regional tissues. All patients had been diagnosed to have breast cancer 1-23 years before scintimammography. Two patients had undergone mastectomy, so that a total of 34 breasts were studied with X-ray mammography and with prone-lateral and anterior scintimammography. Any abnormalities on X-ray mammograms and scintimammograms were noted, as was any additional local or nodal uptake of 99Tcm-MIBI. The nature of any lesion seen with either modality, or in which there was a clinical suspicion of recurrence, was confirmed by cytological or histological examination of tissue samples. There were nine breasts with recurrent cancer in eight patients. X-ray mammography identified six of these cancers. 99Tcm-MIBI scintimammography identified eight of nine recurrent breast cancers (the one cancer not seen was positive on X-ray mammography). In the 26 breasts without cancer, two were reported as having changes consistent with cancer and one was reported equivocal. There were three false-positive and one equivocal scintimammograms. The accuracy of 99Tcm-MIBI scintimammography within the breast (85%) was similar to X-ray mammography (82%). Axillary lymph node recurrence occurred in five patients, four of whom were positive with 99Tcm-MIBI. An additional patient had focal uptake of 99Tcm-MIBI at the site of recurrent cancer on the anterior chest wall. In conclusion, 99Tcm-MIBI scintimammography may provide useful complementary information in patients with suspected recurrence of cancer in the breast or loco-regional tissues.
authors.affiliation: Department of Nuclear Medicine, CMKP Warszawa, Otwock, Poland.
authors.forename: J B
authors.initials: JB
authors.lastname: Cwikla
authors.forename: J R
authors.initials: JR
authors.lastname: Buscombe
authors.forename: S P
authors.initials: SP
authors.lastname: Parbhoo
authors.forename: S M
authors.initials: SM
authors.lastname: Kelleher
authors.forename: D S
authors.initials: DS
authors.lastname: Thakrar
authors.forename: J
authors.initials: J
authors.lastname: Hinton
authors.forename: J
authors.initials: J
authors.lastname: Crow
authors.forename: A
authors.initials: A
authors.lastname: Deery
authors.forename: A J
authors.initials: AJ
authors.lastname: Hilson
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012008:Recurrence
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019275:Radiopharmaceuticals; C074862:technetium Tc 99m CDO-MeB